There are a few stories that are worth sharing.
This patient hears voices but the voices are not violent at all. So the doc try to provoke him by provoking his voices to see how much control the voices have. Doc said, "I'm f**king your mother. She is a prostitute. I'm f**king her." His voices didn't respond to the provocation, only said that the spirits from above will judge on the last day of earth. This was repeated multiple times. This was just not the usual provocation and much more shocking.
Here's another one, this patient first came into the ward very paranoid and doesn't want any students around, but our doc basically said that if she wants to stay, the students are in. At first we didn't know why he did that, but she did eventually talk to us and tell us what's going on with her. The next day, the other male students came and want to talk to her but she refused because she thought they were cops. Once we explained that they weren't, she was more than happy to talk. We got to know her very well and really do wish her well. So on her last day, as her leaving the ward present, we got our doc a cop hat right before we see her. Then we brought her into the office, she just stopped at the door and her jaw just dropped and refused to step into the office. It took her a full 5 seconds to realize that there are no cops, just our doc with a cops hat. Ha Ha. We all had a good laugh.
Being a doc is really what you make of it, fully dependent on relationship with the patient. As our preceptor says it, the best therapy is the physician-patient relationship.
Wednesday, October 29, 2008
Saturday, October 25, 2008
Psychiatric ending
Psych ward out here is mostly for chronically ill patients like schizophrenia, depression or bipolar. The patients here are interesting. I kinda forgot that in the city, "crazy" people like to hit on single gals. In undergrad, I always get hit on by guys on the bus, either crazies or foreigners. So it's been a while for me. It's kind of funny now. For the past 4 weeks, I've had about 5 male patients flirting with me and 2 marriage proposals. What a crazy world since to them, this is all reality but I know that it's only reality in their minds, delusion or hallucinations. Part of me find that it's really frustrating dealing with them day in or day out because it's not something I could understand. But it's actually good for them since they can re-focused by coming into the psych ward and not doing something harmful outside on the streets.
The patients here really know how to play the system. The key phrase they use most often is "I'm thinking about killing myself." That will get them an automatic committed admission to the ward where they don't have to pay for rent (Medicare pays), get 3 meals a day, a bed and people to talk to. But the thing is most of them really do have a pysch problem. It's just that our system is not perfect and can be totally be taken advantage of.
Another thing that they do is the they come in around the 25th of the month when they ran out of money from social security check then they will stay until the 3rd of the next month when they get the next check. This is particularly true for the druggies.
Even though they play the system, our preceptor plays with them too. His reasoning was that it's better for them to be in the ward and trying to get help then get in trouble out on the streets. That does make sense and it seems to be working. To each their own.
The patients here really know how to play the system. The key phrase they use most often is "I'm thinking about killing myself." That will get them an automatic committed admission to the ward where they don't have to pay for rent (Medicare pays), get 3 meals a day, a bed and people to talk to. But the thing is most of them really do have a pysch problem. It's just that our system is not perfect and can be totally be taken advantage of.
Another thing that they do is the they come in around the 25th of the month when they ran out of money from social security check then they will stay until the 3rd of the next month when they get the next check. This is particularly true for the druggies.
Even though they play the system, our preceptor plays with them too. His reasoning was that it's better for them to be in the ward and trying to get help then get in trouble out on the streets. That does make sense and it seems to be working. To each their own.
Monday, October 06, 2008
Psychiatric start
Finished peds rotation almost 2 weeks ago. The NBME shelf exam, end of rotation exam, wasn't too bad. It was mostly case scenarios and trying to figure out what the diagnosis for each case was. I got the score back and I passed. I didn't really study much, just read the Blueprints and Pretest. Well there goes my first end of rotation exam. One down, 7 more to go.
Now I'm on psychiatric ward. It's an inpatient unit with mostly schizophrenics and depressed patients. So far it's been interesting. Even though some of them has the same diagnosis, they all behave very differently. The best or the funniest part is our preceptor (our doc in charge). He's in his 70s and is from Cuban so his accent is still quite heavy. He likes to lecture us on philosophy and it would be on a tangent topic of what we have asked. Also he talk to us about treatments that slightly far fetched and antiquated. Between him and my psych professor in med school, I feel like most of the psychiatrists are very eccentric and borderline being diagnosed with a psychiatric disorder.
