Pediatrics v. Neurosurgery

May 24, 2006 at 11:51 pm | Posted in neurosurgery | 2 Comments

I like pediatrics. I’m a little surprised at that. I’m chilly and reserved, and kids seem like little aliens to me. And I’ve been very ambivalent about clinic in other fields, and that’s a major part of pediatric practice. So I figured I was one of those people from whom kids would run screaming. But it hasn’t been like that at all.

Most parents take far better care of their children than they do of themselves. They don’t minimize their kids symptoms, and they provide excellent descriptions of whatever’s going on. They can be counted on to follow your instructions if at all possible, and you rarely need to consider issues of secondary gain.

The only thing that makes me cringe is watching the interactions between some parents and their children. For all that parents want the best for their children, children are often the hostages of their parents’ dysfunction, whatever that is. So there have been times when I’ve felt sorry for the kids, knowing that he or she was starting out with a handicap in the form of poor parenting, and wondering what I could possibly do that might truly help the child.

It irritates me that there’s no test you have to pass, and no license you need to obtain in order to have children. Any dysfunctional trainwreck of a person can have a child, and in fact those are the very people who tend to have lots of them. It’s truly a wonder that civilization continues on an upward spiral, given the inverse proportion of intelligence and well-adjustment on the part of the parents to the number of children they have. In general–I know plenty of people about whom this is not true, but any sample of people I know is going to be very skewed in relation to the general population. The average person has perhaps finished high school, and maybe a year or two of college at most.

But I digress.

In the other corner is neurosurgery, which has absolutely nothing to recommend it other than that I just love it, for reasons I can’t adequately explain. I can make up reasons that sound good, but at its base it’s not a fully rational thing. It makes me happy to be in the OR and doing something the success of which doesn’t depend on my social skills. I have them, but I find it exhausting to have to use them all the time.

As an aside, my secret is to get other people to talk so I don’t have to. So I could function well in an entirely cognitive specialty. But the issue here is me being happy, not me picking the field where I can be a star. And my question is whether the global level of happiness is higher in pediatrics or in neurosurgery. I don’t know right now, so I’m continuing to prepare myself to go into the more competitive field.

But my mind balks at the thought of a seven year residency, and so I wonder if I could be happy as a pediatrician.

Failure to self-police

May 23, 2006 at 5:25 pm | Posted in professional ethics | 5 Comments

So today I heard reports that a classmate of mine was posing as a 2nd year surgery resident at one of those temporary post-Katrina medical treatment centers last fall. Apparently he didn’t actually do anything that 3rd year med students can’t do without supervision, but still. That’s a serious violation of professional conduct, if not outright illegal, and it probably should have been reported to the dean’s office. But I wasn’t a witness to it, so I can’t exactly report it myself. Apparently one of the faculty members was, and yet still nothing happened. So my classmate who did observe it, even though he feels strongly that his fellow student should be punished in some way, believes that he has no right to report it if the physician faculty member didn’t do so. Still, I wish someone would, because that kind of thing is an early warning of the kind of professional behavior that leads to licensure sanctions and reflects poorly on all of us.

I like the guy, despite the fact that he would constantly talk during lectures 2nd year, which was very disruptive for all the people around him. He’s extremely smart, and always has some snarky comment to make about whatever’s going on, so he’s pretty entertaining to be around. Although I’ve never actually seen him do it, I’m pretty certain he could talk his way out of just about anything. He’s one of those bellwether students, in that the opinion of others’ about him says more about that other person than it does about him. Whether a particular faculty member likes him, loves him, or is skeptical about him generally correlates well with my prior opinion of the perceptiveness of that faculty member.

But he’s fun to have around in more informal settings, and I’m not close enough to him for any potentially less-than-ethical behavior to put me in a difficult position. I’m not afraid to do my professional duty when necessary, but the fact is, I haven’t personally been witness to anything reportable. So there you have it.

May 20, 2006 at 10:52 pm | Posted in Uncategorized | Leave a comment

C. Ray wins.

I’m not entirely sure that there was a best candidate anyway. I don’t pretend to be an expert in Louisiana politics, but it seemed like there wasn’t really any disagreement over what needs to be done in New Orleans. It also doesn’t seem like the mayor has any real power to make it happen, anyway.

This whole election reminded me of some lines from Macbeth:

It’s “… but a walking shadow, a poor player
That struts and frets his hour upon the stage
And then is heard no more: it is a tale
Told by an idiot, full of sound and fury,
Signifying nothing.”

