May Term Day 9
Rounds, the lung lady was sent home today, and one of the other elderly ladies was doing much better, chest tubes pulled on one guy, re-intubation of another one that was unresponsive mostly yesterday - he's now even more unresponsive and possibly had some fluid in his lungs, so he was sent down for several x-rays, went to the office for a bit and listened to Kevin dictate release letters and he told me about med school rotations and what sort of things (pediatrics, general care, more surgery, maybe an ER rotation) to do. I got to hear one of the candidates for the open position talk to Dr K and made note of what kind of things they asked him (what environment he liked etc) and what he asked them (about the surrounding area, procedure things) - it seems that they trust your credentials if you've been through med school, but they're more interested in evaluating how happy the person will be and if they'll mesh with the rest of the staff when they're trying to hire a person. I got to see Kevin talking to a patient post op for 45 mins or so - it was pretty neat that since he's a PA he can spend that much time with patients explaining various physiological reasons for symptoms the guy might be having, answering questions, etc. Kevin told me it's not an efficient use of a doctor's time to do that (they're needed in surgery), so that's what physician assistants are for. Then I went with Bink to lunch and then to see some movies taken of an occluded artery case they'll be operating on tomorrow.. I can pick out the occlusions on films now by myself (it's kind of like looking for pinched in sections). I went back upstairs to see the guy with Bink and then she went back to the CCU and she let me use her stethoscope to listen to her breathing and then she taught me how to take blood pressure (find pulse in the inside elbow, put stethoscope there, wrap cuff around the arm tightly, close the valve and inflate it until the mercury in the meter gets to 200, then slowly release the pressure and note the number the mercury hits (as it is falling) when you first hear a heartbeat, and the number the mercury hits when you stop hearing a heartbeat. These are the two numbers, i.e. 120/60. Tomorrow a corroded artery (on the side of the neck) and one bypass are scheduled for sure, but there may be a third one - the patient isn't sure if she wants to get surgery yet or not.