Random flight of ideas
I just had such a great afternoon on service-- great attending experiences, great patients, and getting out on time-- that I really wanted to write about it somewhere so that I can remind myself that occasionally there are days that make this whole experience worth the $1000/week and ritual humiliation that it entails.
My attending from last week, Attending #1, a Scottish transplant to Ohio and personal favorite, called me on my cell to invite me to clinic with him this afternoon. I got permission to spend the away from my primary team and went to his office. No patients showed up for the first hour, during which time he allowed me to analyze his Myers-Briggs, probe about his life before coming to USA, and chat about international medicine. I found out he owns a kilt and have started requesting that he wear it to work this month (I will be so happy if he does!). He dislikes Marmite, has a historical family style plaid, and owns a cannon (?). Since nobody showed, I decided to go back to the consult service and see if there was anything going on. My current attending, Attending #2, was schooling the team about neurosyphilis, a topic of discussion prompted by an 86 year old woman with mental status changes and a history suggestive of... well... neurosyphilis. Hilarity ensued as he talked about sexual practices of octogenarians... followed by practices of his other patients... followed by an unusually knowledgeable descriptions of bath houses and swingers clubs in Columbus. Since I met him my gaydar was going off here and there, during this conversation it was blaring. He has given us topics to research every night to present to the team the following day. My topics have included abx-resistant strep pneumo, diarrheagenic e. coli... that sort of thing. Tonight my topic is 'public health concerns in local sexual establishments' or some such.
I went back to clinic with attending #1 where I saw a patient who was hallucinating that parasites were crawling in her scalp, in her ears, and in her eyes. The bugs in the right ear were ~1mm and white, in the left were ~1mm and black, and the ones in her eyes were the size of a contact lens... but were invisible unless you splashed them with blue mouthwash or salt water. She said "I've been poisoning them" and brings up some poison she bought at a local pet store that she applies to her body daily, then says "I understand that I've been poisoning myself, too". They have apparently been buzzing in her ears and biting her-- no apparent rash. She brought examples of the bugs, which were only skin flakes and sock fuzz. She told me she felt them crawling on her back... nothing's on her back. She feels them on her feet, nothing's on her feet. She hallucinated one on her leg, pointed at it, and says "see there, isn't it beautiful?". This case is up there with the woman who told me she had gangs of frogs battling with ray guns in her living room and that I was one of them.
The sad part here is that the husband is unwilling to accept that she is completely delusional. He stormed out of the office just like he did with 6 other physicians before this one.
Man I miss psych. Schizophrenia never fails to amaze me.
My attending from last week, Attending #1, a Scottish transplant to Ohio and personal favorite, called me on my cell to invite me to clinic with him this afternoon. I got permission to spend the away from my primary team and went to his office. No patients showed up for the first hour, during which time he allowed me to analyze his Myers-Briggs, probe about his life before coming to USA, and chat about international medicine. I found out he owns a kilt and have started requesting that he wear it to work this month (I will be so happy if he does!). He dislikes Marmite, has a historical family style plaid, and owns a cannon (?). Since nobody showed, I decided to go back to the consult service and see if there was anything going on. My current attending, Attending #2, was schooling the team about neurosyphilis, a topic of discussion prompted by an 86 year old woman with mental status changes and a history suggestive of... well... neurosyphilis. Hilarity ensued as he talked about sexual practices of octogenarians... followed by practices of his other patients... followed by an unusually knowledgeable descriptions of bath houses and swingers clubs in Columbus. Since I met him my gaydar was going off here and there, during this conversation it was blaring. He has given us topics to research every night to present to the team the following day. My topics have included abx-resistant strep pneumo, diarrheagenic e. coli... that sort of thing. Tonight my topic is 'public health concerns in local sexual establishments' or some such.
I went back to clinic with attending #1 where I saw a patient who was hallucinating that parasites were crawling in her scalp, in her ears, and in her eyes. The bugs in the right ear were ~1mm and white, in the left were ~1mm and black, and the ones in her eyes were the size of a contact lens... but were invisible unless you splashed them with blue mouthwash or salt water. She said "I've been poisoning them" and brings up some poison she bought at a local pet store that she applies to her body daily, then says "I understand that I've been poisoning myself, too". They have apparently been buzzing in her ears and biting her-- no apparent rash. She brought examples of the bugs, which were only skin flakes and sock fuzz. She told me she felt them crawling on her back... nothing's on her back. She feels them on her feet, nothing's on her feet. She hallucinated one on her leg, pointed at it, and says "see there, isn't it beautiful?". This case is up there with the woman who told me she had gangs of frogs battling with ray guns in her living room and that I was one of them.
The sad part here is that the husband is unwilling to accept that she is completely delusional. He stormed out of the office just like he did with 6 other physicians before this one.
Man I miss psych. Schizophrenia never fails to amaze me.