His victory speech was actually pretty good, though, from a literary standpoint. Still lacking a mental editor, but I suppose you can’t be a politician in Louisiana without some sort of colorful character flaw. I guess we’ll just have to see what happens.

So, on to the really important news of the day: Reily pool is opening 3 days ahead of schedule. Woohoo! The Loyola pool sucks. Plus the locker rooms there are under construction, and I don’t have a permanent locker. All of which just amplifies the suckage.

Aside from this, there’s absolutely nothing interesting going on in my life. The other day one of the attendings started talking about the guy, all the while watching my face to see how I react. But there’s nothing to tell. Not only has there not been any exchange of academic for personal favors, but I told him in no uncertain terms that I would forgo any academic assistance if it presented a conflict of interest with a personal relationship. However, there’s no personal relationship to present such a conflict, so I’m a little tired of people trying to game me into revealing that there is. All it does is pour salt in the wound. Give it a rest, people.

My next career: standardized patient

May 20, 2006 at 12:25 am | Posted in Uncategorized | 1 Comment

Shit. I have a murmur.

Possibly I’ve had this murmur for a while and just haven’t heard it. I am a student, after all. Plus it’s somewhere between Grade I and II–definitely an extra blowing noise between S1 and S2, but not easily heard, and definitely not the loudest sound in the chest. But up till now I’ve really only been able to hear Grade II – III murmurs.

However, I changed the earpieces on my stethoscope to the hard plastic ones, and difference was like night and day. You know, they tell us the hard earpieces are better, but everyone uses the soft ones anyway, thinking that they hurt less. But the small hard plastic ones don’t actually hurt at all. So I’m sold.

Anyway, with my newly discovered auscultation skillz, I have determined that my cat, when relaxed, has no murmur. Which is partly why I heard my own so clearly. I listened to my own heart after listening to my cat’s very crisp heart sounds, and was shocked to find a loud but indistinct S1. So I listened more closely, and sure enough, I heard a classic systolic crescendo-decrescendo murmur, and then a crisp S2. Goes away with Valsalva, and has a nearly simultaneous carotid pulse. No S4, thankfully.

Still, it’s freaky.

Anyway, I’m sure it’s not significant. Especially since I don’t have any symptoms.

The only way to win is not to play

May 17, 2006 at 10:39 pm | Posted in clerkships | 5 Comments

I feel like an idiot on this rotation. Granted, it’s only week 3, but still. I’m reading a ton, and it doesn’t seem to be sticking. Of course, it doesn’t help that the group of people I’m with are all ridiculously smart. Or that several key pieces of knowledge require doing OB/GYN first (which I haven’t). Or that I have zero pediatric pharmacy experience, and even if I did have any, it wouldn’t mean much since the 3rd year pediatric clerkship is entirely focused on examination and diagnosis, rather than treatment. And clinical pharmacy is all about treatment rather than examination and diagnosis.

In relative terms, I think most other students are better at thinking on their feet. I have to know the material much more solidly than most people do, I think, in order to answer pimp questions correctly. I especially feel pressured, almost to the point of being incapacitated, by the presence of someone with superior knowledge who’s judging me based on my answers. In a written format I do fine. And I can think through a complex problem thoroughly and well, even verbally and in front of others, when I’m not on the spot like that. And the truth is, I don’t do horribly even when I’m on the spot. It’s just that most of the time my mind just goes blank, and then when someone else says the answer, I think to myself, “dammit, I know that! why couldn’t I think of it?” Sooooo frustrating.

Many of my classmates have gotten pretty cynical about rotations, and I can see where they’re coming from. I think we’re all frustrated by the subjectivity of clinical grading. We’ve all seen the slackers who were given honors by their team, and maybe some of us have been that person once or twice. And I’m sure every single one of us has gotten a mediocre evaluation when based on our work and knowledge we deserved honors.

Sometimes it actually seems counterproductive to know your stuff. Ironically, if your residents don’t feel like they have anything to teach you, they blame you for that, not themselves. And so it becomes the norm to slack off, and to feel like your effort is neither seen nor appreciated.

