Last Day at PGH

We started out our last day....late.  We strolled into the ED around 9am.  We saw a few patients, but it was really slow, as Monday's tend to be.  We put in some IVs and NG tubes - I hate that I'm just NOW "getting" how it all works there, and then we leave.  Shannon was an IV pro even on old man rolling veins.  I put an NG tube into a guy, I only knew his name.  When a BUNCH of blood started pouring out I totally freaked.  I asked the resident about his history and he had liver disease - I had just ruptured one of his esophageal varices.  Nearly sweating, I was worried that now he'd bleed out and I'd have killed my 5th person in a few days.....but the resident said "I expected a lot of blood, now we know it's an upper GI bleed and not a lower one."  Well....the next time you know something important like that how about you let ME know too!! Needless to say, the guy did NOT bleed out so no harm done.

We left for lunch around 11:30.  We opted to get dressed up (like going to a funeral) for our presentation at 12:30.  Our presentation was about Thyroid Storm - a literal 1:1,000,000 event in the US and a daily occurrence at PGH.  The consultants went pretty easy on us and it was over pretty soon.  The next girl was not so lucky - she got pretty much grilled on her presentation.  The thing is, the stuff they nit-pick over is stuff like protocol, procedures, not following rules.  They can't really grill the residents on things like not having supplies, not ventilating someone because there is no mask, not seeing someone for 30 minutes who has an emergent problem.  These things are beyond the control of the residents.  We wonder what it would be like to present one of those cases at a Froedtert M&M. (M&M means Morbidity and Mortality - you give a talk on a patient who had a bad outcome and supposedly learn what to never do again.)

After our presentation we left and just chilled for a few hours.  I washed my clothes in the sink - my quarter eating washer and dryer is looking pretty good right now.  Then we got dressed to meet with an esteemed Pediatric Geneticist, Dr. Padilla.  She had us come to PGH and provided us with an early dinner of Filipino fried delicacies and pancit. (Pancit is a term for a noodle dish, this one had seafood and eggs, pretty tasty.)  Then she talked to us about how she's struggling to get Philippino health care to a more developed state.  The obstacles are numerous, as I'm sure you've figured out by now.  She says that over 60% of babies are delivered at home, so there is no way to enforce getting newborn testing done.  She's now working on training Midwives to go out into the provinces and spread the news.  She's hoping to increase newborn testing for things like PKU, Maple Syrup Urine Disease and other congenital problems.  She's a pretty incredible woman and sounds like she has her hands stirring many pots. 

Afterward I went to the Mall (a daily occurrence here) and bought some treats for us.  I gave some cupcakes to the two homeless kids that we pass by every night.  Sad.  Imagine occupying a 1 year old on a 2ft square cardboard mat with hundreds of people walking past and cars and motorcycles just a few feet away.  Awful.  So at least the cupcakes gave them something to do for a little while.

Went to bed and started counting down.  Bry is currently flying somewhere over Alaska or Russia.  He'll be here in less than 12 hours!  Can't wait.