Half way point

Last week went well. I observed some hustle and bustle around a patient with acute MI, but honestly other than that nothing too exciting. A metal worker came in and I tested him for corneal abrasion (yup). I sutured a lacerated ear by myself. I splinted a fractured hand. I listened to this crazy woman who said she was a nurse, tell me that she hoped her abdominal pain meant she was pregnant (let's hope not).

Something interesting that happened was that I diagnosed a patient with pneumonia after doing my history and exam and after seeing their x-rays, and my supervising PA and Doc both disagreed with me saying that it was simply viral flu. Lo and behold the report that had come back the next morning, "XXX DISCREPANCY XXX: PERIHILAR INFILTRATE FOUND" (meaning yes, pneumonia). What was cool was that the PA showed the report to me, I was proud of myself and my developing clinical sense. Then later on in the shift (around 3 am), we got a patient who had eaten some bad fish and whose temp had spiked to 100.1 and then gone down to normal. I told him that he had a simple case of food poisoning, that there are only a few organisms that we would really need to worry about and that if it was one of those he would probably still have a fever. I started him on fluids since he had endured some bad diarrhea (which had also subsided), and recommended that he go home and rest but to return if there were any other complications. Again, both the supervising PA and Doc told me that no way did food poisoning ever present with fever. So I went and got one of my big books that I lug in every day, and showed them that indeed it can.

As proud as I felt on both these occasions, I'm smart enough to know that I could just as easily be sitting on their side of the fence. As I have stated before, mutual discussion can sometimes be a really valuable learning tool ... we can't know everything, no matter who we are, and one of the most important things we can do is to always keep an open mind so that we continue learning at an optimum level. May I remember those words the next time my ego gets in my way!