I’m not quite as cynical as others, though. Yes, I want the stellar grades, and yes, I’m going to feel the injustice if I don’t get grades that match how I feel I performed. But really I’m trying to learn the material for its own sake. Even when I lost any desire to play the clerkship game, I still wanted to learn. I just didn’t care whether anyone knew that or not. Now I just put up with the game, and pay it lip service if it doesn’t cost me much, and try to learn in spite of it. But mostly I just try to wake up on time and enjoy whatever I’m doing that day. Perhaps the grades will follow, perhaps they won’t. Either way, my life is pleasant and I’ve learned something.

It’s the mandate, stupid!

May 17, 2006 at 3:50 pm | Posted in Uncategorized | Leave a comment

This morning there was a segment on channel 4 where they were asking people to call in and talk about the particular issue that determined their vote for the New Orleans Mayoral election. People had all kinds of reasons, most of them based on campaign propaganda from one or the other candidates.

I’ve heard all the crap about the Landrieus being a family of professional politicians, who are beholden to the old guard of Louisiana, corrupt as we all know it to be. And I’ve heard the equally irrelevant claims that Nagin is psychiatrically unsuitable to lead a city in crisis, as New Orleans continues to be, and that he is unable to work effectively with state and national leaders.

All of that is just window dressing for the central issue facing our city.

So here’s my take on the situation:

It doesn’t matter who the choices are, since I know neither one well enough to have an opinion on whether he’d make a better mayor. The salient issue of this election is what happened to New Orleans before, during and after Hurricane Katrina, and the fact that the disaster continues to this day.

The only relevant question is this: was it OK for that to happen?

It doesn’t matter who the incumbent is, or who the challenger is, or whether either one could have changed anything, or has the formal power to change it in the future. What matters is the message that we send to the nation about what happened here. If we re-elect the incumbent, it says the status quo is OK with us. What the mayor did, what FEMA did, what Blanco did, what the government of the wealthiest nation on earth did, that’s all OK with us. We give our mayor no mandate for change.

But if we elect someone new, we say very clearly that we want change. We give the person we elect ammunition with which to gun down anyone who stands in the way of fixing our problems here. Our mayor has to have that, in order for any real change to occur. So I’m voting for Landrieu. He may not change anything, but if he doesn’t, it will be because he chooses not to. Nagin may want to do all the things that need to be done, but he won’t have the power to do so. Defeating an incumbent based on a platform of change is what gives an elected official a mandate for change. And we have to have that.

Don’t get me wrong, I don’t think either guy is necessarily the better choice. And in fact, if Landrieu were the incumbent, and Nagin the challenger, I’d vote for Nagin. Barring gross and obvious unsuitability for office on the part of one or the other candidate (which is not the case here), it’s the mandate that matters, not the person who holds it.

So that’s the issue determining my vote.

From the T-P today

May 13, 2006 at 6:50 pm | Posted in Hurricane Katrina | Leave a comment

Timeline maps course of post-Katrina deluge

City’s fate sealed in hours

By Bob Marshall
Staff writer

Generations of New Orleanians worked for 300 years to raise a great city in the often inhospitable terrain along the banks of the Mississippi River.

It took Hurricane Katrina less than six hours to put that labor of love under water, damaging 200,000 homes and killing more than 1,200 people.

Timelines developed by forensic engineering teams probing the failure of the hurricane protection system provide a slow-motion picture of a deadly tragedy that unfolded with surprising speed.

The costliest natural disaster in the nation’s history began early Monday, Aug. 29, with a small leak near the Interstate 10 High-Rise about 4:30 a.m. and climaxed with the horrific collapse of floodwalls along the 17th Street and London Avenue canals between 9:30 and 10:30 a.m.

It would take many more hours for the water to reach neighborhoods far removed from the gaping wounds in the city’s defenses, but by the time the last section of the London Avenue floodwall came down, the breadth of the damage was inescapable.

The unprecedented scale of devastation to a modern American city has drawn researchers from around the world hoping to mine lessons from the experience. Understanding the sequences of the failures and the paths of the floodwaters has been a part of that effort. Scientists with the Louisiana State University Hurricane Center and others working with an Army Corps of Engineers investigation have scoured the area for evidence to pinpoint the times of failures. Their sources have included witness accounts, video, photos and data on water levels recorded by instruments at many of the canals.

But researchers say the times listed are mostly best estimates because even the witness accounts include differences. For example, witnesses’ accounts of the 17th Street Canal breach vary by as much as one hour, according to the Interagency Evaluation Task Force, which is doing an investigation for the corps.

