Thursday, January 26, 2012

Why I love my job, part umpty-umpty-ump:

1. Standing around on rounds with the chairman of the department and the United Nations of Neurology (aka the residents), trying to figure out what the hell is wrong with a particular person. "He can't read out loud, but he can read silently and give you a good summary of what he's read." "Do you suppose that guy has edge-sensing and blindsight? That would be really cool. I've never seen a case of blindsight before." "How the heck are we supposed to get her to eat all of her food if she has total extinction of the left side?" (Me, having read Oliver Sacks: "Just tell her to turn her plate to the right until more food appears." Neurologists, not having read Oliver Sacks: *gaping in amazement*) "What about that one dude who sees only in black-and-white? Is that any better?"

2. Seeing function come back after TPA administration. Normally we don't do MRIs prior to TPA, just CTs. The MRI suite is always so busy that holding TPA until we have a solid MR image would push most of our patients out of the window (in terms of time, not literal defenestration). That means it's always kind of a crapshoot in terms of what we'll see, depending on whether the embolus was a clot or plaque or whatever.

3. Learning even tinier details of brain anatomy every single day. Just when I think I've got a good handle on things, some genius comes up with a theory that a patient's symptoms are due to a minor derangement of Whargarrbl's Foci of Bolognese's Range of the Straits of Inglewhazzit. It all starts to sound like Terry Pratchett, and I'm off to the textbooks again.

4. Learning really gross things about gross anatomy. Turns out there's a nasty situation that can happen inside an artery that causes a big snotlike glob of fat and plaque to detach partway and hang there in the blood streaming from the artery. Except that it's attached at one end to the wall of the artery, so it just goes "hrrbl hrrbl hrrbl" and blops around, occasionally causing TIAs. I can't remember the name of it, but if I see it again, I'll know it.

5. Knowing enough to explain what's going on when somebody in a different department starts freaking out about the YouTube video with that octopus? That's dead, and in soup, but then somebody pours vinegar over it? And I can explain how the acid in the vinegar stimulates the sodium channels and makes the octopus-food-corpse-guy want to crawl out of the bowl. That's really cool. I like that part.

16 comments:

woolywoman said...

wait, there are neurologists who haven't read Oliver Sacks? Whiskey, Tango Foxtrot. They need to go read that stuff! what else would a neurologist read on vacation anyway?

Laura said...

Is the Whargarrbl's Foci of Bolognese's Range of the Straits of Inglewhazzit superior or inferior to the Whoosawhatsit Thingamajiggy Chiasm of Stoke-on-Trent?

Comrade PhysioProf said...

Me, having read Oliver Sacks: "Just tell her to turn her plate to the right until more food appears." Neurologists, not having read Oliver Sacks: *gaping in amazement*)

HAHAHAHAH! Awesome!

thethingspatientssay said...

MRI is about to get busier, new guidelines call for MRI with ANY TIA symptoms. Fun, fun.

jimbo26 said...

Sometimes , it's the simple things ............. .

Anonymous said...

Being blind in my left eye, I figured out the plate turning trick on my own. It seems like common sense, if you don't see or acknowledge things on one side, move them to the other.

Anonymous said...

Being blind in my left eye, I figured out the plate turning trick on my own. It seems like common sense, if you don't see or acknowledge things on one side, move them to the other.

darev2005 said...

I'm sure Terry Pratchett would be proud. You sounded exactly like one of his characters.

terri c said...

I *love* Oliver Sacks. Love, love, love. You have just bounded off the very top of my scale of esteem!

Rosanna said...

I particularly like your "Reasons Why I Love My Job" posts, Jo, because I always find myself lookin' stuff up, (i.e., just out of my usual curiosity), you know. Not that there aren't lots of different types of Nursing Specialties that really rock, of course............ but, man, the highly-intricate complexity of the Neurological System; your patients' psychoneurological behavior; and Neurological Nursing itself are all (to me) *s.u.p.e.r.*-interesting. Great post!!

Reha said...

Yes, I enjoy them, too, jo.

I deal with some neuro patients: some TBI and some big name neurological disorders.

I don't get residents anymore, so I had to beg the Old Boss to get me a neuro book, so I could keep up with everything I read in the charts.

"Why would a nurse want a neurology book?"

Duh! Wanted to take said book and smack His Highness upside the head with it.

I couldn't do it, or he wouldn't get me anymore free books. Now he's gone and I won't get anymore.

Better work on the new boss...

Nurse and Hospital Stories said...

"What about that one dude who sees only in black-and-white? Is that any better?"

haha. Great question, eh. :)

Cheers,
Peny@discount scrubs

BKB said...

It's really wonderful to come across a positive nursing blog full of enthusiasm and humor. As a nursing student I sometimes get discouraged by the prevalence of burnout and negativity I see in the nurses around me (blogosphere and IRL both)...Head Nurse is a refreshing joy to read! Thank you nurse Jo!

Amelia said...

This blog reminds me of the nurse I had when I was in the hospital a few years ago. She was always happy and joking, night and day contrast to the other nurses. Thank you so much for sharing. Makes me excited to finish school and start my career as a travel nurse! :)

inkgrrl said...

Of course I had to go google that video. Poor squid and poor octopus. That would be a most excellent Halloween trick.

Nuss Twenny said...

http://youtu.be/jwvaEpYbUIM

Just because I couldn't STAND how long it took me to google that whilst procrastinating on my nursing ethics work.