My first rotation is Hematology (blood) and Oncology (cancer). It's a pretty cool rotation and all the PGY-1's (post grad year one, or interns) have to rotate through. Even though there are a lot of sick patients, the nurses are awesome and REALLY helpful and friendly.
I was assigned 4 patients my first day. The first was a 65 year old guy with Hemophilia A. His condition was relatively mild until 2 years ago when he developed antibodies during surgery, now he bleeds with even minor trauma, and requires a $5,000 injection so he will stop bleeding. He went home today (day 2) but will continue his regimen to try and make his disease less severe.
The second is a lady with metastatic breast cancer. She already had a double mastectomy, and had a port catheter placed under her skin so that chemotherapy could be delivered easier over a long period of time. Unfortunately, the port cath became infected with MRSA (methacillin resistant staph auraus - meaning the usual antibiotics are INeffective = BAD). We removed the cath and she is doing much better, unfortunately this doesn't do anything for the cancer. She will probably go home tomorrow.
The third is a guy who was admitted for open heart surgery, a CABG (coronary artery bypass grafting). He also has sickle cell anemia and when he was admitted he started having a sickle cell crisis, which is where you blood cell can't fit through the capillaries and you have lots of severe pain all over your body. By the time I saw him his pain was much better. He went in for surgery this morning and had one-vessel disease. He was transferred off my service and into the ICU.
The fourth is a guy with Hepatitis C who subsequently developed cirrhosis and Hepatocellular carcinoma (liver cancer). He was admitted for a special procedure where they go though your femoral artery (similar to a heart catheterization) and inject chemotherapy agents directly into his liver, followed by a special gel that clots off the artery leading into the liver -effectively removing the blood supply to the tumor. He is doing well after his procedure.
So my day basically consists of: waking up as early as possible, arriving to the hospital and checking new labs, overnight test results, vital signs, nursing reports (all pre-rounding) in order to get ready to round with the attending. Being one of the hospital newbies, I have LOTS of questions of how to do stuff, where stuff is, and also questions about the management of patients (you know, why I'm there in the first place!) There is no senior internal medicine resident, instead we have a Heme/Onc fellow. Our first 1.5 days there was a great fellow named Seth who was nice and knowledgeable - a seasoned doctor. Today we were introduced to the new fellow who will be with us for the rest of the month. She is new to SLU too, so it's kinda like the blind leading the blind, except she had 3 years of experience on the rest of us. (My second day was her first day of her 3-year fellowship in Heme/Onc, so she'll improve - she also went to East Tennessee, in Jackson City, or something). After rounds we grab a bite (after this week it will be during noon conference) and try to catch up on all the work we need to do: discharge summaries, endless orders, checking on patients, and tons of paperwork. While it's intimidating, it fun too.
Tomorrow is my night on call, which means when my fellow interns are going home at 5:00, I'll be roaming the hospital waiting for nurses to call with any questions they have, or orders I need to write. And if a patient needs to be seen, I'm the one who has to see them. I'll stay at the hospital until we finish rounding the next day (July 4th) at noon, after which I can go home and get some sleep. Fortunately I'm off Saturday, so I think Kim and I will get a chance to hang out with my buddy, Lee and his wife Danielle, who are coming to St. Louis for the downtown arch fireworks and to see one of his other friends and his wife. So after all the work, I think I'll still try to have some fun - I usually do ;)
Someone else needs to post, by the way. It doesn't have to be anything amazing.
