Providence just before sunrise
Ho Ho Ho's friends,
now here in Providence, the cold broke. With days to
chill minus 10 degrees and the snow, winter is often 10cm definitely there. I am now in my second week children Endokinologie "and hit me with small children or teenagers and their cheeky diabetes around.
If it's cold, what game you should not miss -? Brown Icehockey !
I was with Maren and Meike in Brown vs. . Cornell Game. Despite an exciting game we have lost. The mood was definitely not to blame!
now here in Providence, the cold broke. With days to
chill minus 10 degrees and the snow, winter is often 10cm definitely there. I am now in my second week children Endokinologie "and hit me with small children or teenagers and their cheeky diabetes around. If it's cold, what game you should not miss -? Brown Icehockey !
I was with Maren and Meike in Brown vs. . Cornell Game. Despite an exciting game we have lost. The mood was definitely not to blame!
Now to my second Emergency Medicine Report: [...]
Another layer I spent in children in the ER HASBRO-Kinderklinik. Eine komplett andere Art zu arbeiten, was aber auch super Spass machte. So hatte ich sehr viele 
"Schweinegrippefälle", aber auch ernsthaftere Erkrankungen bei Patienten der ersten Lebenswochen bis zu 18 jährigen. Auch hier konnte ich vieles selber machen und durfte bei einem 17 Wochen alten Baby eine Lumbalpunktion (mit einer Nadel in den Rückenmarksraum um Gehirn -und Rückenmarksflüßigkeit zu erhalten) durchführen.
Meist aber sind nicht die kleinen Patienten das Problem, sondern die Eltern, die man "mit behandeln" muss :-). Und es ist nicht immer so, dass ein George Clooney als ER-Kinderarzt mal schnell noch ein Kind 3 min vor der nächsten Werbepause rettet...
Was mir im Allgemeinen sowieso vermehrt aufgefallen ist, dass Patienten durch die verschiedenen Ärzteserien ein ganz falsches Bild von den Ärzten und Krankenhauesern bekommen, denn der Alltag sieht nicht immer so rosig aus und der Patient kann oft nicht am nächsten Tag wieder das Krankenhaus verlassen kann.
"Schweinegrippefälle", aber auch ernsthaftere Erkrankungen bei Patienten der ersten Lebenswochen bis zu 18 jährigen. Auch hier konnte ich vieles selber machen und durfte bei einem 17 Wochen alten Baby eine Lumbalpunktion (mit einer Nadel in den Rückenmarksraum um Gehirn -und Rückenmarksflüßigkeit zu erhalten) durchführen. Meist aber sind nicht die kleinen Patienten das Problem, sondern die Eltern, die man "mit behandeln" muss :-). Und es ist nicht immer so, dass ein George Clooney als ER-Kinderarzt mal schnell noch ein Kind 3 min vor der nächsten Werbepause rettet...
Was mir im Allgemeinen sowieso vermehrt aufgefallen ist, dass Patienten durch die verschiedenen Ärzteserien ein ganz falsches Bild von den Ärzten und Krankenhauesern bekommen, denn der Alltag sieht nicht immer so rosig aus und der Patient kann oft nicht am nächsten Tag wieder das Krankenhaus verlassen kann.
Einer meiner Schichten verbrachte ich im Rettungswagen , was wichtig war mal miterlebt zu haben, denn bisher habe ich Patienten erst im ER gesehen und war nie am Ort des Geschehens. Ich war der Wache 3 der Eastside Providence zugeteilt. Meine erste Blaulicht Fahrt :-)
In Amerika und fast ganz Europa (außer Deutschland) the paramedics have much more responsibility and freedom of action: They may also be administered as adrenaline and other drugs. We had had a variety of trips from chest or back pain, falls or simple "cold". It is unbelievable how so many people, the "911- system " "abuse" (in 112-D system). We had a 27 year old patient with a sore throat and mild fever without insurance, who called the ambulance because it is cheaper than a taxi in the end, because in this case, the hospital pays about $ 500 for the expensive trip. And the bad thing is that you often can not distinguish from serious illnesses and often with a false sense arrives on site. The day was definitely very helpful and interesting to get an idea of the sequence before to have the Krankenhausankuft.
had in my last week, I see layers Miriam Hospital , a smaller Jewish teaching hospital of Brown Medical School in Providence (it was the writer of the TV series " Scrubs " a doctor, and Miriam just like the series and also has some characters there, like the hospitals chief Bob Celco :-)) -!> No joke!
Here come through the less serious injuries, but the patient often with serious medical problems. The Last is day of my electives in the Miriam Hospital but I be remembered , more specifically, the last 10 minutes of my shift. It was a very min overweight 52 year old patient with cardiac arrest in 30 (ie, from the beginning, little hope) and do many pre-existing conditions in the emergency room. That day I had one of the best Attending my 4 weeks, Dr. Lauro. He has me so well as can do everything, of course under supervision. Despite all efforts, our patient unfortunately died after 30 min resuscitation. What I said Dr. Lauro but then, I will probably not forget. He showed me how the members of one of the worst deliver messages should. Two things are particularly important: the moment at which one conveys the message will never forget the families and therefore you should dressing as possible before the interview (coat and shirt). The other important point is that you should respond directly and not the death of phrases such as "ascended to heaven" or "she passed away" is used. So I brought Dr. Lauro and the sad news that I was not even allowed to cold.
