As per popular request, this will be a picture post. You're right, my past posts have been .. shall we say biased towards text. So I took the camera with me on Thursday - and you'll have the questionable pleasure of following me along on that day. There'll be huge gaps in between - that's when I either felt I shouldn't be pointing my camera at people or when I simply forgot to take pictures.
Here we go.
At around 7:30, I got out of bed, which looks somewhat like this.
As anyone who knows me will be aware, my first order of business is switching on my computer - yes, the thing in the middle of the mess on my desk.
After checking my mail in the morning, which usually isn't much given that people in Germany are usually still at work at this time, I visit my beautiful bathroom.
After about 1 minute to shave, 30 seconds for the hair, two minutes for my teeth and 15 minutes for my tie I look somewhat like this.
Notice the camera bag on the right, that baby is coming with me today.Out the door and to the left, we're heading down the corridor
to the stairs
through this door into the laundry room
to find my beautiful bike.
Can you see it? You should know what it looks like by now!Well, I found it and with it, I headed out. Three doors later, which I'm actually not going to show you, we hit this fence.
After having overcome even this obstacle, we go down the driveway,
Make a right onto this little street, glancing at Ratner's across the intersection, (yes! This part of the story is very detailed!)
carefully making sure there's no police cars when I fail to stop at every friggin' stop sign around here before making a left at this intersection.
One left turn later, we go straight ahead across 55th street (the red lights seem to be another suggestion to stop around here, how anyone gets from A to B here is beyond me).
Look at that! There actually was a police car across the street there.We're on Ellis Avenue now, going south - in case you'd like to know so you can follow along on Google Earth. Quite exciting, isn't it.
Here we are, merrily whistling a song while going south on Ellis.
We wave at that nuclear thingy, before pretending to stop at yet another stop sign and making a right turn onto 57th.
After that turn, we find yet another stop sign. By the way, that pedestrian crossing connects Crerar library on the left to the Pritzker med school building on the right. Isn't that interesting.
Next stop sign - let's make a left here. It'd really be shorter to go one more block ahead and then turn left but hey, I'm taking the scenic route for you guys.
We're getting closer .. look to the right.
At the end of this street, right where it says "Adult Emergency", we turn right.
There we are .. "The University of Chicago Hospitals".
Let's make a sharp right in front of the new Duchossois Center
and park our vehicle.
Turn around - and there it is.
Mitchell Hospital. Where I'm going to be for the next 10 hours.
It must have been around 8:30am by now. It was Thursday, which meant Jen would be in clinic all morning. That's not a good thing. By now, we actually had two residents on the service. Interestingly, both were post-call this morning. That means they have spent the night here and courtesy demands they should be let go as quickly as possible, usually until noon.That was semi-good for me, it meant that the residents would get the very first consults this morning and I could go have breakfast.
So I entered the hospital through the lobby
and went on through
to the "T" elevators.
These elevators actually have three cars but sometimes you're just out of luck and they're not coming by any time soon.So I took the stairs
up to the fifth floor.
My first stop as every morning is the residents' workroom.You can actually see the door, it's the first one on the left in the corridor ahead.
This is where I leave my jacket during the day.
But we said breakfast, right? Right! So we leave the workroom and navigate towards A700.
You are going to see parts of the way there, I took a picture whenever there wasn't anyone coming the other way.I went down the D corridor, past the Clinical Research Center (this is a place where they emulate any kinds of conditions they need for patients enrolled in studies. For example, there was "wake at 7:06am" written on one of the doors. I fought the urge to knock on it, heheh). But today, I walked past the CRC in the W corridor
and continued straight ahead - the D corridor is from here on called M corridor. And no, there is absolutely no logic behind the naming of corridors here. The whole complex has been designed to get you lost.
After I made a right at the next intersection - you'd expect to be in a corridor with a different letter. And that's true most of the time - except M (as well as at least C, D and W) is an exception here. I made a right, yet I was still in the M corridor. I'm telling you - if you're there for the first time without a map you will not find anything by yourself. Nothing.Strolling down the M corridor, I saw a familiar face.
