Radiology @ Duke

I started Radiology at Duke this am. It was great - the only way it could've been a better first day is if I hadn't gotten sick over the weekend. The people here are really nice, and were really excited to have a visiting student (I'm the only visitor here - as opposed to at UNC, where at least half the students in the ED last month were visitors), which is kind of odd....I haven't seen any other visiting students wandering around either....hmm....Anyways, it was a good first day, and I already feel more competent reading x-rays.

I am on the Neuro service this week. They have such a big department here they don't divide it up like most normal hospitals, into CT, ultrasound, MRI, etc. They have Neuro, Chest, Abdomen, GI, etc.. So I will be learning about all things Neuro this week.

We spent almost all of today looking at chest x-rays which are about the hardest thing in radiology to learn how to do. One awesome thing about this rotation is that we get 3 hours of lectures each day, which is great, considering that as students, there really isn't any conceivable way we can contribute to patient care yet. So we might as well spend it getting great lectures (which they were). My favorite part was the lunchtime "hot seat" x-ray conference, where they said right up front that there would be NO calling on students. You can see why I enjoyed it so much! The cafeteria has decent coffee here (as opposed to UNC), and the hospital kind of looks like a castle - how much better can it get?

I had a bad day (...cue Daniel Powter song....)

So I had kind of a rotten day in the ER today. I guess it's only fair to have one bad day to balance all the great days so far. It was the kind of day that really makes me want to do Internal Medicine....

I worked with the worst, most negative, unprofessional group of nurses I think I've ever met. One of them actually got mad that she (apparently) wasn't finding an open computer, so she wrote a note in crayon that said "Nrsg Only" and stuck in on the computer. Later on I needed to use it, and she promptly had a fit, started swearing to the nurse next to her about me (I'm serious), and then made a 15-minute personal phone call...So I guess she must've been really busy...I just sort of laughed and kept on working, which may or may not have been the right way to go about it. [Side note: this was discussed by the students at our lectures this am, and we've resolved to put a note on said computer stating "Med Stdnts Only" with the "S" backwards...]

Oh well, over and done with! So I was already kind of annoyed about that, and then as I went to see the next patient after that, two nurses each interrupted me twice while I was trying to talk to a patient (this is a relative no-no, especially if the questions are totally unimportant, as these were)...and I'm not meaning that they were interrupting the conversation to talk to me - I mean that they came and physically stood between me and the patient, interrupted me mid-sentence, and were asking the patient totally unimportant questions that should've waited till I was done...Such is the life of a med student....and intern....and resident, I guess!

Safe & Sound in NC (and busy!)

So I made it to Durham, NC. I'm actually starting out with three weeks at UNC-Chapel Hill, and then after that I do a month of radiology and a month of CCU at Duke. So it's going to be a lot of driving for the first three weeks, but not too bad after that, as I live just a few miles from Duke's Medical Center.

I'm basically working every day for the next three weeks (I might get 1-2 off, but not sure yet), as I have to fit in 13 8-hour shifts as well as lectures and conference twice a week, and one shift with Orange County EMS, which I'm really excited about. In the meantime, I'm running back and forth between Raleigh (Wake Medical Center, which is where I'm doing most of my shifts for the first two weeks) and Chapel Hill, which is where our lectures/conferences are.

I've already met some other really nice medical students from around the country. We went out and had Mexican food as soon as orientation was over, as some of us are going into southwestern food-withdrawal. They are going to be a fun group to work with.

Monday was orientation (boring) and then last night I had my first shift at Wake Med. It was awesome - there we just work with one attending, and mine was totally excited to have a med student with her, and she constantly was asking me questions and teaching me different things. It was a great night. We got several traumas in, so I was happy, and I got to see a bunch of medical patients on my own. One of the traumas was a nice open tib-fib fracture (where you break both the bones in your lower leg, and open means that the bone fragments have gone through the skin), so that was neat to see. I found a similar x-ray on Google, so for you non-medical people, here is what a tib-fib fracture looks like:

These are pretty bad and definitely need surgery - you can't fix this with a cast. And it's especially an emergency because when the fracture happens, the bone fragments can cut the blood and nerves supplying that area, so it can actually end up being even a worse injury than it looks. Anyways, that is my teaching for the day, and I hope the x-ray wasn't too graphic for those with weak stomachs.