Hurricane specialists knew there would be flooding to study as Katrina moved toward southeast Louisiana. Storm-surge models done by LSU showed the area’s eastern defenses of levees and floodwalls would be topped.

But the models predicted the flooding would be far less than catastrophic in most neighborhoods, with water levels staying below 3 feet, because the surge would last for less than two hours.

Breaches in those defenses changed everything. With levees and floodwalls down, water poured into the metro area until the volume in the infamous “New Orleans bowl” — actually a series of bowls bounded by levees and natural barriers — was at the same level as lakes Borgne and Pontchartrain, something that didn’t finally occur until Thursday, Sept. 1, about 2 a.m. The floodwater rose for days instead of hours, and inconvenience had become a deadly tragedy.

Researchers now say as many as 30 breaches in the system accounted for 84 percent of the metro area flooding, with most of the water coming from the big gaps along the 17th Street, London Avenue and Industrial canals, as well as holes in the Mississippi River-Gulf Outlet and Gulf Intracoastal Waterway levees and a gap in the Orleans Avenue outfall canal that flooded much of the City Park area.

Determining the specific source of water that flooded various sections of the city is difficult because several breaches could have affected the same neighborhoods, researchers said. However, a report by LSU marine scientist Paul Kemp made these estimates for the larger sections of the metro area:

St. Bernard Parish: 89 percent of the flooding came through breaches in the MR-GO levees on the eastern side of the parish and from the Industrial Canal, also called the Inner Harbor Navigational Canal, on its northern end.

Eastern New Orleans: 63 percent of the flooding came from breaches along the Gulf Intracoastal Waterway and the Industrial Canal.

The rest of New Orleans: 87 percent came through the holes in the 17th Street, London Avenue and Industrial canals, as well as the gap in the Orleans Avenue outfall canal.

“We have a reasonable measure of which breaches added water to different bowls of the metro area,” said Ivor van Heerden, assistant director of the LSU Hurricane Center and a member of the state team investigating the levee failures. “We’re more confident about the times. We’re confident this started around 4:30 in the morning.”

That first step in the flooding of New Orleans was small, and came at an unexpected spot. The water it released was a small stream rather than a torrent. But investigators have discovered that the circumstances underlying it would become a theme to the shocking systemwide collapse that drowned the region.

Investigators have constructed this timeline for the flooding:

4:30 a.m. or shortly before: Rising water on the Industrial Canal begins leaking into neighborhoods on either side of the I-10 High-Rise at the CSX railroad crossing. Metal gates designed to prevent such leaks had been damaged by a derailment, removed and replaced by sandbags, according to LSU researchers. The flow continues for about 13 hours, with water moving east into neighborhoods off Downman Road and west into the greater metro area, including the Pontchartrain Park, Gentilly and Desire areas. This is relatively minor compared with what those areas would face in just a few hours.

5 a.m.: The storm surge is still well below the top of the levee on the west side of the MR-GO in St. Bernard Parish, but the pounding of 5-foot to 7-foot waves driven by Katrina’s winds and the speed of the storm surge moving up the channel already are having an effect on the poorly built structure. By dawn, sections of the slopes facing Lake Borgne are starting to crumble. Entire sections eventually would disintegrate. Water begins moving into the marsh between the MR-GO and 20-Arpent Canal levee.

6:10 a.m.: Katrina makes landfall at Buras on the west bank of the Mississippi River in Plaquemines Parish. The initial storm surge pushes against the hurricane protection levee on the western edge of the parish but does not overtop it. However, as the storm moves north with a counterclockwise rotation, high winds from the northeast drive a 21-foot surge that rolls over the eastern half of Plaquemines and the river, then over the levees on the west side of the river. Communities between Port Sulphur and Venice that were not destroyed by Katrina’s winds are inundated by a flood that will remain for days.

6:30 a.m.: Witnesses report sections of the floodwall on the east side of the 17th Street Canal are leaning toward Lakeview. There is no breach yet, but water is pouring through the cracks. This is less than a trickle of what would follow.

6:30 a.m.: The storm surges moving up the MR-GO and the Gulf Intracoastal Waterway come together where the two channels meet in eastern New Orleans, the now infamous “funnel.” Squeezed into a narrower single channel constricted by levees, the surge gains speed, power and height. The levees begin yielding, eroding and breaching in numerous spots. The first breaks seem to occur along the “spout” of the funnel west of the junction of the two waterways; others will occur close to the junction, and some on the north side of the Intracoastal Waterway east of the junction. Breaches on the north side send water into homes across eastern New Orleans from the Chef Menteur Highway area to the newer subdivisions along I-10.

