Pulm: New Attending

Because Dr. JS (new preceptor) didn't start clinic until 1:00 pm, I was able to drive to Tyler this morning (after telling my dad to go to see his doctor since he's been coughing for a week). I still haven't finished filling out my paperwork for Drexel but did submit my offer letter today (among other things). I saw a few patients with Dr. JS, but it wasn't long before he fell over an hour behind schedule. I did meet one patient who had Fuchs' dystrophy (hereditary corneal dystrophy that eventually results in blindness), but she recently got an epithelial cell transplant down at TMC and has regained some of the sight in her left eye. Yet another patient had a lung removed in 1985 due to lung cancer, and he's still going strong. Amazing. During clinic, Dr. JS got a page about a new TB patient and told me to go do an H&P on him. The patient was a 45-year-old man originally from Grenada (he still has a Caribbean accent) who was diagnosed with TB in September but even on 3 anti-TB meds his hilar lymphadenopathy and infiltrate-laden lungs did not improve. He had never given a sputum samble and his notes were disorganized so Dr. JS and I had no idea how he got diagnosed with TB in the first place. By this time it was past 5:30 pm, so Dr. JS told me to go through all the notes from the other hospital and then dictate my H&P. Easier said than done. I ended up having to put the notes in order before I learned that the TB was diagnosed after a bronchoscopy revealed AFB-positive stains. And my dictating skills suck; I haven't had to dictate anything since Tanner week in family medicine which was well over a year ago. The transcriptionist is going to have a field day when she hears my stammering...