30 Something Baby Doc

I pray for all the victims of Katrina. I hope this crisis brings out the best in the residents of the gulf coast and not the worst.

UPDATE: People are dying in and around the Super Dome. The majority of the more than 25,000 refugees that are held up there are indigent African Americans who are dehydrated and starving. These are the individuals that had no or limited means to initially evacuate the city. How did the conditions deteriorate so quickly. These are the individuals I care for every day at my hospital and I'm very confused why the federal government has been so slow in it's response. We are now more than 3 days after Katrina made land fall. I understand this crisis is of a tremendous scale (ie. evacuating an entire city!) and I continue to pray for victims, and their rescuers. I can't imagine what's occuring at Charity hospital at this moment.

I hate that fucking word. I saw a 50 yo asian female with abnormal bleeding a week ago and performed a endometrial biopsy. She came back to my office yesterday for the results. I checked the computer to get the results. The pathology lab had not contacted me prior to this so I assumed everything was OK. I called up her results and it turns out to be the worst case scenario...poorly differentiated endometrial carcinoma (aggressive cancer). I've never been good at giving bad news. I just try to be blunt but optmistic. I walked into the patient's room, greeted her, sat next to her and told her the biopsy came back as cancer. She nodded her head and showed no emotion what so ever. I continued to expain the next steps including surgical staging and possibe ajuvant therapy. The patients affect was still blunt. She expressed an understanding and quietly left my office.

An hour or 2 later my nurse called her to give her a follow up appointment. After their phone conversation the nurse came to me and asked me why I let that patient leave so upset. I looked at her puzzled. My nurse told me the patient was frantically yelling and shouting obscenities at her family members.

I drove my new mustang up to the dry cleaners yesterday to drop off some shirts. (I take advantage of any small excuse to get out and drive). I was conversing with one of the guys behind the counter (I go there so much we're practically friends). A really hot blond woman wearing a short skirt comes in with two equally attractive friends. She drops off some dry cleaning then turns to me and says in a seductive voice, " I really like your car, I think it's sexy"

When she leaves, I turn to the dude behind the counter and says, "Man, she is hot" The guy replies "dude , she's only 17"

It's official,................. I'm a dirty old man.

I saw a 19 year old patient today for her first pelvic exam. She said she had sex once and would never do it again soon. Regardless I was still able to talk her into using birth control and counseled her on the value of safe sex. She swore to me that condoms were used during this brief encounter. But when I examined her, a foul smelling greenish yellow purulent (pus like) discharge was oozing from her vagina. Under microscopic inspection, it turns out she had contracted Trichomonas (A very nasty STD where small creature can be seen swimming around under higher magnifications). The latter is less likely if condoms were used.
I asked her if the condom had burst or come off? She then stated that intercourse had commenced with out a condom and her partner put the condom on just before he ejaculated (.....very thoughtful indeed).

I got to the point yesterday, when I was sick and tired of several patient refusing a pelvic exam from my male medical student after I asked if they would mind or not. (they never seemed to have a problem with the female students)

I therefore had the student begin to perform exams under my supervision WITHOUT asking the patient if it was OK. It seemed that the patients were very accepting when they weren't given a choice.

It really pisses me off sometimes when I see my office patients respond negatively to my male medical students when compare to the female medical students. No wonder male student avoid a career in obstetrics like the plague!!

Do my patient believe I was born with the fucking knowledge!!!!

Last night I awoke to find my TV turning itself off and on by itself. I checked to see if I had rolled over the remote and I hadn't. This has happened before, but I attributed it to a possible temporary power outage in the neighborhood. But I look at my bedside alarm clock and it was working fine.

I have and open mind. If something suprnatural was occurring, obviously this entity was not hostile .....matter of fact she or he might be saving me electricity my turning my TV off while I'm sleeping:-)

I got out of bed and tried to change the channel (I have digital cable). The channel guide was warped and all the programs said " TO BE ANNOUNCED" That explained what happened.......my cable box reprograms itself in the middle of the night on occasions and that's why my cable box turns itself off and on.

Well it looks like I won't be charging anyone else rent:-(

One of my readers Christa, had a friend who delivered her baby 14 weeks premature The following is the most recent survival data based on gestational age. It's important to also remember that survival doesn't equate to quality of life and many extremely premature infants will suffer permanent disabilities.

Regarding your friend with Wegeners Granulomatosis, nasal symptoms are usually the first presenting symptoms, but ive never heard of the total destruction of nasal cartilage. These patients present with blood or purulent nasal discharge; oral or nasal ulcers. I can only encourage her to remain under the care of a rheumatologist

1) Italian Sausage Sub with Onions

2) Ear of Fresh Corn with Butter

3) Steak on a Stick

4) Another Ear Corn

5) Barbequed Pork on a Stick

6) Beef Taco

7) Fried Wiconsin Cheddar Nuggets

8) Another Italian Sausage Sub

9) Elephant Ear

10) 3 Sprites

No Beer....Dammit!!!

