My time in the ER

or "ED" if you keep up with fashionable new medical terminology.

Anyway, I haven't blogged in a while, so I'm combingin all my recent happenings in one convenient post.

Why I Love America
Guy has average/mediocre job in America.
Guy can't afford good health insurance in America.
Guy develops Schizophrenia.
Guy can't get adequate medical treatment in America.
Guy loses job.
Guy still can't get adequate medical treatment in America.
Guy becomes an alcoholic because the voices in his head aren't as loud when he's drunk.
Guy becomes homeless.
Guy gets jumped under a bridge.
Guy comes to the ER, gets stitched up, and still can't get adequate medical treatment because there's no one to pay for psychiatric therapy.
Guy gets kicked out of ER two hours later.

I love it.

ER Quote of the Day (For Jen)
"There's not that much that Percocet and Valium can't fix."
-my attending physician

I'm not going into ER
When I came to medical school I figured I'd go into ER. I thought I'd love the shift work, and love never being on call. I remember thinking the last thing on earth I'd want to go into was Family Medicine. I thought it'd be the crappiest, most boring field in medicine. Well, once I actually did Family Medicine, I freaking loved it. I loved being in the clinic, I loved keeping up with patients that I was treating, and I loved having a regular schedule. Still, though, I hadn't given up on ER.
All that changed on Tuesday. I was presenting a patient to my attending, and this guy was on insulin and four different diabetes medications. That's absolutely ridiculous. So, I bring this up to my attending, and he just looks at me for a little bit, and then says, "Oh, I was waiting for you to get to the part that I'm supposed to care about." Now, to be fair, he wasn't being a jerk, he was just pointing out that in the ED, we can't manage every aspect of a patient's health care because we don't have the time or the resources. That's just not what the ED is for. Anyway, right then it hit me- I want to manage this guy's medications. I cared about what would happen to him after I left, and the next day, and a year from now. I liked talking to my patients, and I liked looking at the big picture of their care. And I really don't care about doing some awesome procedure or managing a trauma patient.
Also, I really hate being in hospitals.
So all this to say that at that moment I realized that I am going into Family Practice, and I'll be probably be poor, and I'll probably take it up the butt from Medicare, but I will be happy.

My Life Really is Like the TV Shows
Keith came to town today. He starts his ER rotation tomorrow. Being the kind, even saint-like, friend that I am, I told him to come up while I was working tonight and I'd show him around. Right, so I do, and Keith leaves to go home and I walk back into the ED. As I walk in the door, paramedics blow through the outside doors with a guy on a stretcher getting CPR. The attending looks at me and goes, "Josh! Get some gloves on take over. Now." and so I rip off my white coat, grab some gloves, jump on this guy's chest, and start doing compressions. Unfortunately, the guy dies in the middle of this. So then we're backed up, and I turn right around and start seeing a new patient while my attending goes to break the news to the family. All in a day's work, I guess.