Yo estoy calculando.

This past week was more intense as I added on average a patient a day to my workload. I know that doesn't sound bad, but from my perspective I was being asked to magically know how to recommend individualized parenteral nutrition perscriptions for these patients when a dietician gets years of practice before actually being put on the spot like that. So in other words I was doing a lot of calculating both in and then for hours out of the hospital too. So now at the end of the week I've ended up with pages and pages of scribbled calculations and lots of crossing out followed by rescribblings.

And yes, the actual work is fuzzy in the above picture. You can think HIPAA for that ;) I haven't done this much math since I was last in a math class, probably over 4 years ago now.

Something else I'm experiencing here that is quite unique is specialization. I can say that so-and-so is my patient, which would be true, but at the same time I am just 1 of about 14 doctors that is able to say that. I have yet to form an opinion on what I think about this as there are quite obvious pros and cons to this form of medicine. Say it's a baby in the cardiac ICU, who now has an intestinal infection rendering him NPO (nothing by mouth), that's where I come into play --- cue the parenteral nutrition *trumpet fanfare*!!! But I'm just one more doctor being added to the already long list of neonatologists, cardiologists, gastroenterologists, and of course all of the fellows, residents, interns, and students that go along with each of those areas. Pro- this baby is getting the best attention possible because it's got specialists for each different area. Con - this makes it so easy to turn communication into miscommunication. You figure out your recommendations, figure out who you need to communicate them to, then actually communicate your recommendations, and finally you have to remember check up on them later to make sure that said recommendations were communicated correctly. By taking a step back and just observing this mechanism at work, I see that it really isn't that bad as long as those involved in the relay are well practiced in the art of communication. On my part, I've definitely improved this week, but probably still a few kinks to work out before I can run smoothly with the rest of Children's.

One more picture to share with you. I discovered the use of my Webcam, which then proceeded to provide me with a few minutes of delightful entertainment!


Hasta!