If your need is to own a fancy car and be able to park it in a handicap spot - like the guy above - then you have your work cut out for you.
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Tuesday 3 May 2011
Had a fantastic resident tonight who gave me the confidence to write out full charts. I can't believe how terrible most doctors are when it comes to teaching and managing subordinates and tonight just drove that point home; the resident was kind honest and superhelpful in ways that should have been as soon ad I arrived and was working. I guess the difference is that great places of excellence are able to recruit individuals who have the ability to inspire confidence and know that's what they're looking for- the bad ones just recruit randoms or easies. So as always the most important factor is to figure out what you need and then setting up a framework where everything you do points to that.
If your need is to own a fancy car and be able to park it in a handicap spot - like the guy above - then you have your work cut out for you.
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If your need is to own a fancy car and be able to park it in a handicap spot - like the guy above - then you have your work cut out for you.
- Posted using BlogPress from my iPhone
Sunday 1 May 2011
I am a big fan of doing whatever you can where you are and taking full advantage of social engineering to further your goals ESPECIALLY educational. It comes from a petty officer I worked with in the navy, PO Gardner who always was asking "what else can we do?" and always had an answer. I definitely was inspired by that method of thinking and it's always served me well.
This last day of mine I was able to schedule a ride along with paramedics. This is a wicked opportunity to learn just how the sickest and the most hurt are found on the scene and how they're initially treated and taken to the hospital by the EMS staff. The crazy thing is though that this is run out of the fire department! So I'm at a fire station!
- and a kinda fancy one at that. After two hours on the public transit system (by the way foothill transit is now most comfortable public transit system in the world from what I've seen) I made it to the fancy part of a city way east of LA.
Posted using BlogPress from my iPhone
This last day of mine I was able to schedule a ride along with paramedics. This is a wicked opportunity to learn just how the sickest and the most hurt are found on the scene and how they're initially treated and taken to the hospital by the EMS staff. The crazy thing is though that this is run out of the fire department! So I'm at a fire station!
- and a kinda fancy one at that. After two hours on the public transit system (by the way foothill transit is now most comfortable public transit system in the world from what I've seen) I made it to the fancy part of a city way east of LA.
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Sunday 17 April 2011
I'm going to miss these walks in the dark through east LA. It's interesting how time is a factor usually forgotten when it comes to judgement- at first two shadowy figures are walking towards you and ou feel apprehension but then they walk by and it's not a problem. Same people and two different reactions that you have against them.
So why when it comes to how people act towards us we judge someone and then label and treat them accordingly? Shouldn't there be some reevaluation that takes place?
The resident that I was working under I felt was very hard to read the entire time I worked with her. I wasn't really sure if I was doing a terrible job or a great or even ok one- there were times when I felt like I wasn't making her standard so I would pull back from making written documentation and she would tell me "no it was great;" similarly I can come up with plenty of situations in the opposite direction.
When all was said and done and my time with her had finished she said that I had been one of the most improved ever - she had thought that I would be such drag and she would have to make up for my failures -which she did at first- but by he end of it all she was quite prepared to trust me in taking full control of a patient.
Usually you learn the most from the ones who you find most annoying - they're most different. If you judge them as awful then that just places you further away from being able to learn from them.
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So why when it comes to how people act towards us we judge someone and then label and treat them accordingly? Shouldn't there be some reevaluation that takes place?
The resident that I was working under I felt was very hard to read the entire time I worked with her. I wasn't really sure if I was doing a terrible job or a great or even ok one- there were times when I felt like I wasn't making her standard so I would pull back from making written documentation and she would tell me "no it was great;" similarly I can come up with plenty of situations in the opposite direction.
When all was said and done and my time with her had finished she said that I had been one of the most improved ever - she had thought that I would be such drag and she would have to make up for my failures -which she did at first- but by he end of it all she was quite prepared to trust me in taking full control of a patient.
Usually you learn the most from the ones who you find most annoying - they're most different. If you judge them as awful then that just places you further away from being able to learn from them.
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Saturday 16 April 2011
Burn the bridge of your choosing.
