Pulm: Change of Pace

Dr. Ozzie was gone for the rest of the week so instead I was assigned to Amber's preceptor, Dr. JS (with whom I'd be working for the last two weeks of my rotation here). Dr. JS works long clinic hours, and today he also had to see Dr. Ozzie's inpatients. When he told Amber to see the inpatients, I offered to go with her since I knew them fairly well (having followed them for two days). The first patient we saw was a pleasant Vietnamese patient with miliary TB who had been presented at the TB conference yesterday for treatment options since she also had Hep C (and INH is hepatotoxic). This was the first time I ever met her since Dr. Ozzie had not let me see her previously, but she was very sweet. She told us that she had no idea when or how she contracted TB, and she was all alone since she had no children and her husband passed away within a year or two ago, but she was determined to get well no matter what, even if she had to stay in the hospital for one year. We assured her that most likely would not be the case, but she would definitely be on medications for six months to a year. Amber and I were both wearing the N95 duckbill masks, but as we examined her I couldn't help but wonder what my chances were of accidentally inhaling air droplets that contained TB and seroconverting into TB positive from this rotation. My other two patients were about the same, so I wrote notes for all 3 before we attended noon conference.

Kate has lobbied for us to get Good Friday off, and all we have to do now is fill out paperwork and clear things with our preceptors and lecturers. Lisa and I watched the series finale of ER tonight, and we were shocked when a placenta accreta/uterine inversion was shown in gory detail after a woman gave birth to twins. You didn't actually SEE the uterus or placenta, just tons of blood spilling down the foot of the bed to the floor, but the effect was pretty darn real. Having delivered several babies during my obgyn rotation, I was aware of how much a woman bled during birth, and this TV delivery gave a new meaning to "huge blood loss." Needless to say the woman went into DIC and died, but seeing all that (fake) blood on TV...damn.