Tales from the Residency Dark Side

I had my first complaint this week. Or at least I think it was for me. And I don't think it was deserved.

I saw a patient the other day, something like a 29 year old female complaining of chest discomfort, squeezing in character associated with shortness of breath. I saw her a bit later in the afternoon and came into the OPD with an ECG in hand.

Nada, sinus rhythm, non specific ST and T wave changes (for lay speak, perfectly ok).

During the interview, I found out she has had this complaint fairly recently, she recently took the bar and was awaiting the results, and the night prior, she got into an argument with his brother.

No history of heart disease, high blood pressure, diabetes, and the like.

I pretty much came up with an anxiety reaction or a hyperventilation syndrome.

Sure, sure, it still could have been something more severe like a heart attack and the like but practicing here in the Philippines have forced doctors to sharpen their clinical skills and all the years of internships (though not much yet) told me that this was nothing like that. I could never, in my right mind, order for stress testing, angiograms or even cardiac enzymes for a clinical setting like that.

So I proceeded into what was like a 15-minute discussion of her symptoms, explained that her ECG was ok, and advised her to come back should she have any further problems.

I asked her if she had any questions, and she told me she was fine.

The next morning, while at the ER, the nurse received a call from the insurance coordinator relaying a complaint that someone consulting for chest pain the day before was not properly diagnosed.

I was pretty certain it was her.

Everybody can't be pleased. Would she have rather welcomed the news that she had coronary blockage rather than an acute stress reaction? And after spending the time I did to explain to her and her boyfriend, the nature of her reaction, I get that?

But I'll take that, 1 undeserved complaint in 4 months from a well-attended patient, that's a pretty good rate, I'd say.

Or maybe some people just have a funny way of saying thanks.

Small Blessings

I think we've all received this text message:

Little birdie in the sky
Dropped a poopoo in my eye
then something like
I thank the Lord, that cows don't fly.

You get the message, right?

I couldn't help but remember this message as residency life goes on for me (gasp, going 4 months of Internal Medicine, who would have thunk it?).

I went on rounds with one of my consultants the other day and came to a really well-off patient in the suite room on my floor. While doing the usual check-up -- BP, physical examination, pulse rate, a random scan of the labs and ECG -- the usual chit chat came to discuss his many medical problems and previous hospitalizations. He had Coronary Artery Disease (fancy medical term for heart blood vessel blockage), hypertension, Diabetes Mellitus and had underwent bypass grafting, percutaneous transluminal angioplasty, and a pacemaker insertion all in the last 8 years.

He casually chuckled and said that he had too many problems and it was all because of how old he was.

My consultant shared a laugh and said, "Well, you have lived a full life."

My patient said, "Well, you know, life is like money, you can never have enough of it."

There it was, the lesson for the day.

Well, this statement was coming from a guy who owned companies (plural) and had loads of money, but he longed for more days to his life as well. It helps that you have money to spend during those additional days too, but what caught me was how simple a thought it all boiled down to: You can never have enough of life.

Then I was brought back to how I measured my own life -- the sleepless nights, the endless reports and assignments, the proddings from our superiors, the way we drag ourselves out of bed EVERY morning -- and stopped.

I realized, I didn't have to look at it that way. I'll try my darndest to look at the small blessings -- the extra hour of sleep I get for finishing work early, sharing a cup of coffee, studying with the beautiful woman reading William's Obstetrics across from me, helping people get well, the mystery and allure of diagnosis that got me into IM in the first place -- the small blessings.

It's true, you can never get enough of life. One would want to suck it's marrow for how many days we are given. But the funny thing about it is that we don't have that expiration date stamped across our foreheads, so even though how much likening the need for life to money, it isn't measured with the latter, it's measured in blessings -- the blessings of how we lived it.

So thank God for the small blessings.

Thank you for yet another day.

Off to do rounds again.

Tinseltown Gets Scrubbed Out

Ahh, don't you just love the movies?

I know I do.

From my earliest recollection of going to the movies with my family, and the Betamax tapes stacked up in the corner of our bedroom when I was a kid, to the new-fangled special-effects laden movies and pirated torrents of today, I've always seen the imagination and cinema of movies as my refuge from reality along with books.

That is why I love the movies.

To narrow down 10 of the top movies of all time would be, difficult, in every sense of the word. I've seen too many movies, and loved most of them, hated some, laughed with and cried from, and each of them cleaves a place for itself in my wildly imaginative psyche.

But, like most of those submitting entries for this TBR, one has to try. And so Scrubbed Out's Top 10 movies are:

10. The American President - I happen to have the biggest crush on Annette Bening, but, I love this movie because it gives us a glimpse of how love works, even for the most powerful man in the world and it's just funny seeing a president find time to date.

9. Indiana Jones / The Goonies - Hidden treasure, adventures, and good times with good friends. What's not to love? I used to imagine myself riding a horse with a Fedora on my head and using my whip to swing over a crevasse of snakes and alligators, and finding a hidden pirate ship with loads of gold bullions and jewels beneath our house. Now, I don't think of those things as often as before, but the thoughts do cross my mind. I wonder what's under my apartment? Hmmm.

8. The Count of Monte Cristo - Betrayal, revenge, intrigue. So much weaved into the storyline and I loved how Jim Caviezel played Edmund Dantes in this movie --cool and calculating. Don't you just love it when the good guy who goes through heck get his due in the end?

7. A Knight's Tale - For the witty dialogue and the rags to riches story of a squire-turned-knight. It's a perfect blend of comedy, action, drama, romance and good music. I like how seamless the movie transitioned into modern and medieval times with great and fun performances from the late Heath Ledger as William. See ending line of #8.

6. E.T. - A score for imagination. Who doesn't love what ET brought to our world? I mean, aside from Drew Barrymore.

5. Braveheart - I loved this movie so much the first time I saw it that I was trying to speak Irish for a week. But I eventually gave up, but watched the movie again, and again, and again.

4. Shakespeare In Love - Yes, this movie stars Gwyneth Paltrow, but I don't like her as much as Annette Bening, haha. I think the movie is beautifully made and rightfully won the Oscar for that year.

3. Love, Actually - Great great movie. And well, this movie holds more meaning than just the actual movie for me. But several love stories being told, intertwined beautifully into one story involving among other people, the Prime Minister of England, his secretary, two porn stars, divorcees, a widower and his housemaid, in a story you just have to see to love. Oh Keira Knightley is in this movie too! Hahaha.

2. Mr Holland's Opus - I love music -- and music with movies are a plus. Here Richard Dreyfuss plays a music teacher who has, as a goal in life, to compose the perfect symphony, and keeps putting it off to teach and make an impact on the lives of his students. He is a music teacher with a deaf son and goes to war against the educational system that cuts art programs in school. He ends up retiring without his symphony but realizes that his each student became the notes of his real legacy and in the end, a fitting tribute as his students render him his completed masterpiece.

1. Hook - You have to love Spielberg's imagination in this movie. That Peter Pan grows up and goes back to Neverland and to save his kids, he has to find that Peter Pan again. Now why couldn't I think of a storyline like that? More than just the story, the fun, and the general makeup of the movie, this is the last movie that I can recall that I watched with my mom, dad, brother and sister at the local movie house in Dumaguete. And THAT is why it tops my list.

Honorable mentions are the sports movies I love to watch: Tin Cup, The Mighty Ducks, Major League, The Replacements, Rad and all those wacky, funny, inspiring, heartbreaking sports movies, I can't get enough of them from.

I'm sure I've left out some movie I love somewhere, but as of now this is the top 10 list I'm going with.

Oooh, Underworld is coming up...