Always a surprise

This morning started with grand rounds. That's where all the docs sit around and discuss the patients and events of the last 24 hours. There seemed to be an unusually high number of psych patients. I hadn't really thought about mental illness in this population. Towards the end, one of the docs said something about me getting report on the six new inpatients since I was going to be the hospitalist for the duration. This is news to me. My boss had told me we were to be strictly inpatient. This caused a flurry of concern but the dust eventually settled. I rounded on one patient that I really wanted to see. A pediatric admit is right up my alley. I felt quite useful since it was a submandibular abscess and I was able to correct the antibiotics to the correct coverage.

Other small changes kept me busy. One of my nurses got moved to recovery room. She had been working as a nurse practioner but come to find out she doesn't have the correct credentials in the military for that.

The patients are coming in earlier now. Thanks to the radio ads we are busting at the seams. Next thing I know, its lunch at we are working through it. The Cpt and I are doing the bulk of it and we make a rotation for eating. The MREs are starting to get a little old. I like them at first but one can only eat so much peanut butter.

There were some interesting things to see. I had one patient answer me by raising her eyebrows. That means yes. Wrinkling the nose means no. She had an incredible case of frostbite. I've never seen that in person. There are a couple of broken bones. Extremely common place here since they slip on the ice and wreck snow machines. I get to see a few kids. The mothers are giddy when they find out I am a pediatrician. I play with some adorable babies and hand out stickers. Stickers are way cooler here than they are back home. Kids back home are used to them now I guess. They ask for 3 or 4 of them in AR. Here they are happy to have one.

There is an incredible amount of rheumatoid arthritis. There must be something genetic going on. I followed up on one patient that I saw yesterday. I was convinced he had cancer in his stomach. The EGD was negative. His lab came back way too anemic and I also asked the GI docs to transfuse him. I spent awhile talking to his wife again. She has invited me to visit her house and see their sled dogs.

I have discovered that the northern lights can be seen from here. Unfortunately they show around 2AM and you have to go up cemetary hill. I am determined to stay up late enough to see them. One of the travelling nurses has a new Canon SLR camera and I offer to teach her how to use it if she will show me some stuff. They are organizing a sled ride for some of the other docs. There is cool stuff to do and I want to see more than just this hospital.

We finished with patients at 1700. I guess you can finish on time if you work through lunch.