Can I get your number? And an STD screen?

ALEX

Michelle, I hate psych residents.

ME

Take it back! You love me!

ALEX

Haha, you're the exception. But, okay, fine, I just hate the psych ER in general.

ME

Rough patients?

ALEX

Yeah, this 23 year old girl flipped out on me today.

ME

Oh.

ALEX

Actually, saying that out loud -- that basically sums up my life!

ME

Haha, so really, it was just another day in the life of Dr. Alex.

ALEX

Exactly, except this girl was a crack addict and had herpes and chlamydia...oh wait, still no difference.

ME

So this wasn't a patient at all, was it? Alex, you really ought to screen your dates better.

Why I need to read Perez Hilton at work

Confession: I reference pop culture all the time when I'm talking to my patients.

The one I use most often is Lindsay Lohan and her alcohol addiction.

The second-most common one is Britney Spears, especially when I need to talk about conservatorship. "You remember when Britney Spears shaved her head?" "Oh yeah, she was a trainwreck!" "And have you heard about her in the news recently?" "No, well, yeah -- they're doing some MTV tribute to her...they were talking about it on that talk show--" "I mean, have you heard anything negative about her recently?" "Hm, no, I guess not." "Well, that's because she's conserved. And that's what we want to do for you..."

I had a patient who agreed that her life was kinda spiraling out of control - Britney Spears style - and she probably needed someone to keep an extra eye on her. So we went to court to get her conserved and set up with a public guardian.

But there's a lot of waiting involved with court. We had to sit through current conservatorships that were getting renewed, asking the court for specific resources (bicycles, tennis shoes, shopping carts, etc), and then we had to sit through conservatorship terminations.

---

LAWYER

We would like to end this conservatorship because the conservatee is no longer with us.

JUDGE

What happened?

LAWYER

She died, Your Honor. The conservatee was placed at a nursing home two weeks after conservatorship was started --

JUDGE

Oh, I remember her. She had a diagnosis of Stage IV skin cancer. Is that why she passed?

LAWYER

Unfortunately, she choked on her dinner and was unable to be revived.
---

Over in the audience gallery, my patient turned to me and looked at me in absolute horror.

PATIENT

Dr. Wu! I don't want to be under conservatorship! I don't want to die!!

ME

Don't worry, you won't die. We'll make sure you go to a good facility. But to be on the safe side, just make sure you chew your food carefully.

My adventures on night float, night 7

I wasn't prepared for an emergency. I mean, during my entire week of night float, the craziest thing I had to do was disimpact a pregnant lady and ward off the gays who then all claimed that they too had abdominal pain and hadn't pooed in days. (Insert obligatory "full of shit" joke here.)

So on my last night, I was sitting in the resident library, waiting for sign out, and embarrassingly reading about the Kim Kardashian wedding. And then, one of my fellow residents walked in, "Hey, um, do you think you can come help with this patient? There's something wrong."

I jumped up and went with him to the unit, where pandemonium was everywhere. Nurses were furiously clicking on computers, someone was tasked with calling 911 but kept getting the sheriff's office, people who should have been watching their suicidal patients were milling about the nurses' station instead, and no one could tell me where the patient was. After finally getting the proper room number, I walked over, and saw five different doctors and nurses simultaneously assessing the patient all at the same time.

I honestly didn't know what my place was. There was an attending, but she seemed overwhelmed, the charge nurse was trying to put the patient into restraints, and my fellow resident was checking pulses but couldn't find any. And all the time, the patient just laid there, completely unresponsive. I don't know what came over me, but my Northwestern training clicked into place, and I started barking out orders.

Someone call 911 for immediate transfer to a medical center.
Someone tell me his one-liner. What's his name, age, diagnosis?
Take those restraints off.
Did someone do vitals? You, go get me the vitals machine.
Unless you're directly involved with this patient's care, please leave the room and wait outside.
Someone tell me what meds he had today, and if there were any recent changes.
Call phlebotomy; I want a stat blood draw.
Charge nurse, what was he doing prior to this happening?
How long has he been like this?

And all the time, I was going through the head to toe physical exam checklist. Thank you Northwestern for tediously testing our physical exam skills five times a year. I can now do this in my sleep. Sternal rub. Checking for posturing. Checking pupils. Checking his mouth. Checking his pulses. Checking his heart. Checking his lungs. Checking for urinary and bowel incontinence. Checking reflexes. So on and so forth.

I was surprised at how outwardly calm and cool I seemed. Especially since I knew my mind was racing, my heart was pounding, and I was thinking a colorful rainbow of curses, as I tried to figure out how to best take care of this patient with my rather limited County resources.

Before I knew it, the paramedics were there, and as we rolled the patient towards the hospital exit, I told them all that I knew, and my best guess diagnosis (seizure). And halfway towards the ambulance, the patient started coming out of it.

