IM Sub I: First Call

Today was my first day on call, and despite going to bed at 11:30 pm with the intent to wake up at 6:20 am, I woke up at 5:00 a.m. instead. *sigh* Still not used to this place, I guess. I was assigned two patients to round on this morning: one was a sweet, compliant lady with a lumbar abscess, and another was a disgruntled, non-compliant diabetic with cellulitis. He has refused to eat his diabetic diet and says he just won't eat until he gets a regular diet (even though it's against the law to grant his request), and he flat-out refused to let me examine him. *sigh* He had the exact same cellulitis problem the last time he was here last week (and he'd left AMA); I think everyone on the team is hoping he'll leave AMA again b/c he's flat-out rude to everybody. Heck, I'm dreading having to see him tomorrow. He said he didn't want to see any doctors for the rest of the day, and since I'm not a doctor yet, Greg says it's my job to bargain with him to be compliant (even though he'd refused to sign Greg's contract to "stop being an asshole" earlier). *sigh* Yan said that she never had difficult patients in China, but that's because in Asia, doctors are well respected. My first patient got me out of a lecture on chest xrays; I had to write an acceptance note for an ICU patient coming to our service. A nearby intern was shocked that Greg would give a med student such a complicated case (this guy's been in the hospital for 5 weeks secondary to complications of a perfed bowel), but when she found out I was an AI and not a third year she said that was okay. Then I had a 3 hr break during which I surfed the net, slept, or ate dinner before I got my second admit of the night. This lady had a cholecystectomy for abdominal pain that never resolved and began draining dark bilious fluid, so another hospital did a CT scan and found tumors in her lung. Biopsy revealed metastatic giant cell tumor of the gallbladder, which is VERY rare. I felt so horrible for this woman after I learned her diagnosis; when I was talking to her, she said she'd heard that she had tumors in her liver but didn't know how bad it was. I don't think she was under the impression that this would kill her, and gallbladder cancer is highly fatal =( I was done by 9:00 pm and allowed to leave, but I stuck around until An finished presenting her patient b/c it'd look bad if the AI went home before the med student. I'm supposed to be acting like an intern here, after all.