Well things have been fairly peaceful- the patients I've seen are really complex usually but atraumatic. This is good for the patients and the workers here sine there's less stress for all parties but it sucks for me since that means that I'm spending most of my time with people that really should be with either their family physician or are heavily in internal medicine - and the way the system is setup in Mexico we haven't actually done rounds in internal medicine so we are at an incredible disadvantage when it comes to that.
However
That does mean that I can take the time to catch up so to speak. I also have a resident who is particularly anal about charting too which means once again I feel like an idiot since I'm so behind in the knowledge factor and she gets fairly annoyed at my ineptitude early on- but that's what it takes: you will always burn your first bridge, be it for the step, for any test or any skill. The trick is that if you know you're going to burn your first anything, to make sure that that is the first purpose.
When you start to learn how to play guitar you don't pick up a thousand dollar model. Your first car shouldn't be a mazzeratti (sp? I know nothing about cars, natch!). And your first rotation in a specialty or your first shift of any job will be incredibly inefficient while you learn where everything is at.
including the "drink ice chips" box.
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However
That does mean that I can take the time to catch up so to speak. I also have a resident who is particularly anal about charting too which means once again I feel like an idiot since I'm so behind in the knowledge factor and she gets fairly annoyed at my ineptitude early on- but that's what it takes: you will always burn your first bridge, be it for the step, for any test or any skill. The trick is that if you know you're going to burn your first anything, to make sure that that is the first purpose.
When you start to learn how to play guitar you don't pick up a thousand dollar model. Your first car shouldn't be a mazzeratti (sp? I know nothing about cars, natch!). And your first rotation in a specialty or your first shift of any job will be incredibly inefficient while you learn where everything is at.
including the "drink ice chips" box.
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Friday 15 April 2011
Saturday 2 April 2011
A chat transcript with my friend Lisa explaining how I met Ellen Page!
23:08 lisa.smyth: you met ellen page?!
me: awesome
plastic surgeons are smart but jerky
oh YEAH!
I should'vce asked her to hang out
but I got tongue tied!
lisa.smyth: LOL
i would have too
she's awesome
me: oh and
tiny!!
she's like 5'1
23:09 lisa.smyth: yeah...
me: but so cool
lisa.smyth: she has such presense though
me: we talked for a bit
oh the things she asked me weere
1)what's your name
2)where are you from
3) what are you doing in La | | 16 minutes |
we totally like locked eyes three times but it wasn't like a checking out thing it was a "man I need to get out of here" look
lisa.smyth: ha!
23:33 me: I wasn't 100% sure it was her
until I saw the security guy say "hey I see you"
and then the workers were checking her out and stuff
she was just shuttling through the aisles
lisa.smyth: was anyone with her?
me: so then Im getting some other random things
oh no
dude she was totally incognito and cool
lisa.smyth: dude!
me: just jeans and a plaid top
23:34 lisa.smyth: nice
me: no hat no shades
lisa.smyth: casual
me: backpack
totally
man I should've asked to hang out with her
so as I'm leaving thinking wow that was amazing
I line up to pay
lisa.smyth: what were the exact words exchanged?
me: and she lines up sorta beside me
oh nothing yet
23:35 lisa.smyth: oh ok... i'm getting ahead of myself!
me: keep in mind too I'm carrying my labcoat around
lisa.smyth: ha!
me: so I'm thinking this is once in a lifetime - I gotta go talk to her
23:36 the cashier is not that bright - she's screwing up codes and not really sure where anything is
Ellen's just very serious and wanting to leave a bit it looks like, but keeping it cool
so she's checking out and I walk up and I say "Ellen Page?"
and she turns and stares at me
23:37 lisa.smyth: amazing
me: and I say with a big smile "Hi I'm Canadian and lived in Halifax for a while! Just wanted you to know that we're really proud of you"
and she's "Thanks!"
23:38 lisa.smyth: perfect
me: "You're a super inspiration and ever since you did Juno you know we had our fingers crossed (for the oscars but I'm totally lost in the moment and I think this made no sense) and I think it's crazy that I got to see you here in LA!
