Unexpected Birth

Working in the ED is not without its own source of entertainment. From drunks to drug addicts, to patients with actual medical illnesses and emergencies – there are plenty of cases to learn from.

A 20 year old girl attended ED with abdominal pains. She had just found out she was 39 weeks pregnant the other day. She screamed for help in the bathroom, not knowing she was actually in labor.

Nurse: Congrats, it’s a beautiful baby boy!

Boyfriend: If that baby’s term, it ain’t mine.

It was a full term, healthy baby boy…

Risk Factor for Urologic Cancers – Smoking

As I was starting my Urology elective, I was hanging out in the doctor’s on call room, waiting for him to show up. He came and was a cheerful fellow. He said we’d start by taking a tour of the department. We left the on call room and as we’re about to round the corner the doctor, with a smile on his face, say “And smoking is absolutely forbidden inside the hospital.” And there was a group of 5 or 6 doctors standing by the window having their post-round morning cigarette. *faceplant*

Heart Anatomy

During a second year Intro to Internal Med course, part of the course was made up of clinicals. I was placed in cardio. One day, while waiting for the doctor, one of the students and I had a conversation.

Student: “So today we’re doing valvular diseases, right?”

Me: “Yeah.”

Student: “Sometimes this doc is so complex, so I prepared a bit for this session. And I figured I’d go over some of the basic heart anatomy too – ’cause, you know, that’s probably useful to know, right?”

Me: “Of course, I should really take the time to go over the vasculature of the heart. I still get confused with it.”

Student: “Right, so want to do a quick review?”

Me: “Sure, we’ve got time to kill.”

Student: “Ok, so let’s start with the pumping action of the heart. Blood travels from the right atrium to the left atrium, and then to the right ventricle and finally to the left ventricle.”

Me: “…”

Student: “And the first valve at the atria is the tricuspid and between the ventricles you have the mitral.”

Me: “…”

Yes… someone in med school really told me this. And not a first year. This is someone who passed first year – someone who passed anatomy and physiology. I spent a few minutes explaining to this student how venous blood travels into the right atrium-tricuspid valve-right ventricle path before being pumped into the lungs, and then how this newly oxygenated blood returns to the left atrium-mitral valve-left ventricle path before being pushed into the aorta. I think they understood me.

Later, while we were examining a patient’s heart via echocardiography, the Doc kept talking about heart valves and leaflets. At one point, the student whispered a question, “What’s a leaflet?