Things I've Learned...

I guess the best-laid plans end up in about the same place as all those good intentions... Anyway, I'm done with my first clinical rotation (surgery / anesthesia) and a week into my second (infectious disease up at the VA). Some things I've learned from my patients and colleagues during that time (edited to ensure HIPAA compliance):

-It's a terrific idea to play with a loaded firearm. Because it's not like the .357 hollowpoint will blow a sizeable hole in your leg that will require the EMS paramedic and I to take turns holding pressure on the wound for nearly an hour in the trauma bay. You're just lucky that the bullet and all the shards missed the femoral artery.

-It's been said before, but it bears repeating. There is one action that will inevitably land you in serious trouble. So whatever you do, avoid minding your own business. Whether you're standing on a corner or you're hanging out in some park, a bunch of dudes will seek you out and beat you and your buddy to a pulp. When you are telling me your story, I will be hard-pressed not to laugh out loud because, according to you, you were SOCMOB (if you don't recognize the acronym, go to the "Things I Learn from My Patients" link on my blog and read a few entries) when this all went down. The sad part? You're probably telling me the truth.

-If you're an kindly, mild-mannered older gentleman with diabetes and you whack your head on some sharp edge, by all means ignore the laceration and the egg-sized lump on your head and try to tough it out. No reason to trouble the doctors and nurses with something so minor, right? A week later, you'll end up coming in because the wound isn't healing and is purulent and you have a substantial hematoma besides. Bonus: you'll end up with sepsis and round out an evening by coding and being brought to the ICU (first of my patients to code on me...sure he won't be the last).

-As an FYI: if you're going to call an ID consult for a patient to make sure you know what course of meds he/she needs to go home on, you might want to do that BEFORE discontinuing the patient's antibiotics. And if by some chance they do get cancelled / lapse, it's probably not a good idea to wait for a week(!) before checking with ID to see if the meds should have been stopped.

There are more (both ironic and genuinely useful), but that's all I have time for tonight. Till next time, peace and God bless!