Tuesdays

This picture really has nothing to do with medicine (or Tuesdays for that matter), but it's one of the first pictures that pops up on Google Images when you search the word, "Tuesdays." I thought it was cute, so there we go. Anywho, before I start weighing in on last week's ethical dilemma, I want to get back to some of my bread and butter. Two things that I've been behind on are 1) profiling my fellow medical school classmates, and 2) going through a typical week to talk about our program's design. I'll start with the latter today, but since my post about Dan "The Man" White, I haven't done any in depth investigative reporting on my Asheville compatriots. We'll get there.

Onto Tuesdays. These are my "lite" days. Every other week I work the afternoon in Cardiology, but I'm scheduled to have the whole morning off each week. This works well for continuity clinics and spending half-days in other offices. I've had the opportunity to sit in the Radiology reading room looking at pretty (and not so pretty...) pictures, as well as drilling holes in people's femurs in the OR. Here is a brief list of a few of the specialties I've seen:

• Cardiology - Every other week I try my hand at "Cards." From 1pm to 3pm, we rotate through different aspects of cardiology, then hop on over to an hour and a half of "heart" lectures. I have spent a few hours with the Echo techs (they take souped-up images of a person's heart using ultrasound), a day working with the EKG techs in the Emergency Department obtaining bedside heart graphs (looking for MIs, arrhythmias, etc.), and working in the clinic taking care of outpatients. This latter experience is my favorite, because I get to hear a whole bunch of different "murmurs." These are extra heart sounds in the cardiac cycle that I can hear whilst listening to someone's chest through my stethoscope. Usually, one should only hear the classic "lub-dub, lub-dub, lub-dub." But sometimes I can hear "KEN-tuck-eee, KEN-tuck-eee, KEN-tuck-eee" or "lub-WOOOOSH-dub, lub-WOOOOSH-dub." Weird, huh? Now you wonder what your heart sounds like...
• Radiology - Pretty pictures. This is always a very satisfying half-day. What's awesome is that I get to see each image, come up with my own impression of said image, and then immediately have the answer presented by the attending. This is what I see when I look at this abdomen; see this [insert pathology here]? You can't miss that! I get to see appendicitis after appendicitis, chest x-ray after chest x-ray. It's the repetition, as I try to build a catalog of images in my brain for future reference. Picture, impression, answer. Picture, impression, answer. The radiologist immediately dictates his or her report on vocal recognition software, so I can hear exactly how the picture should be interpreted. Like I said, very satisfying.
• Orthopaedic Trauma Surgery - Another very satisfying field, because in this one I get to put screws in people's bones. Literally. I had the opportunity to take electric drills and screw in plates of steel (or some kind of metal) into broken femurs and elbows and ribs and clavicles. It is very meticulous for a specialty notorious for its brute strength. Everything is so precise: there has to be a certain amount of strain this way, and a little bit of stress that-a-way to make sure the patient's leg isn't turned 90 degrees when the patient wakes up the next morning. I also like Ortho because, instead of just wearing the shoes' coverings, I wear the moon-space boots that cover my scrubs all the way up to my knees. It makes me look uber-cool when I waltz into the cafeteria...
• ENT - "Ears, Nose, and Throat." It's an awesome field with a great mix of outpatient and surgery, pediatrics and geriatrics. Ultimately though, I just don't like the ears all that much. Too much wax...
• Neurosurgery - A very interesting specialty that I am definitely going to have to spend more time in. One of the docs I worked with does "deep brain stimulation," which means he actually inserts an electrical device into someone's brain and then it sends out all these stimuli. I've mostly seen it used in patients with Parkinson Disease, but I think there are a lot of indications for it. I've only seen a couple chronic neck pain cases, so I'm definitely going to have to go back for some brain drilling. Ultimately, I think I enjoy the abdomen much more, but it's worth a second look.
• Continuity - same old, same old. Taking two patients from the ER straight to the OR was the latest and greatest I've done.

I also have half-days in Pediatric Endocrinology and rural General Surgery to look forward to (I hope!) in the near future. So next we'll tackle the ethics issue presented last week, and then hopefully some class profiles to follow.