6:50 a.m.: The surge from the funnel has reached the Industrial Canal, spilling south toward the river but also rushing north toward Lake Pontchartrain, which at this point is 10 feet lower than the water in the canal. The surging water quickly begins flowing over the floodwalls and levees on both sides of the canal, heading into the Lower 9th Ward, upper St. Bernard Parish, the Upper 9th Ward, Gentilly, Bywater, Treme and even into Broadmoor. The worst is still ahead.

7:30 a.m.: The levees on the west side of the Industrial Canal at the railroad yard between Florida Avenue and North Claiborne Avenue breach, dramatically increasing the flooding in the Upper 9th Ward, Bywater and Treme. This flooding continues for 12 to 15 hours.

7:45 a.m.: The I-wall and levee on the east side of the southern end of the Industrial Canal catastrophically breach in two sections and send a wall of water into the Lower 9th Ward, killing people as houses are flattened and automobiles are tossed around like toys in a bathtub. As it flows south, the water stays high enough to flood homes in Arabi and other neighborhoods in the northern end of St. Bernard Parish.

8:30 a.m.: The milelong stretch of floodwall behind Lakefront Airport that is 2 feet lower than the adjacent earthen levee is overtopped by the surge from the lake. Water pours into eastern New Orleans homes for about three hours.

8:30 a.m.: With large sections of the MR-GO levee gone by 6 a.m., Lake Borgne advances to the 40-Arpent Canal levees. Now it begins moving over the top of this second barrier. Water starts rushing into neighborhoods from Poydras to Paris Road.

9 a.m.: As the storm surge in the London Avenue Canal reaches 10 feet — 4 feet below design capacity — sections of the floodwall on both sides start bending away from the canal, one just south of the Robert E. Lee bridge and another just south of Mirabeau Avenue bridge. Water starts leaking into adjacent yards, but the flow is minor at this point.

9:30 a.m.: The stressed sections of I-wall on the east side of the London Avenue Canal near Mirabeau finally give way, sending a wall of water through homes and adding to the general flooding in Gentilly, including at Dillard University and the University of New Orleans

9:45 a.m.: A catastrophic break at the 17th Street Canal floodwall and levee occurs, releasing a roaring torrent of water into Lakeview that collapses homes and claims lives. The nation would watch in disbelief for the next 60 hours as the corps struggles to plug the gap. This breach accounts for most of the water that destroys homes and ruins lives from the Jefferson Parish line east to City Park, north to the lake and south to the river.

10:30 a.m.: A section of I-wall south of Robert E. Lee Boulevard on the west side of the London Avenue Canal comes down, sending an 8-foot wall of water through homes in Gentilly and contributing to the rising flooding across the city.

This is the last major breach. With Katrina already north of the city and quickly moving away, the surge has begun to drop. For levees and floodwalls still standing, the overtopping is over. But the large sections of levees and floodwalls that have collapsed will keep bleeding water into the city for more than four days.

It would take weeks to get the water out.

Katrina Path

Medicine needs smart people too, y’all.

May 12, 2006 at 8:09 pm | Posted in Uncategorized | Leave a comment

Another recruit for neurosurgery, making a grand total of 8 from my entering class. Three transferred out and one is taking a year off to do research, so there will be 4 applying in the fall. That’s more manageable than the original 6, but it’s still a lot. Pediatrics has recruited one person away from family medicine this rotation. And I have to admit, I like peds better than psych. Maybe because I know less about it?

So for those keeping score at home:
neurosurgery>peds>>psych>trauma surg=IM(heme/onc)>>other surg=EM=neurology>other IM>radiology

If that makes any sense. I’ve given up trying to make it seem rational.

Apparently urology also has a big fan club in my class. I know 5 people off the top of my head who want to go into that field. Only one person admits to wanting dermatology, but I’m sure there are others. We have 3 or 4 OB/Gyn people on this rotation alone. I know 2 people who want to do psych, and one future radiologist. Only one medicine person.

See Jill juggle. Juggle, Jill, juggle!

May 10, 2006 at 10:45 pm | Posted in Uncategorized | Leave a comment

My mom’s been visiting for the past few days. She wanted to see what New Orleans was like, post-K. However, we didn’t get to do a whole lot, since I can’t exactly take time off a rotation just to entertain a guest. She says she knew that coming in, so she didn’t mind. But still I feel bad that we didn’t get to do more.