And I didn't even get sick:-)

Has it been since last Sat that I blogged!!!!!!?????????

sorry guys....getting my case list proof read , edited, and mailed took up alot of my time this week and I'm truly sorry.

I'll start answering some of the questions you guys have asked me this week and I'll sart up again with the juicy stories of my life that you guys love so much...zzzzzzzzzzzzzzzzz

Washing my hair has seemed to evolve into a huge ordeal. Shampooing twice, rinse, deep conditioning for 1 hour, rinse, hot oil treatment for 15 minutes, rinse. And after all that my hair still looks like a fucked up Brillo pad.

I'm going to find it difficult to leave the midwest after reading an article today in the Ob-Gyn News indicating that the midwest region has the highest median salary compensation for my subspecialty compared to the eastcoast, westcoast and southern region.

This must be the longest hangover ever documented.

My case list is done with 2 weeks to spare. I'm just getting it proof read now, should be in the mail by the beginning of next week. Thank the Lord:-)

The following incident occured when I was a 2nd year resident.

I was admitting a patient for active labor, she was a very pleasant 21 year old black female. I needed to perform a pelvic exam to access how her labor was progressing. I walk in the room with the nurse , introduced myself to the patient and family and put on a pair of gloves. The nurse helped me to put the patient in the lithotomy position (legs spread). At this time the patient's boyfriend along with 2 of his friends walk into the room (and I have to admit they look very thuggish). The boyfriend ask the patient, " where's the women doctors!" The patient replies, "this is Dr------, and he is very nice"

I proceeded to put my hands in the patient's vagina to examine her dilation. The boyfriend start to lament, " Ahhhhhh...that's wrong.......shit, man .....ahhhhh...that's wrong" I finished examining the patient, turned to the boyfriend and ask him politely what the problem was. He shouts, " Motherfucker how would you like someone puttin their fuckin hands in your girl's shit!!!!!!!!!!"

I paused a moment, thinking of some sharp comeback ....like, "you better shut the hell up before I put my foot in your shit"

But I opted to have the nurse calmly and quickly escort me from the room:-)

I stayed at the hospital late last night working on my case list. My buddy(K) who just moved back into town with his wife and kids called me around 8pm to go out for drinks (he had a hard day at work and wanted to bitch). I had a private patient (a nurse) who called to tell me she was in labor and coming to the hospital. I called K back and let him know I could do dinner but no drinks. Of course he gave me shit (he's a physician too). My patient arrived, when I examined her she was 2 cm dilated, I let her walk for a while and told her I would re-check her in 2 hours.

I should have just continue with my case list, but I decided to join K downtown for a quick dinner. I came back to re-examine the patient and she was 4cm dilated....cool. I admitted her for active labor. I knew it would take her awhile to deliver, so I bagged my caselist and went home for some sleep and told the nurses to page me when she was closer to delivering. Of course I get paged at 4am and I'm told she 9 cm dilated. I rushed to the hospital believing I may not have enough time.

I arrive at the hospital and entered the room. The night shift attending physician was standing infront of my patient with gown and gloves on ready to catch the baby. I put on some gloves, thanked the night attending for covering for me and told her I would take over at this point. She gestured as if she didn't want to move. I repeated " thanks again, I'll deliver the infant now". She slowly backed away looking disgusted (this physician tends to be a little bit quirky). The entire situation was very weird. After the night attending left the room, my patient looked at me and whispered," thank you"

She went on to deliver a healthy baby boy. dad cut the cord:-)

My parents let me borrow their EZ Pass for when I travel back home to the East Coast (because I usually take the PA turnpike) . The EZ Pass indicator attaches to the front inside windshield of my car with 2 long velcro strips and allows me to wiz thru the toll with out stopping to pay:-) I hated the ugly velcro strips, so I removed them. Therefore as I go thru the toll, I need to manually hold the EZ Pass indicator up to the windshield.

Unfortunately the last time I went home on vacation, I must have been holding it incorrectly and the indicator did not register as I was leaving the toll. As I was pulling away from the toll, I looked in my rear view mirror and saw this bright light shining at me. I didn't think much of it at the time until I got a 40 dollar bill in the mail yesterday along with a beautiful picture of my plates (they charged me the entire length of the turnpike along with processing fees) , normally I would only be charged $3.90 if I paid in cash at the toll.

Moral : Vanity will always cost you in the end

The exploratory laparaotomy (surgery) on the 400 pound lady was cancelled!!!!!

The benefits of going to church this weekend:-)