Saturday, June 14, 2008

muppet murder

Yesterday Aubrey and I drove to the outlet mall to look for a few birthday gifts for her boyfriend Kyle. Along the highway stood a billboard that displayed a massive head of Elmo perfectly perched to glare at those who passed by. I turned to her and said,

Me: You know, Elmo creeps me out a little.

Aubrey: Me too... I used to watch Sesame Street when he wasn't as popular. It was more Big Bird, and Oscar the Grouch, and Bert and Ernie when they still had Bert.

Me: What? They got rid of Bert?

Aubrey: Yeah, a few years ago. Since some people complained about the two living together. they thought it implied a gay relationship. you know how everything has to be p.c. these days...

Me: So they killed off a muppet?

After hearing the news, I felt sad for the loss of Bert. Out of all the characters, he's the only one I know that had my laugh and a shared fondness for paper clips. I wanted to do something to show my love for him and the thing I came up with was to say a few words.

Eulogy for Bert:

Bert, I loved everything about you from your boring persona to your unibrow. Your sense of fashion said it all. You reminded me of a guy I used to date, and I'll never forget that. The times I remember best were when you learned how to fish by yelling and when you chatted on a banana. Most of all, you helped me through the rough times of 2nd grade, teaching me that I am special just as I am.

Wednesday, June 11, 2008

decreasing the surplus population one hypothetical patient at a time

I've been taking a Foundations of Clinical Medicine class for the past few weeks, and to understand my story I should give some background info. Each week of FCM is like a mini rotation in preparation for the ones that I'll have this next year. So the first week was Ob/Gyn week, the second Psych week, last week was Peds week, and this week is Medicine week. During each section I've been assigned a different patient with a correlating disease for that field of medicine. I should note that these are standardized patients, a.k.a. actors who play up an illness. You gotta love those safety nets.

So this week I've been working with nine of my classmates on a case of a 54 y/o female with a history of significant alcohol use and Hepatitis B. Colby (one of my teammates) and I performed a complete history and physical on her, and of course her chief complaint was "I just don't feel right" x 1 month. nice. That's like going into the auto shop and saying "Um, there's something wrong with my car. not sure just what, but I can sense it. can you fix that? by tomorrow? grrreat." We got little from talking with her, aside from the fact that the day before she drank "half a fifth" and that multiple times a week she drinks before noon. In fact, when Colby asked if she drank to pass out, her exact words were "Yeah, on Fridays... and Wednesdays" and I chimed in "And Saturdays?" Yup. And Tuesdays, and Thursdays... She's a pro.

Her physical exam revealed acute liver failure. she's got severe jaundice, ascites, caput medusa due to portal hypertension. In other words, her liver has completely crapped out. If ever you are in a poker game where you find yourself betting organs, don't go for the liver. it's important.

Today she's now showing extensive signs of hepatic encephalopathy, which means that toxins are backing up in her blood and going to her brain since the liver can't process them properly. and she has an increasing fever which is difficult to treat since a LOT of drugs are metabolized in the liver. NOT GOOD. this is like One Foot In The Grave sort of news.

update: she's alive! our group rocked the house at treating her, and she pulled through. i knew there had to be a happy ending... after all, it's make believe.

Saturday, June 07, 2008

Monday, June 02, 2008

Good ol' San Antonio

The PA national conference was this past weekend, and OMG I forgot how hot Texas is. Before my visit, I considered moving back (possibly Austin), and though I haven't thrown it completely out, I now am looking for a place that doesn't immediately melt my face when I step outside. Seriously, it was like walking through a Dali painting.

I went down with a few classmates and before we arrived I of course couldn't resist talking up Texas. Come on, It's Texas! With Big Tex at the state fair, big drinks of Diet Dr. Pepper, big people. So when we arrived, the manager at the front desk was very cordial and gave us a room with a "river view." Awesome, I thought since the last time I was there as a kid I remembered how cool I thought the river was. We get in the room and I walked over to the window and opened the drapes to find this ity bity trickle of water.

Julia sidles up beside me and says, "That's it?!?"

Me: "Yup."

Julia: "That a creek!"

Me: "Yup. Isn't it awesome..."

As luck would have it, Lark, an old roommate of mine who is originally from the east coast, moved to San Antonio awhile ago and we got together. It was good to see her and meet her very nice boyfriend and tour her new home (she has a home!!).