23:39 at this point the cashier says something like "did you drink this already? What do I do with this?"
it's an empty bottle or something
she says "yeah just charge it"
and returns to the conversation where she says
"What's your name?"
"Richard"
"Great to meet you Richard"
23:40 "Thanks great to meet you too!"
"Did you say you're from Halifax?"
and I totally was not in my right mind and said YES
lisa.smyth: oops!
me: so then she puts down what she had in her hands
blocks herself squarely to me
and shakes my hand
23:41 "What are you doing in LA?"
"I'm a doctor (gesturing to my labcoat folded onto my arm) and I'm rotating at cedars sinai"
see here I assumed she's from La
but I think she was just in for the weekend
she says "oh cool"
23:42 AND THIS IS WHERE I SHOULD HAVE OFFERED SOMETHING ELSE UP
but I get the feeling she wants to go so I'm like
"well excellent to meet you"
lisa.smyth: well... she might have thought you were hitting on her if you asked her to hang out...
me: and she says "okay later dude!"
23:43 oops!
23:44 but then I just kinda turn around and just smile for the rest of the day
lisa.smyth: ha!
great story!
she's cool
i would have loved to meet her
i think you covered up your star-struck-ness well too
23:45 me: well then I find her page on fb and get a twitter account
lisa.smyth: you played it cool escobedo!
nice work
me: oh dude that's the most uncool in like two decades!
lisa.smyth: whatever
it's probably not as bad as you think
me: yeah it was awesome
I just really wish I was able to chat with her some more
23:46 lisa.smyth: you were probably suave
;)
me: I get the feeling that she feels like she's missing out on reality and needs some friends
oh dude I haven't had a proper haircut in like a month
it's a mess
lisa.smyth: LOL
me: and I was breaking out a bit too from being an intern
lisa.smyth: LOL
me: so I was not at my top form
23:47 but a smile always gets across your intentions
lisa.smyth: exactly
me: hey in other news
well unless you want to chat more
it was crazy
she got some greens and this crazy iced tea concoction
it was like veggies and tea
weird
lisa.smyth: ya
weird
Friday 1 April 2011
Moving on
So things have been going crazy but amaZing. I was at children's hospital for a week and learned a lo from the resident there called Ali ( though he looked more like a Max). We had some amaZing cases with mostly flaps but sadly I got to see zero cleft lips/pallets. One thing I did like from this rotation was that the weekly meetings were held with everyone watching a screen where pictures would go up of each o the individual cases so far I've had to do minimal rounding as the residents feel bad or feel like it's not my responsibility so instead of waking up at 4 and showing up at 530 I get to sleep in till 530 and show up before 7.
Oh LA transit!
That week ended not so good in the OR as the attending got upset that I couldn't read his mind in where he wanted me to help him- suction, fanning, cutting etc. I left dejected.
This week I'm at cedars Sinai. .
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Thursday 24 March 2011
The change catches you
Sometimes you lose everything in the smallest changes. I've had my iPod for about half a year now And it's been a constant problem. It was from amazon at a deal of $100 off but I think the previous owner dropped it which caused me grief in repairing it in Mexico.
But now here in LA, land of the pod, after explaining the situation, they switched it up with a brand new one. I lost the two updates to the blog in the process though!
Anyways we also had a patient with something I wished to never see: Treacher Collins. These kids are essentially born without proper facial bones and they look like they should be mentally retarded. They're not. They're perfectly aware that they look hideous to a typical person-which is tragic. This is all caused by one small mutation on one gene. This one small change caused this child to need to have all his facial bones repaired by us, including cheek implants, teeth pulling and fixing his ear cartilage implants.
And now my small change of taking the 71 instead of the 70 bus tool me to Pershing square instead of union station. I'll have to run two blocks to recatch the red line
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But now here in LA, land of the pod, after explaining the situation, they switched it up with a brand new one. I lost the two updates to the blog in the process though!
Anyways we also had a patient with something I wished to never see: Treacher Collins. These kids are essentially born without proper facial bones and they look like they should be mentally retarded. They're not. They're perfectly aware that they look hideous to a typical person-which is tragic. This is all caused by one small mutation on one gene. This one small change caused this child to need to have all his facial bones repaired by us, including cheek implants, teeth pulling and fixing his ear cartilage implants.