So far the schedule has been morning group session where they talk about their goals for the day and meeting anyone that's new. Then either exercise session or we read then lunch time for us. After lunch, we see the patients with either Dr Gomez, our preceptor, or with Dr. Lizardo, the doc for the involuntary committed patients. It's been a relatively light rotation with lots of time for reading, chatting or taking breaks. I got to know a few students from UNE, Firas, Ryan and Eric. They are funny and very informative. This is the first time since I've been here where I feel like I'm actually meeting people and being able to talk to them.
We'll see how the rest of rotation pan out.
Now I'm on psychiatric ward. It's an inpatient unit with mostly schizophrenics and depressed patients. So far it's been interesting. Even though some of them has the same diagnosis, they all behave very differently. The best or the funniest part is our preceptor (our doc in charge). He's in his 70s and is from Cuban so his accent is still quite heavy. He likes to lecture us on philosophy and it would be on a tangent topic of what we have asked. Also he talk to us about treatments that slightly far fetched and antiquated. Between him and my psych professor in med school, I feel like most of the psychiatrists are very eccentric and borderline being diagnosed with a psychiatric disorder.
So far the schedule has been morning group session where they talk about their goals for the day and meeting anyone that's new. Then either exercise session or we read then lunch time for us. After lunch, we see the patients with either Dr Gomez, our preceptor, or with Dr. Lizardo, the doc for the involuntary committed patients. It's been a relatively light rotation with lots of time for reading, chatting or taking breaks. I got to know a few students from UNE, Firas, Ryan and Eric. They are funny and very informative. This is the first time since I've been here where I feel like I'm actually meeting people and being able to talk to them.
We'll see how the rest of rotation pan out.
Sunday, September 21, 2008
Kids and parents
It's been a couple weeks into my peds rotation. I'm able to do more in terms of physical exams, but I still don't feel like I'm training to be a good physician. I don't know if it is because I'm not learning much or that I have not much of a way to communicate with the patients since they pretty speak Spanish only. By now, I can understand them most of the time but I can't speak so that pretty much limit my ability to do any one on one.
The one thing that I feel like I've learn the most is listening to the lungs. I am getting to where I can actually what rhonchi, rales, crackles and wheezing sound like. A lot of these kids come in having asthma exacerbations and getting sick from the new school year. We even had one come in having croup.
One reason why peds is not for me is that the parents are not my thing. The kids are actually ok but the parents just not my thing. The most common thing is having an obese kid come in and the parents ask what they can do to help their kid to lose the weight. But when you really tell them what to do, they say that they are doing all that but I'm thinking "Wow! you did all that and the kid still gain 10-15lbs since the last visit." Carzy parents.
The one thing that I feel like I've learn the most is listening to the lungs. I am getting to where I can actually what rhonchi, rales, crackles and wheezing sound like. A lot of these kids come in having asthma exacerbations and getting sick from the new school year. We even had one come in having croup.
One reason why peds is not for me is that the parents are not my thing. The kids are actually ok but the parents just not my thing. The most common thing is having an obese kid come in and the parents ask what they can do to help their kid to lose the weight. But when you really tell them what to do, they say that they are doing all that but I'm thinking "Wow! you did all that and the kid still gain 10-15lbs since the last visit." Carzy parents.
Tuesday, September 02, 2008
First Day
I just started my Peds rotation today. I am assigned to a private clinic setting with 2 docs. Today was a lot of kids coming to get their school physicals signed. It was a lot of the same things but there are variations. I saw some of the cutest kids.
The one thing that strikes me was that I'm at lost half the time. It wasn't because of being the first day, it was the fact I have to listen hard just to understand the patients. Majority of the patients speak Spanish. It's been so long since I have really listened and tried to understand Spanish. I was surprised at the words that I was able to pick just today. I'm guessing by the end of this month, I'll at least be able to understand Spanish like I was in high school. Haha. Who would've guessed.
Anyways, I'll just have to see where this goes.
The one thing that strikes me was that I'm at lost half the time. It wasn't because of being the first day, it was the fact I have to listen hard just to understand the patients. Majority of the patients speak Spanish. It's been so long since I have really listened and tried to understand Spanish. I was surprised at the words that I was able to pick just today. I'm guessing by the end of this month, I'll at least be able to understand Spanish like I was in high school. Haha. Who would've guessed.
Anyways, I'll just have to see where this goes.
Sunday, August 24, 2008
Death
Death seem to be everywhere, especially recently. People that I know of from home church, my friends' friends' relatives, relatives of people that I just met at the new church. Has it always been that many or has I just become aware it more as I get older and going through med school?