Part of the problem is that she has really bad osteoarthritis in her knees, and can hardly walk. So she gets exhausted from very little activity. I know she’d like to do more, but it’s just too painful. It’s frustrating for both of us. She wants to sit around the house with me and I want to go out and do stuff with her.

It’s also frustrating because I need to be studying pediatrics in the evenings, and it’s hard to do that when you have a guest who’s here to see you, and you already only have 1/3 of the day to spend with them. And it’s very obvious that I haven’t been reading as much as my classmates, and I hate that feeling.

The other thing I’m upset about is that I thought I’d have time to take her to the airport, but the traffic is really horrible at that time of day. There’s no way I’d be able to get there in time. So she decided to spend tonight in a hotel, in order to take the shuttle to the airport tomorrow.

But it was nice to have her here. At least she got to reassure herself that I don’t live in total squalor, and that my area of New Orleans really looks about the same as before the storm. We drove around Lakeview today, and she’s going to try to take a tour of the 9th ward tomorrow before she flies out. So she’ll have some pictures of the devastated areas to show her friends.

As for me, I feel like I’ve had one too many balls to juggle this past week, and I definitely dropped a couple. But hopefully it’s recoverable.

On a completely unrelated note, today at lunch one of my classmates was complaining about how AOA at Tulane is like some secret society. None of us know who’s eligible, or who’s in it, or when the elections are, or who gets to vote, or even if the election has already taken place.

In fact, we don’t even know our own class rank, and most of us can’t even narrow it down to a single quartile. We are totally kept in the dark about our standing relative to our classmates, and discussing your own or others’ grades in anything but the vaguest terms is practically taboo. Which I find really bizarre, considering Tulane has a standard five-letter grading scale. That generally creates a very competitive atmosphere. But the atmosphere at Tulane is that of an entirely Pass/Fail school. You get the sense here that people are struggling to conquer the mountain of medical knowledge, rather than competing with each other to climb higher or faster. I like that.

Anyway, I was glad to know that I’m not the only one completely in the dark about my academic standing.

Talk to the face, not the hand

May 7, 2006 at 11:05 pm | Posted in Uncategorized | 1 Comment

In response to a comment on an earlier post: I think when you change the rules on someone, you owe them time to adjust. Not a lot, but some. I’m not interested in punishing people. I’m simply interested in being treated with respect and honesty. If there’s measurable progress being made toward that end, the right thing to do is be patient.

So, while the situation may very well be irreparable (although I hope not), I think when you shut someone out, you eliminate the chance for anything to get better. I don’t really know if people can change, but the only way to find out is to allow for the possibility. I’m not putting my life on hold, but there’s no harm in being receptive. Some of my dumbest mistakes have been from not letting others speak when they had something to say, for fear that they might say something hurtful.

No games, though. For the life of me, I’ll never understand why people feel it necessary to hide a positive emotion.

Whose peers are these?

May 6, 2006 at 5:05 pm | Posted in Uncategorized | 1 Comment

I’m back early from Houston. Apparently I wasn’t doing anything wrong with my assay procedure. Upon closer reading of one of our source articles, it became clear that they were using paraffin sections for their experimental slides, with frozen sections as their control slides.

Holy invalid results, Batman!

So we’re going to repeat the whole thing using frozens instead of paraffin sections, for both our experimental slides and our positive and negative controls. I predict that, contrary to the prior literature, we will find low to moderate staining at best.

Tsk, tsk, tsk. The things that make it past peer review…

Do we really need sinuses?

May 5, 2006 at 1:58 am | Posted in Uncategorized | 4 Comments

I’m hating mine right now. They’ve got a nasty strep pneumo infection, which I can tell by smell, and I really just want to flush them out. If only I knew how.

Peds has been pretty fun so far, and I haven’t minded clinic so much. But the whole infectious disease issue makes it out of the question as a specialty. It’s no accident that I’m taking it during late spring and summer. The last thing I need is to hang around a bunch of little vectors during peak cold and flu season.

I’m actually carrying around my own bottle of hand sanitizer, which I’ve never done before, and I’m sure I’ll go through the whole thing and maybe another on this rotation. All my patients have been healthy so far, and honestly today on heme/onc I was much more worried about infecting them than about getting infected. But still.

Blog at WordPress.com.
Entries and comments feeds.