After confirming with Borat that there'd still be food for me upstairs I continued on merrily.
A left at this intersection brings us to the A corridor! Hooray!So all we need to do is go two floors up.
And we're here!There's "hot" breakfast on Thursdays, so it's a good idea to be there rather early (as opposed to 10am with morning report).
There's "breakfast pizzas" in here. I'm sure that sounds like a strange idea to some of you - but as you can probably imagine, I can eat anything at any time of day, and I like pizza.
In the back, around the corner, where the "cold" regular breakfast usually is, beverages await.
And there you go, a nice, fresh, warm, cholesterol-binge breakfast to start off a beautiful day.
Sooner or later, I would have to inform Jen that I was here though, so I paged her.
She called back and said - as expected - she didn't have anything for me yet. And actually, one of the residents was up there in A700 with me, so he hadn't been sent out yet either.But this was actually rather normal. The primary teams get around to calling consults only after they're done rounding in the morning. That's usually not until 9:30 or so.
That meant, I had time to check labs and imaging studies on my old patients. So I sat down at one of the computers up there and had a look around in oacis, their clinical data software.
Not too long though, since as expected, Jen chimed in around 9:30.
65 year old female with protein and blood in her urine for over a week. Jen gave me the parts of the story that the resident on the primary team had relayed to her and off I went to 5NE (five-north-east) in the main building.Down the stairs
This time I chose to take the W corridor, so straight ahead past dialysis and the urine room (don't worry .. you'll get to see that later ..)
Back into the D corridor
past the ICUs (there's a different ICU on every floor in the D building, or rather the "Rubloff ICU Tower")
and on towards the Mitchell main building.
We're heading north here and if I make a right turn behind these doors, we will be in 5NE.
An example of what I could have found out about this lady is on the picture below.Naturally, I cannot divulge any information about my actual patients, so the information in that picture is purely fictional and written down by me as an example template. Any resemblance to persons, living or dead, is of course purely coincidental.
Click on the picture to magnify.
I spent about two hours on this consult, including actually talking to the patient, physical exam and acquiring the patient's urine. I spent most of the time rummaging around nurses' and physicians' notes and deciphering handwriting since I was interested in the time course of this lady's surgery, hematuria, foley placement and antibiotic administration - which of course had to be reconstructed from clues hidden around the chart.So around 11:30am, I went on my way all the way back to the W corridor (I'll spare you the way there this time) and entered the urine room.
Ta-daaa!
Yucky, isn't it.Before I could dip the urine and spin it down, the pager went off again.
Jen again. Uh-oh.
Next consult. Patient with questionable altered mental status. Oh, and she doesn't speak English, only Spanish. Yay.Jen also told me that we'd try to get together to round around 2pm.
After I was done dipping the urine
and looking at the sediment, it was almost noon.I decided that I'd have lunch despite the consult and went up to A700. And at the prospect of food I actually forgot to take any pictures of it. Sorry. It was good though. About 15 minutes later, I went to see that other patient.
While I was starting to look if I could find anything that would correlate severe iron overload with renal failure, I was interrupted by the pager again.
OK fine, no looking things up yet again.Jen wanted to meet soon, so I had to go spin down this patient's urine now.
After all three of us (residents were at home by now) had looked at today's urines, we unanimously decided to sit down in the nephrology conference room to discuss the new patients.
This is the conference room with Jen and the attending trying to find the stuff they'd need to make coffee.
After that, there's not much more to show. After Jen and I had presented our patients to the attending, we went on to see them all (6 today, three seen by the two residents, two by me and one Jen managed after clinic) plus the old ones. When they offered for me to leave at around six, they were not done rounding yet.I got some bad news from Trillian, so I went home quickly to talk to her.
I needed water (still not convinced to drink the tap water here that has so much chlorine that showering reminds me of a swimming pool), so I went grocery shopping afterwards and brought back another two gallons. They last for about three days, at least my fluid intake seems to be good enough.
Anyway, that was my day, hope you had enough pictures to last you a while. Next post will contain pictures as well, though.
Blog to you later.