I don't remember death as something as prominent when I was younger. My grandmother's death in '93 and my grandfather's death in '96 didn't make me to be more aware of it. Yes, my grandmother's death eventually led to church and to Christ. My grandfather's death was the first one where I was actually present for. But neither one brought me the awareness that I have now.
I really do wonder whether it's age or is it my career choice in medicine? I'm sure for others it's the age thing but for me, I think both played heavily in my life. I have to deal with death and the possibility of death with patients in my daily life as a physician and I have to figure out early on about what my perception of death is.
One thing I am very glad is the love, hope, grace, mercy and trust that I have in Christ. I have the comfort in knowing that I will be taken cared of whether it be on earth or after death. Death is not really the end of all because I have hope in Christ. It's just a time for a long nap before joining God in His kingdom where I can praise Him and everything is so perfect that earth pales in comparison. Wonders will never end.
I don't remember death as something as prominent when I was younger. My grandmother's death in '93 and my grandfather's death in '96 didn't make me to be more aware of it. Yes, my grandmother's death eventually led to church and to Christ. My grandfather's death was the first one where I was actually present for. But neither one brought me the awareness that I have now.
I really do wonder whether it's age or is it my career choice in medicine? I'm sure for others it's the age thing but for me, I think both played heavily in my life. I have to deal with death and the possibility of death with patients in my daily life as a physician and I have to figure out early on about what my perception of death is.
One thing I am very glad is the love, hope, grace, mercy and trust that I have in Christ. I have the comfort in knowing that I will be taken cared of whether it be on earth or after death. Death is not really the end of all because I have hope in Christ. It's just a time for a long nap before joining God in His kingdom where I can praise Him and everything is so perfect that earth pales in comparison. Wonders will never end.
Friday, August 22, 2008
Week of Little Things
Oh Boy! This week was not busy but just lots of things to take care of. The first grocery of the apartment and the little things that my apartment needed, ie nite lites, flashlight, butcher knife. I spent too much time looking for a decent and cheap pitcher for making iced tea. That shouldn't be hard but it was. It seems like people here don't use it or they buy ones that are overpriced.
Then I have to take care of car insurance, registration and losing my CA driver's License. Really didn't want to do that but if I want my car to be legal here in Jersey, I gotta lose it. ::sigh:: Totally not happy about it. So I went to transfer my insurance from MO to NJ within State Farm. I find out I have to pay arms and legs for insurance, tripling what I was paying in MO. Totally not cool. So I spent a couple of hours shopping for insurance and now I'm with Geico. They only double what I was paying in MO and I get Roadside Assistance. How awesome is that. It's the one thing that has gone my way. :)
Then I went to get a library card. The library around my place still uses the catalog index cards system and not computerized. So I have to wait another 30 days before I could check books out from another local library. Ugh.
Then I find out I can't order checks from WaMu because I have changed my address and I have wait for 30 days. And on top of that, the branches here can't do any maintenance stuff because the CA system is different than the Jersey ones. They are suppose to be a nationwide banks. I'm ready to pull my hair out.
Nothing is going my way and the errands are taking too long to get done. So I'm catching up on the TV show, The Closer as a comfort. On a side note, I found those caffeine mints that I've bought in Walmart in Kirksville. I found them in CVS. Yippee.
Then I have to take care of car insurance, registration and losing my CA driver's License. Really didn't want to do that but if I want my car to be legal here in Jersey, I gotta lose it. ::sigh:: Totally not happy about it. So I went to transfer my insurance from MO to NJ within State Farm. I find out I have to pay arms and legs for insurance, tripling what I was paying in MO. Totally not cool. So I spent a couple of hours shopping for insurance and now I'm with Geico. They only double what I was paying in MO and I get Roadside Assistance. How awesome is that. It's the one thing that has gone my way. :)
Then I went to get a library card. The library around my place still uses the catalog index cards system and not computerized. So I have to wait another 30 days before I could check books out from another local library. Ugh.
Then I find out I can't order checks from WaMu because I have changed my address and I have wait for 30 days. And on top of that, the branches here can't do any maintenance stuff because the CA system is different than the Jersey ones. They are suppose to be a nationwide banks. I'm ready to pull my hair out.
Nothing is going my way and the errands are taking too long to get done. So I'm catching up on the TV show, The Closer as a comfort. On a side note, I found those caffeine mints that I've bought in Walmart in Kirksville. I found them in CVS. Yippee.
