Family Medicine: Burned Boobs and Benicar

This morning we had an ethics orientation after which we had to sign up for a date to attend an ethics commission meeting. Most of the dates were during my hospital week (not to mention the JPS ones were snatched up fast), so I ended up with a 5 pm slot at Baylor in April. I also found out Andrew will be doing hospital week with me, so it's good to have a friend around. In clinic Dr. RR pimped me on anti-hypertensive drugs (assignment) but aside from knowing why clonidine is such a bad drug to take (rebound HTN), I didn't do so hot. I didn't know the difference between atenolol and metoprolol (long acting vs short acting) and he told me to study it a bit more. One thing I've noticed about JPS clinics is that a lot of kids have caps on their teeth. It makes me wonder, if they can afford to buy candy to rot their teeth, then why don't they invest in toothbrushes, too? We had a few interesting/crazy patients today. One guy had flu on Sunday that led to non-stop vomiting and hiccups that disable him from keeping anything down (other than sips of water). He was, by his own admission, so weak that his wife had to wheel him in via wheelchair. But the wheelchair they used belonged to the clinic, and Dr. RR wanted to know how he was able to move from the car into the clinic. "Where's his weight?" he asked. The nurse didn't take it b/c he couldn't get up from the chair. "I don't believe that. Go weigh him," he said. When I examined him he had hiccups every 5 seconds and was constantly spitting up phlegm, and I was so scared he was going to spit on me while I was listening to his heart.

The last patient of the day was a very interesting African American lady. When Dr. RR saw her file, he said, "Is that the lady with the burned breast?" I must have looked very surprised, b/c he immediately told the story of how this lady came to the clinic years ago with a second degree burn on her breast. It made no sense how that could have happened, until the lady said she was cooking chicken at the stove without her clothes on (ok, who the hell cooks naked??), leaned over the stove, and her "titties fell in the grease." Everyone's reaction to the story: BWAHAHAHAHA! "Everyone likes that story," said Dr. RR. The reason she came today was because she had some congestion that hasn't resolved with medication. She also recently underwent a lung biopsy for a suspicious mass, and she was anxious about her results. Dr. RR later told me she probably had lung cancer b/c she was a heavy smoker. *sigh*

Later I went to a Benicar drug rep dinner at Pappadeaux (courtesy of Fallon's attending giving a lecture there and Fallon emailing us about it) with Carisa and Fallon. It was my first drug rep dinner, and it was really good. Later we talked with one of Fallon's residents about Drs B and S from obgyn, who were currently doing their medicine rotations. Apparently they haven't changed too much since August =P