Day off

Wow .. just one single little consult for the entire service today. And since I checked in after one of the residents this morning, he got it and I didn't even have to do it. Now I know what hem/onc service must feel like ;D

I had time for morning report as well as electrolyte conference today. I'm going to miss the latter next month. The attending - or should I say guru - at the head of the table has an extremely calm and wise aura about him as he infers incredible amounts of information from little more than about a dozen lab values and how they develop over time. Actually, the fellows go through the labs, commenting them, and the attending - who never heard about the case before either - asks questions. Questions like (I'm just making these up for illustration, don't even have a clue whether they make sense) "so, what would give you a urine osmolality this high with a TTKG (trans-tubular potassium gradient) of 5 in the setting of severe dehydration?" Or "what's the mechanism of renal failure in severe hypercalcemia with non-gap acidosis?" Uh, well, uhm .. luckily the fellows react similarly often enough, which makes it even more humbling and awesome when this attending kindly and most of all vividly describes (or leads us on the way of finding ourselves) the pathophysiology behind everything.

Yes, you read right. Physiology. This man does care about mere ions and ion channels and enzymes and pathways yet manages to not only integrate all that knowledge into an astoundingly accurate clinical picture of the patient (without history, physical exam or any other information, just part of their labs over one or two weeks!) but he also describes them as entertainingly and plastically as only Americans can. It's like a German professor in pathophysiology crossed with an American teacher.

He's awesome.

If my kidneys ever get sick, I'd rather have this man take a look at my labs for one minute than 10 other docs conferring for hours.

Oh, and I believe I had already mentioned that the pizza is good.