In Amerika und fast ganz Europa (außer Deutschland) the paramedics have much more responsibility and freedom of action: They may also be administered as adrenaline and other drugs. We had had a variety of trips from chest or back pain, falls or simple "cold". It is unbelievable how so many people, the "911- system " "abuse" (in 112-D system). We had a 27 year old patient with a sore throat and mild fever without insurance, who called the ambulance because it is cheaper than a taxi in the end, because in this case, the hospital pays about $ 500 for the expensive trip. And the bad thing is that you often can not distinguish from serious illnesses and often with a false sense arrives on site. The day was definitely very helpful and interesting to get an idea of the sequence before to have the Krankenhausankuft.
had in my last week, I see layers Miriam Hospital , a smaller Jewish teaching hospital of Brown Medical School in Providence (it was the writer of the TV series " Scrubs " a doctor, and Miriam just like the series and also has some characters there, like the hospitals chief Bob Celco :-)) -!> No joke!
Here come through the less serious injuries, but the patient often with serious medical problems. The Last is day of my electives in the Miriam Hospital but I be remembered , more specifically, the last 10 minutes of my shift. It was a very min overweight 52 year old patient with cardiac arrest in 30 (ie, from the beginning, little hope) and do many pre-existing conditions in the emergency room. That day I had one of the best Attending my 4 weeks, Dr. Lauro. He has me so well as can do everything, of course under supervision. Despite all efforts, our patient unfortunately died after 30 min resuscitation. What I said Dr. Lauro but then, I will probably not forget. He showed me how the members of one of the worst deliver messages should. Two things are particularly important: the moment at which one conveys the message will never forget the families and therefore you should dressing as possible before the interview (coat and shirt). The other important point is that you should respond directly and not the death of phrases such as "ascended to heaven" or "she passed away" is used. So I brought Dr. Lauro and the sad news that I was not even allowed to cold.
Emergency doctors work in contrast to many other disciplines through a layer without a break, but are then replaced by the next shift and then have free. It has no Stadium work or operations such as orthopedic surgeons in the emergency room clear D. Yes, you must create often at weekends and overnight, but so far I still love the night shift (but have no family, too ...). In addition, there is another big advantage: the characters of the doctors in the Emergency Department : All are fun on it and have a Arts ! The doctors do sports, have fun and family and do something together outside of work! Something like this is, for example in internal medicine often, because often they are there more and less focused on team work out (hopefully not soon comes to suspect that I am the interior nicht mag: Nein!!! Ich bin ein großer Innere Med Fan, aber habe jetzt in meiner Zeit hier ein wenig Vergleichen koennen!!). Das Beste war immer, dass viele meiner Attendings und Residence wöchentlich vor oder nach einer Schicht mal kurz zum Wellenreiten sind.
Am letzten Tag musste ich dann vor gesammelter Ärzteschaft eine Präsentation über einen besonderen Fall halten und dann über diese Erkrankung reden. Also ein Fall mit typischen Symptomen, aber einer untypischen Erkrankung oder anders herum. Ich hatte das Glück einen Patienten mit Myxödema Koma (lebensgefährliche sehr seltene Komplikation einer Schilddrüsenunterfunktion) präsentieren zu dürfen. Und da ich es Liebe vor Leuten zu sprechen, und Glück mit dem Fall hatte, war es eine erfolgreiche Präsentation.
Schade, dass die 4 Wochen so schnell vergangen sind. Ich hab unglaublich viel gelernt und viele nette Ärzte getroffen. Ich glaube kaum, dass ich in einem anderen Elective freiwillig Überstunden machen würde. Jetzt kommt nur die Frage auf "was mache ich nach meinem Studium?!" Ich wusste schon vor der Grundschule, dass ich Arzt werden will (damals noch mit dem Traum Kinderarzt und Hausarzt). Doch jetzt stehe ich hier, sehe viele interessante Fächer (und auch einige Fächer, die ich nie machen würde), jedoch für was ich mich am Ende entscheiden soll, I do not know. Many sites I like, but it's missing the last decisive kick. He has only convinced me so far right. It was ever since the idea to start my residency in the U.S., but I'll probably make less. Determined since three months, I'm wondering about a daily basis. For a few weeks I'm going more and more certain, but perhaps this later ...
On Sunday evening lands Bärbel finally in Boston and I have for their short time here a lot planned, including New York, Boston and many things in Providence. 'm Looking incredible (after 4 months which is enforceable even think to). I've fortunately one weeks from tomorrow Christmas holiday.
soon and beautiful Christmas,
Biro
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