Sunday, February 03, 2013

cold leftovers

Here are some little nuggets I was going to put in my last post, but my last post turned out to be long enough, so I figured, "Hey, free post!" Or something. I just worked six days in a row and ended it by barricading a door while a nude, obese elderly woman charged at me with her walker, screaming obscenities because she wanted me to push her around in a wheelchair. She later apologized very sweetly and asked me to bring her a strawberry shortcake and give her a leg massage. I brought her the shortcake despite her poorly controlled diabetes and wiggled her feet around a bit. (You gotta pick your battles.) Anyway, I am tired.

Frequently, medical teams in one specialty need to consult medical teams in another. For example, if our 38-weeks-pregnant psych patient is reporting contractions, we get on the horn with OB. When this happens, the consulting team writes a note about their findings, and the home team mentions the consultation in their OWN note, to indicate that all bases have been covered. When the consulting team has not found anything and doesn't feel the need to pursue the issue further, the home team will write that the consulting team "was not impressed." I love this.

Patient does not, in fact, have symptoms of meningitis? "Neurology was not impressed." [And thousands of dollars are spent on tests anyway to prevent the teeny tiny likelihood of being sued.]

Patient who's 38 weeks pregnant and reporting contractions but who is also attention-seeking and dramatic? "OB was not impressed."

The skin around patient's feeding tube is reddened and pus-y and painful and causing him to whimper each time you administer anything through it or change the oozy gauze dressing? "GI was not, for some reason, impressed."

(Poor guy.)

* * *
In nursing school, we are taught to write all our notes in a 100% objective manner. There should be no opinions, assumptions, judgments, etc in nursing notes (there totally are, of course, but that is another post). "Patient showed this. Patient said this. This treatment was given. The result was this." Done. Doctors, however, who should probably be more objective than they are but whose jobs revolve around rendering opinions, have much more leeway. The other day I was reading a History and Physical on a new patient. At the end there's always a plan, often many different plans if a patient has multiple issues. At the very end of one patient's list of plans was the following:

Those toenails have got to go."

I didn't see the toenails in question, unfortunately, but I get the sense that Podiatry would have been impressed.

* * *
I was recently impressed by a quote from a patient hidden deep within one of the notes. The writing physician was apparently walking the patient from the ER to our unit when the patient said, among a zillion other things, as the patient was severely manic, "I just want to find medicines that aren't Zyprexa that help me be mellow without making me fat or drooling or shaking."

Fair enough, kid. Fair enough.

Zyprexa, an oft-prescribed antipsychotic medication, does indeed cause drooling and shaking and "metabolic syndrome" aka "gaining a bunch of weight and getting diabetes." This kid is wise for not wanting to be in that club. The other day I was waiting for an internet video of tigers eating a snowman to load (yeah, I don't know), when this ad popped up...

How far we have come that someone out there wrote the most overly chirpy jingle of all time to advertise diabetes paraphernalia. Humanity is screwed.

Speaking of the future of humanity, am I the only one (besides my roommate Joni who is sitting here at the table as I type this) who was unaware that Mariah Carey had twins and named one of them Moroccan? MOROCCAN. As in, a person or thing from Morocco. Which this boy child is not.

Certain that this choice must have some Special Meaning, I went a'Googlin'. And lo, I was right. The child is named after a room in the Cannon-Carey NYC penthouse, which is furnished and decorated in a Moroccan style. It was in this room that Nick Cannon proposed to Mariah Carey. Glitter and butterflies!

The twin sister, Monroe, has a sensible name by comparison. And how nerdy am I for first thinking of James Monroe, the former POTUS, and not Marilyn?

Portrayals of romantic love among the elderly always makes me so happy. It is so refreshing and inspiring to see people living it up when they're going down, so to speak. (Sorry.) Also, maybe I like them because they give me hope, should I find myself still single 40 years from now HAHAHAHA *sob* 

But seriously, these stories are both really sweet.

Grab a tissue.
Sam and I dated for two years. Then, when I turned 70 and he 80, we had a joint 150th birthday party and announced our engagement. We married a year later.
The bride, 97, is keeping her name.

And last but not least, my two new favorite Instagram accounts (you can find yours truly @ginageener) both happen to be focused on pets in Japan.

And now I want to change the names of my cats Walter and James to Mitsumame and Yohkan-san and acquire a flock of colorful, adorable lovebirds.

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