Tue, 07 Mar 2006 01:16:10 GMT

Interesting few days. Saw Ruthven, who's not doing as well as he would like, but is something of a miracle nonetheless, and put him on albuterol which ought to help. There was a particularly tiresome drunk in the casualty department today who insisted not only that he was not drunk but that he was, in fact, Ludwig of Bavaria; a statement which was met with much hilarity from the rest of the meth-addicted kiddywinks waiting for the spiders to go away. He proceeded to enlarge on his theme before being cataclysmically sick all over two perfectly innocent physicians' assistants, which wasn't at all fair on them.

I'm still stupidly happy. It's been days, and I've not heard from him, but I'm not yet getting that oh-god-I-scared-him-off thing just yet. Martinson is being a dick, as per usual, and he's apparently decided out of his infinite wisdom that all on-call physicians attend a class on Patient Sensitivity, which apparently means not telling an idiot he's an idiot. Martinson himself could use some Patient Sensitivity training: I saw him frighten a poor young girl who had come to the wrong department for her first gyn appointment ever--she actually burst into tears. He's a bastard.

I suppose you have to be, to run a department. Still, I wouldn't mind having at him with the Thorazine some of these nights.

Ah, well. Back to work.

In the call room, halfway through the shift.

Sun, 05 Mar 2006 16:04:17 GMT

I shouldn't be doing this, but then again most of the people who use this computer in the small hours do it to download crappy porn or NEJM articles dealing with pica or some damn thing, so I don't feel so horribly guilty as I should.

I'm still glowing. I put on makeup today before my shift, and came in in a decent Oleg Cassini suit I bought for ten quid down the charity shop; and Martinson even said to me that while it's perfectly respectable under the coat I ought to be thinking less about the impression my clothes make on patients and more about how I can help them. I looked at him and I smiled, and after a while he buggered off to yell at nurses for using the straight needle for venipuncture rather than the butterfly Vacutainer setup.

Had a couple interesting cases today: thank god, nothing that said Gladius Sancti to me, but a kid who was pretty obviously getting more arsenic (or thallium, the tox results aren't back yet, but I'm betting arsenic) than he really ought, and had been in and out of casualty departments with acute gastritis for what counts for most of a year. His mother was your classic MSBP mother, rattled off the list of symptoms and diagnoses like a damn textbook, and required that she be with her kid for the entire hospital stay. Needless to say, I said no fucking way and had the kid screened for every damn household poison one can imagine, plus a total blood workup and history based on the other London hospitals he'd been admitted to. Looks like it's sewn up. He's okay now, as far as he can be until the chelation kicks in, but we've got hidden cameras in his room now so if Mommy Dearest tries anything it'll be cut and dried.

I fucking hate the living sometimes.

Other interesting case was the young man who came in with exacerbated ARDS consequent to a case of untreated bacterial pneumonia: I talked to him briefly in the ER before he got transferred up to IC, and he told me the sort of story one doesn't expect to hear these days. Came down to London to seek his fortune, worked as a barista to get himself into University College London, and lived in a garret with no heating, the whole Raskolnikov bit. He said he thought it'd go away if he could just keep warm, and when he fainted in class the professor told him to go to the local clinic which he couldn't pay for, and so he ended up incubating this damn pneumonia for a week and a half before it got bad enough that he decided to come and actually seek help. He'll be all right, I think. If he's lucky. Lung volume may be decreased.

I am so damn sick of typing up notes for the rotating residents. I do it because I can type the things faster than they can and on a long call night it gives me something to do: but really, when I was a resident, nobody ever offered to do it for me.

...damn, Sarasvat's paging me, something big just came in. No rest for the undeserving, I'm telling you. I'm still so damn happy it hurts.

Greta

In the call room, halfway through the shift.