One of the many new ideals my 17K has paid for this fourth and final year. I started to short change this day, but this rotation lived up to its expectations and then some. My preceptor, we'll call him D-dub, to protect the innocent, is a master of clinical knowledge and mental annihilation of his students. Today's weather is a metaphor for this month in IM, mentally I had prepared myself for the 15F bitter cold with windchill of 4F, I was strong and resilient. But when it came time to step from my warmed silver tiger tamer the awesome force of the strategic numbing cold struck away at my codsack relentlessly. Yeah, that's exactly my month. Having said my peace I learned that:
1. You don't chase an NH+3 level even if it is 591 as long as the patient has no AMS
2. Tap water enemas of 150-200mLs or lactulose 300mLs in 1L of H2O is not only easy but good clean fun for the nurse and patient
3. Doctors don't always know their drugs
4. There is a difference between "pimping" and "grilling" students, during grilling you feel as though you have been eaten alive, not just "hoed" out
5. *Drumroll please*, your preceptor does want you to feel loved, just not by them and you can't start anything with anyone else because it's like cheating on them;)
This month every time I have reached into the fridge, I've heard the collective sigh of the specialty six-pack I bought at the New Years when it's the chocolate milk I pull out because I simply can't spare the neuron. Today, when I looked in I realized that it's nothing that a banana bag times 3 days and PRN ativan won't take care of. They scream, "Yes, we'll give you transient gastroenteritis!! We may cause your AST to be at least 2x your ALT in the short run because in the long run your liver won't be able to mount that kind of response, and we can cause hypertension/tachycardia due to central nervous system dehydration. But hold us, we'll make you happy, you'll see." So tonight Brooklyn Winter Ale is my hemlock and Gurkha Reserve Perfecto #2 is my firing squad smoke.