And now my small change of taking the 71 instead of the 70 bus tool me to Pershing square instead of union station. I'll have to run two blocks to recatch the red line
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Tuesday 8 March 2011
Ouch
We had this sweet old lady who came in because she was using an electric saw and went right through the base of her skull. She wasn't in pain and was so embarrassed.
- Posted using BlogPress from my iPhone
- Posted using BlogPress from my iPhone
Sunday 6 March 2011
Burn Ward
The burn ward came and went. The whole week was so fast and incredible that it felt like longer; you know that kind of time where so much is jam-packed that the morning seems as if it were the entire day yesterday (until you think about it).
I have to say the most amazing part of it seems to be how elite the doctors there were: they do everything. There's all the spectra of care all in one section of the hospital all for burns. In increasing intensity, they have a clinic, an inpatient ward, an ICU and an operating room all staffed by the same team of doctors who take care of it all. I get the feeling that this is way higher than most specialties but I've yet to be able to compare it to anything so for now I'll say that it was impressive to see doctors who were putting IV lines like any nurse, a few minutes later were harvesting skin and implanting it like the most advanced burn clinics in the world.
It was an honour to see people who were excellent do their thing.
Even if the head was a bit. . . .strident. He's well-known to be heavy-worded but fair. He definitely knows what needs to be done but is also fairly condescending when dealing with newer people: he will call you out (and talk you down) when you do something without him asking you to but he will also call you slow if you're not doing anything at all or take no initiative.
I took what I could from the experience and that was A LOT. I learned so much from physiology of burns to care and treatment to management. He really was a pro (as was the whole team) in spite of his attitude.
I was able to see some pretty insane cases too - one involved a girl of 2-something years who had her boyfriend not like something she did - so he set a blanket on fire (by putting gas or something on it? Unclear exactly how) and threw it on her. She was severely burned to 47% of her body (50%+ means you are not likely to survive) and lost all her fingers. She couldn't blink because her eyelids had scarred to the point where they were contracted and barely moveable. She had no lips. It was tragic and I was glad to be able to help her, even in a minimal capacity.
The learning goes on. Would I like to work in a burn ward? Probably. We'll have to see. The funny thing is, I did more surgery in one week at a burn ward than a whole month at that hospital I have a lot of spite for that I did my rotation in.
I have to say the most amazing part of it seems to be how elite the doctors there were: they do everything. There's all the spectra of care all in one section of the hospital all for burns. In increasing intensity, they have a clinic, an inpatient ward, an ICU and an operating room all staffed by the same team of doctors who take care of it all. I get the feeling that this is way higher than most specialties but I've yet to be able to compare it to anything so for now I'll say that it was impressive to see doctors who were putting IV lines like any nurse, a few minutes later were harvesting skin and implanting it like the most advanced burn clinics in the world.
It was an honour to see people who were excellent do their thing.
Even if the head was a bit. . . .strident. He's well-known to be heavy-worded but fair. He definitely knows what needs to be done but is also fairly condescending when dealing with newer people: he will call you out (and talk you down) when you do something without him asking you to but he will also call you slow if you're not doing anything at all or take no initiative.
I took what I could from the experience and that was A LOT. I learned so much from physiology of burns to care and treatment to management. He really was a pro (as was the whole team) in spite of his attitude.
I was able to see some pretty insane cases too - one involved a girl of 2-something years who had her boyfriend not like something she did - so he set a blanket on fire (by putting gas or something on it? Unclear exactly how) and threw it on her. She was severely burned to 47% of her body (50%+ means you are not likely to survive) and lost all her fingers. She couldn't blink because her eyelids had scarred to the point where they were contracted and barely moveable. She had no lips. It was tragic and I was glad to be able to help her, even in a minimal capacity.
The learning goes on. Would I like to work in a burn ward? Probably. We'll have to see. The funny thing is, I did more surgery in one week at a burn ward than a whole month at that hospital I have a lot of spite for that I did my rotation in.
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