Sunday, January 9, 2011


I know I'm a little behind; I also know that this is a little dramatized, but I'm down with the idea of this video

Happy New Year!

Sunday, November 28, 2010

Follow Your Nose, Lucky Charms

I remember reading an essay from "Surely, you must be joking Mr. Feynman," where good Richard himself describes a scientific publication on the superior olfactory sense of bloodhounds. Led by simple human hubris, he decides to test the olfactory powers of homo sapien, himself. At the time, his wife was in hospital (Is that the way the Brits use it? I hope so cause I really like it) with something serious. On his next visit to hospital, he described to her the publication and his belief that the human nose, when put to the test would outperform expectation. To test his theory, he asked his wife to choose one of the books from a stack of five or ten on the window sill while he was outside of the room. He would return and smell out which of the books she handled. And so it went that he was able to pick the right book. I don't know how many times. I can't even remember if I got all the details right, I'm just going on recall having read the essay one time five years ago. It stuck with me though because I've often noticed how powerful scents can be.

The other morning I was dramatically reminded of this as I walked onto the hospital floor. My resident enthusiastically greeted me, "Hey Jeff! Check out Mrs. W real quick. I think the nurse still has the bed pan. Let me know what you think!" The sun was no where near rising, the majority of the lights on the floor still hadn't come on. Roasters were still in deep slumber, and here I was catching an eye opener of Mrs. W's diarrhea. I dutifully inspected the soupy content for any signs of mal absorption, blood, or infectious process thinking the whole time, "Is this really what I want to do with my life? Seriously, who does this?"

Days have passed; Some days I don't have an answer to that question. And then there are moments, like the few I've experienced over the past couple of days that remind me that it is the uniqueness of our job that makes it so precious.

Ms S traveled to us, transferred by ambulance from a small hospital two hrs away. 39 yrs old, two kids at home, and her parents trailing the ambulance in the slow traffic that always ensues with the year's first snowfall. She left the outside hospital in a stable condition. When she got to us, she had all of the signs of sepsis--an infection that can quickly take the unsuspecting patient to the morgue. Two days later, I stepped into her room, examining a totally different patient. Her skin tone was back, her eyes had cleared, her breathing returned. It was apparent without a stethoscope or any exam that she was out of the storm. My team followed into the room and the parents kept pointing out what a miracle had been worked; going on praising us for the work we did and kindly reminding us that it was God and not the white coat behind it all.

In these instances, you know it is nothing that you did. Of course you did what evidence-based medicine dictates so you never feel like it was something, "you" did; but that still doesn't take away from how awesome you feel in those unique moments. You don't feel pride, you just feel luck. You feel the luck of the situation, that the medicine worked, that this patient is back, smiling along with everyone else in the room, and the luck you have to be a part of it all.

Tuesday, October 19, 2010

Where is the writer?

"Is that thing moving anymore? It's been like months"
"No... I keep checking; no sign of life. It's been long, too long"
Give it a poke; Get a stick, maybe we could turn it over."
"Sick, what if there is nothing but maggots on the other side?"
"No point in turning it over. It's been so long, that's the only possible thing we could find"
"Oh sick, absolutely! I think I smell them. Do you smell them? Sick, it's on my clothes. Smell my shirt! Let's get out of here!"
"Wait, wait! I need to see, just a peak at what is really on the inside."

How long can one go without writing before it is assumed you are all washed up? This picture I snapped the other day raises the question.

Lying on a Rochester beach post Labor Day = poor prognosis

Sunday, August 15, 2010

"When there is nothing left to burn..."

Surgery clerkship, complete.

I finished the last three weeks on the burn unit. My take home message for us all: Don't throw gasoline on anything!!

I can't believe I made it through Boyscouts, through adolescents, without a serious burn. It turns out that lots of people do get burned when gasoline is mixed with an open flame. Another common combination is chicken and grease. The one I was excited about most was the cigarette and gasoline, just like, Zoolander. The case I was the least excited about was the two year old who tripped into the campfire.

Oh, and the stuntman for all of the Jason, Friday the 13th movies came to the hospital and handed out autographed photos to all of our patients. He is a burn victim himself who spends his spare time making others' lives better. Pretty cool! He actually was burned in a demo tape he made. It was over a year before he was back to his stunts, but though the only door opened by his demo tape was to the hospital, he went on to have an amazing career. He's done many other famous films working as a stunt double for most of the big names in Hollywood.

Keep on grillin, but please, be careful.

On to Geriatrics...

Sunday, July 25, 2010

Adventures in General Surgery

Favorite quotes from my first three weeks of the surgery clerkship

Attending Physician: "What is this?" Pointing to a structure in the heaps of bowel resting partly in the attending's hand, partly in the patients abdomen, and partly on top of the patient's abdomen.
Me: "Is that the appendix?"
AP: (Spoken in strong southern drawl) "Jeffrey, this is not Jeopardy, this is the OR. There is no need to state your answer in the form of a question. What is this?"
Me: "The appendix!" Affirmatively
AP: "That is right!"

Second episode
AP: "What is this?"
Me: "Transversalis fascia"
AP: "Give him a zero!"
Me: "oh, sorry, that is the aponeurosis of the external oblique muscle."
AP: "Correct. Don't apologize to me. You can call your mother and apologize to her. She might appreciate that."

Third episode
AP: (to the scrub nurse) "Scissors to him." "Cut this"
Me: (cut)
AP: "That was too short"
Me: "OK"
30 seconds later
AP: "Cut this"
Me: (cut)
AP: "Too long"
Me: "OK"
60 seconds later
AP: "Cut this"
Me: cut
AP: "Too short"

There are two lengths that a medical student can cut the sutures in a Rochester OR...too short or too long. At least this takes the pressure off of cutting the sutures at the right length.