And just as I was finishing the transfer note, my pager went off. Five new admissions would be hitting the floor in about 30 minutes. Fabulous. Just enough time to eat dinner.

My adventures on night float, night 6

Our call room is musky and malodorous.

Even though housekeeping cleans it every day, vacuums the floors, wipes down all the surfaces, and provides us with new sheets and blankets, something about the room just makes it feel dirty. All the time. You start itching if you spend more than thirty seconds in there, I swear.

It smells like body odor mixed with essence of skunk meets teenage boy basketball shorts. In summary, it smells. It smells absolutely nasty.

Since the dawn of time, none of the residents have ever slept in that call room. Besides, the call room doesn't have a computer, doesn't have a TV, doesn't even have a pillow. So we sleep in the residents' library instead. Because there's a giant comfy couch in there, computers galore, a TV and DVD player, and Season Three of The O.C. It really doesn't get much better than Misha Barton and Adam Brody. I mean, how can it, right? Look at them! And their snarky commentary about their overly dramatic teenage lives!

Granted, some of us don't sleep in the call room because some of us don't know where the call room actually is. [Side story: I was trying to get into my call room for a good fifteen minutes, wondering why my key wouldn't work, before my attending finally opened the door and asked me if I was at HIS call room because there was a patient to staff. Luckily there was, otherwise I would have had to pretend that I'm a sleepwalker or something. Seriously, so embarrassing.]

Anyhow, normally we sleep on this giant red couch in the library. But on the first night of night float, I came in, and on my would-be bed, there was a note instead:

So after trying to sleep on the table, or in a cubicle, I finally fashioned a bed out of chairs, and this is what I slept on for a good three days:

It wasn't the most comfortable, and I definitely fell on my butt one night when the chair rolled away and my body kerplunked onto the floor, but on night float, you start to take what you can get. And well, if five chairs was the only way I'd be able to sleep without waking up to bug bites all over, five chairs it would be.

My adventures on night float, night 5

I love food.

Big fan.

In fact, that's a major reason why I ended up choosing USC. We have a fabulous meal plan. Ten dollars a meal, three meals a day. And the cafeteria food isn't bad. It's not bad at all.

And so, my attending wanted to make sure I was getting fed while I was on night float and he brought me a little sack dinner, prepared just for me by the executive chef at our hospital.

This is what was inside:

Apple juice, a pear, and mystery fruit submerged in orange jello as my main entree. So appetizing, no?

(The answer is no.)

My adventures on night float, night 4

My attending told me to call him if I had any problems.

Problem: he gave me my own call room number to call.

My adventures on night float, night 3

I have a patient who legally changed her name to Tupac Shakur.

Seriously.

Except she's nothing at all like Tupac. She's teeny tiny, doesn't know anything about rapping, and she's definitely not from the hood. And her voice sounds like a five year old child's. As mean as it may be, she seriously sounds like Little Orphan Annie when she speaks.

TUPAC

Doctor! I have chest pain!

ME

That's not good. Where does it hurt?

TUPAC

In my leg!!

ME

Does it hurt in your chest?

TUPAC

No! Just my leg!

ME

Errr, so do you have chest pain??

TUPAC

Yeah! And the only thing that can make me feel better is some juice and a cigarette!

ME

Well, I can't give you a cigarette, but I can get you some juice.

[thirty seconds after finishing the juice]

TUPAC

Thanks doctor! My chest pain is all gone now!

It's the newest regimen for chest pain, my friends. Forget the morphine, oxygen, nitro, aspirin. All you really need is a good juice box. What can I say? I'm a miracle worker.

My adventures on night float, night 2

My patient pointed to his feet. "See? I told you! Behold the miracle!"

He thinks he's Jesus Christ. And so he told the nurses he was going to take a shower, but flooded the hallways instead.

Just so he could prove that he could walk on 2mm of water.

---
*Note: this patient is not to be confused with my other Jesus patient. Yes, this is a completely different patient. In fact, I actually have three different patients who believe they are Jesus. I wonder what would happen if I put them all in the same room. Would they form the Holy Trinity?

My adventures on night float, night 1

Getting paged in no big deal in psychiatry. Our patients aren't acutely sick and well, minus the occasional psychotic person lashing out and needing a few IM medications to calm them down, there's really not much to do. So typically when my pager goes off, it's to reassure the nurse that having a systolic blood pressure of 125 is okay and the patient is most likely not stroking out, or that yes, the patient is allowed to eat food that friends and family might have brought in for them, or of course, I'll be right there to sign the order to renew restraints that  won't expire for another three hours.

But yesterday, I got the strangest page in the world. Usually, the charge nurse will give me a brief heads up or a quick cliff notes version of events so that I know what I'm walking into, which is always a good idea if you don't want psychotic or manic patients charging at you for not believing that they're Jesus Christ. But this time around, the nurse just frantically asked me to come - come quickly - to her unit.

