Crotchety Old Men
by fiona
I just got done giving the weekly autopsy presentation. Every Thursday morning, the resident/student on the autopsy rotation presents one of the interesting cases of the preceding week. This is a one hour presentation that is attented by the pathology staff on service, the dean of the department, various interested doctors and students, and this group of crotchety old white haired men. These guys are retired doctors - and we're talking RETIRED, like 75-80 year olds - who come every week without fail to comment on the cases. Now, these gentlemen are for the most part very nice, and very interested, and clearly they are very smart with a lot of experience. Its kind of awesome that they make their way up here every week.
Anyway. So my presentation. It was an old lady who died after she clotted off her bowel. It contains numerous images of her organs, as well as microscopic pictures, plus facts and research and references - enough to fill pretty much a whole hour. I will say that I have spent the last few days working on it, and yesterday, the day that I wanted to devote to polishing and honing, was spent attending lecture, assisting on two fetal autopsies, and having very long convetsations with the IT guys regarding why my presentation was not opening.
Turns out it had been "corrupted" when I saved it on the "network." Great. Note to self: save multiple copies in as many places you can think of.
So, my presentation. It contained the following joke: "So the internist said that her hypertension, hypercholesteremia, and diabetes were "well controlled" (with two-fingered hand motions) and she hadn't had a cardiac or cerebral event since 2002, so she was deemed to be a LOW RISK SURGICAL CANDIDATE. Famous last words!" Killer.
So anyway, I am doing my presentation. The audience is riveted. I start fielding questions from the crotchety old men. One of our exchanges goes like this: Crotchety old man (COM): "what is that in that artery? Is that a thrombus?" Me: "Well, we didn't think so. Is it a thrombus that formed in vivo, or could it be a clot that formed after death?" (as in, I'm putting it up for discussion). COM: "I ask the questions." I ASK THE QUESTIONS! Who says that? I can't put a question out to my experienced audience during my presentation? Me, with 1 and a half months experience in autopsy, and you with like 70 years? Cool. Asshole.
Anyway. It went fine. It was not corrupted or "fragged" at any point. And most of the COM's thanked me and said I did a nice job. Except for Dr. I Ask The Questions. Who is a big jerk. Maybe he just felt intimidated by my impressive wielding of terms such as "heparin induced thrombocytopenia" and "hepatic extraamedullary hematopoeisis". Ask me a question about that! Jerk.
Posted on January 27, 2005 | Comments (16)
Dead people
by fiona
I am on autopsy rotation right now. It is a very intense and weird experience. Being around dead people. Seeing their faces, their haircuts, their cute little painted toenails, the evidence of them in the world leading lives surrounded by loved ones. This is my second autopsy rotation this year, and what strikes me is actually how much less it affects me now. Seeing a dead person is not shocking or suprsising. I can walk into the autopsy suite and have a casual discussion about weekend plans with someone without even referencing the dead person in the room. I can cut into their flesh without the pangs of emotion, the heavy feeling of "whoa. this is a big deal. i can't believe I'm doing this." It doesn't get to me anymore.
Does that mean I'm dying inside? How ironic- i'm spending all this time with the recently deceased when really I am the one whose soul is dead? Naw, not really.
You just get used to it.
The thing that takes the most work on this rotation is acutally going through the person's chart. You have to piece together their last waking moments through snippets of hastily scribbled medical notes. Quick three-line entries from doctors, residents, respiratory technicians, nutritionists. You try to figure out what was happening inside that person's body - why did it stop working? And its kind of funny, the notes seem to decrease in number as the patient gets closer to death. Those big time lapses in the chart are filled, in reality, with people scrambling around, IV's going in and out, units of blood given, resucitation attempted. Family members notified.
Those are the weird ones to read: "The operative findings are incompatible with survival. Discussed with husband. Comfort care measures initiated." Straight up. Aka, we discussed with the man sitting anxiously in the waiting room the fact that his wife, the one who he has spent everyday of the last 45 years of his life with, is going to die soon and there's nothing that can be done about it besides keeping her sedated until she goes. Discussed with husband.
Dying is intense. It is also very smelly.
Posted on January 23, 2005 | Comments (8)
Look at my new hat!
by fiona
I made it! Yesterday! I says to myself, Fiona, I says, You need a new hat. You need a bright green hat, and it needs to have a brim. Alright, I says, lets do this. So i went to the yarn store, bought the biggest, brightest, greenest yarn I could find, and the next day I just effin' did it. First hat ever. I threw in a pink band and a dainty little bow (on the other side) for good measure. Knitting RULES. I love me my new green brim hat!
Posted on January 18, 2005 | Comments (1)