IM: Pre-Call Blues

Because we still had 14 patients this morning, I saw 4 instead of 3, but fortunately these cases were pretty straightforward. Mr. Roboto is doing better; when I saw him he was eating a muffin without assistance. Then J, the inmate in the bed next to his, got my attention, saying he was trying to eat the muffin wrapper and needed help using a spoon. "He don't know what he's doing," said J, who was in the same prison unit as Mr. Roboto before their hospitalizations. Sure enough, Mr. Roboto couldn't aim well with his spoon; the eggs and cereal kept spilling on him. His nurse ended up having to feed him. I asked J if he knew what happened to Mr. Roboto prior to his arrival here, but J said no, they'd arrived at different times. "I'm suicidal," he said, "but I'm fine up here (mentally). But him..." He made a twirling motion around his ear (i.e. psycho), and another inmate across the aisle laughed. I'd overheard some of the nurses talking about J, saying that he'd eat anything he could get his hands on (nails, razor blades, etc) just to get a "get-out-of-jail card" and end up in the hospital. Still, he and Mr. Roboto seem to be fairly good buddies (Mr. Roboto is most talkative when he's chatting with J), and with Mr. Roboto doing better, maybe he can go to TSP soon.

My stroke patient got her MRA done yesterday; she was found to have extensive blockage in her right ICA and parts of her right PCA and MCA. It was really obvious in the MRA, with the left side all lit up with vessels and the right side not so much. We had hoped to discharge her today but that wasn't going to happen. Dr. L didn't even go see her, which surprised me and I asked him about it, but he said he had other things to check (and other patients to see since it was close to noon by this point). After we were done, Sarah asked if Angela and I could each do a discharge summary on one patient since we'd known them longer than any of the residents have. Thank goodness we've both dictated before, though I had to do it in front of an attending (who was writing a note in the computer room where I dictated) and was very embarrassed b/c I kept messing up. Either way, I didn't leave the hospital until 1:30 pm, the latest I've ever stayed. I think I'll be working a lot harder these last two weeks on this team.

In other news, there won't be morning report tomorrow, so I won't get a chance to present Mr. Roboto =( Ah well. I also got an email saying that my medicine sub-I for August has been approved, finally. Looks like I'll be going back to Austin this summer!