I ran.

Turns out a female patient, manic and hyper-sexual, had gone to the nurse to ask for one of her as-needed medications to calm her anxiety. The nurse was surprised; this was one patient who never wanted meds, but went to go get the Ativan. When the nurse came back, the patient was nowhere to be found. She looked in the group therapy room. Looked in her roommate's room. Looked in the dining room. Nothing.

Then they heard loud moans coming from the male dormitory side.

Yes.

Really.

It's just what you think.

The female patient had taken that short amount of time to sneak over to the guys side, find one willing participant, and give him a blow job. While he, in return, massaged her breasts.

Seriously.

And now they were sitting there, caught red-handed as thieves, waiting for me to dole out their punishment.

My first night on night float. And this is what I get paged to do. And besides the standard police report (just to make sure no one was taking advantage of anyone else), and the typical STD screen, I didn't know what else to do.

I'd order chastity belts for the two of them, but 1. it's not on formulary, and 2. that probably counts as some kind of restraint order, which needs renewing every three hours. And well, I like my sleep far too much for that.

My first death threat

A nurse paged me to her ward today, saying that a patient's husband wanted to talk to the doctor right away. I checked her chart. No consent form to speak to the husband. No way was I going to tell him anything.

ME

Hello?

MAN

[breathing heavily]

Yes.

ME

[after 30 seconds of silence]

Um, may I help you?

MAN

Who is this?

ME

This is Dr. Wu. Who is this?

MAN

I'm Mr. Smiths. You're holding my wife there illegally.

ME

Sir, I cannot tell you who is and who isn't at the hospital.

MAN

Are you telling me I have to get on a fucking plane and drag my ass over to the hospital so that I can take her home with me?

ME

Sir, I'm not saying anything like that. I'm saying that I cannot give you any information.

MAN

Shit bitch. All right, you wanna play that way? I'll get on a fucking plane to-fucking-night, and you will pay for this. Shit will go down, and you're gonna be in the middle of it. Watch yourself. [hangs up]

My first death threat! Oh I love my job I love my job I love my job. Weird thing is, the patient has been divorced for twenty years, and her daughter claims there's no relationship there anymore, and he definitely wouldn't care if she was alive or dead, much less if she were in the hospital. So now I'm just confused who the heck that guy was.

Superstar

ME

We just admitted a patient to our ward. He thinks he's Jesus Christ. He's also an ER doctor.

CO-RESIDENT
That's a strange delusion: to think you're God AND a doctor?

ME
Oh, the doctor part's not a delusion. But I'm pretty sure the Jesus Christ part is.

CO-RESIDENT

Hm, strange. Are you sure he's not a surgeon? Those are usually the ones with the God complexes, you know.

---

He's smart. Really smart. Went to an amazing undergrad. Went to an even more amazing medical school. On a full scholarship. Seriously. Who is this kid? Five months into his intern year, he has his first psychotic break. His program forces him into an outpatient clinic; he's stabilized. Three months before graduation, and three months into moonlighting, he starts to exorcise demons from his patients. His program takes away his moonlighting privileges, but let him graduate.

And now he's my patient. 

It makes me just a little bit worried. I'm two months in, but hopefully not anywhere near to suffering my own first psychotic break.

P.S. Is it unethical to ask him to sign my prescriptions for me since I'm not fully licensed yet?

10,000 photos

I haven't fallen completely in love with Los Angeles yet.



But I'm getting there.

Take a good look at me now

Two months and still accident free. 

Who's a female Asian driver now, eh??

Please don't let this jinx me. Please don't let this jinx me.

Well, if you ask me like that...

PATIENT

WHAT THE FUCK DO YOU WANT?

ME

Sir, please lower your voice. I'm just dropping by to see what's going on.

PATIENT

You aren't giving me the right drugs, that's what the fuck is going on, bitch!

ME

Oh?

PATIENT

DON'T FUCKING PLAY WITH ME, YOU FUCKING BITCH. I'M GONNA CUT OUT YOUR FUCKING HEART AND FUCKING EAT IT IF YOU DON'T GET ME MY MARIJUANA.

ME

Sir, really, I don't need to hear that kinda language. Especially when you're trying to get me to do something for you.

PATIENT

If you're not gonna give me my fucking medical marijuana, then get your fat ass in here and suck my cock, bitch. I haven't had sex in four days! I fucking have needs!

---

Dear God,

I would really appreciate it if you could give me one day when my patients aren't cursing me out and asking for uppers and pain killers. Just one day. If you have time.

Thanks,
Michelle

P.S. Is it bad that in that entire diatribe, I was most offended by the "fat ass" comment? I blame the free meals at County.