Wednesday, August 20, 2008
Week in Weston, Florida
Back from a week in Florida during a hurricane season with a girlfriend. The week was muggy, warm / hot and wet. It literally rain for a couple of hours 3 days out of the 7 days we were there. The place we stayed, Mizner Place in Vacation Village. The place was gorgeous. We mostly sat around the pool and got sun and read random fiction. very chilled. We gone a yummy Italian restaurant not once but twice. The first time we got their appetizer caprese and it was yummy. The second time we got dessert instead, Italian canoli and Tiramisu. oh boy were they yummy beyond description.
We also went to one of the sports cafe and the bad for you fried seafood. Tried conch fritters which I'm sure I've had before but it was in Chinese soup that my mom made. We also tried one of the one of the more upscale restaurant for their yummy fresh fish. I had the seared halibut. It was done to perfection. We went to one very popular Asian buffet. It was only $11 and they've got sushi and hot foods and green tea ice cream. We have definitely had our share of unbelievable yummy food.
We spent half a day in the famous Everglades. We took the tour of the Everglades via an airboat, like the ones on CSI Miami. Saw bunch of crazy native birds ie vultures. Saw 2 alligators in the swamp. Then we got the alligator show and took pictures of me holding a baby alligator (Liana).
The Airboat Ride in the Everglades
The Gator in the Swamp; Vultures waiting for meat
The Gator Show
Me and Baby Liana; Lovely sign :)
Last nite out
More pics of the resort to come.
We also went to one of the sports cafe and the bad for you fried seafood. Tried conch fritters which I'm sure I've had before but it was in Chinese soup that my mom made. We also tried one of the one of the more upscale restaurant for their yummy fresh fish. I had the seared halibut. It was done to perfection. We went to one very popular Asian buffet. It was only $11 and they've got sushi and hot foods and green tea ice cream. We have definitely had our share of unbelievable yummy food.
We spent half a day in the famous Everglades. We took the tour of the Everglades via an airboat, like the ones on CSI Miami. Saw bunch of crazy native birds ie vultures. Saw 2 alligators in the swamp. Then we got the alligator show and took pictures of me holding a baby alligator (Liana).
The Airboat Ride in the Everglades
The Gator in the Swamp; Vultures waiting for meat
The Gator Show
Me and Baby Liana; Lovely sign :)
Last nite out
More pics of the resort to come.
Saturday, August 09, 2008
First week in New Jersey
The drive to Jersey from Missouri took forever. With all the breaks, it took me 15 hrs or so to get to Harrisburg then another 2.5 hrs to my apartment. It just felt like forever. I don't think I would ever want to do it again. It was cramp driving and not much leg room. Ugh.
Then we sort of unpack a bit then me and my parents took a tour of East Coast for 5 days. It is my second time but their first. It was still fun but my favorite this time is Niagara Falls and the Bostonian atmosphere. Perhaps I might spend some time in my fourth year there. Who knows.
The Brooklyn Bridge
Fake or Real? Wax Museum, NYC
Capitol Hill, White House, Washington D.C.
Hershey's Chocolate World
Niagara Falls
Bostonian Lobster (yummy)
Boston Harbor Boat Ride
Will be going to Florida to enjoy the sun next week. Be a fun boring bum.
Then we sort of unpack a bit then me and my parents took a tour of East Coast for 5 days. It is my second time but their first. It was still fun but my favorite this time is Niagara Falls and the Bostonian atmosphere. Perhaps I might spend some time in my fourth year there. Who knows.
The Brooklyn Bridge
Fake or Real? Wax Museum, NYC
Capitol Hill, White House, Washington D.C.
Hershey's Chocolate World
Niagara Falls
Bostonian Lobster (yummy)
Boston Harbor Boat Ride
Will be going to Florida to enjoy the sun next week. Be a fun boring bum.
Tuesday, July 29, 2008
Packing and Mum & Dad ::sigh::
How I hate packing all my things into bags and boxes. It's so annoying and tiring. Ugh!! Now I just wish my mum is here to sort out all my things and my dad is here putting things into bags and boxes nicely. It was impressive what they did for me when I first needed to pack for med school. Parents are just amazing. Thank God for my parents.
I'm moving my things tomorrow and driving Thurs. I will be very sporadic with internet, but I will check in once I get internet.
I'm moving my things tomorrow and driving Thurs. I will be very sporadic with internet, but I will check in once I get internet.
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