Skip to main content


Showing posts from January, 2018

2.2. MI = Myocardial infarction (heart attack)

If a patient says she feels like she is going to die, take her seriously. She might code before finishing a sentence about her cat. Heart patients in particular get premonitions, a sixth sense related to poor oxygen perfusion to the heart, a nagging sense of doom, as they repeat, "I just don't feel right."

Many women don't experience the typical symptoms of a heart attack (chest pain/pressure radiating to arms, irregular heart beat, shortness of breath). Instead, they report indigestion, pain between shoulders, an aching jaw, even a choking sensation. Also: fatigue, sleep disturbance, and dyspnea (labored breathing). The elderly may present with disorientation or acute confusion due to decreased blood flow to the brain, with no complaints about the organ in actual distress--the heart.
Not to be confused with the act of leaping off a cliff, into the sea, just for fun, an elevated ST segment on the electrocardiogram is referred to as "tombstoning," because th…

2.1. Neonate = newborn, 0-28 days

Babies are cool. They breathe 2-3 times faster than we do; their hearts beat 1.6 times faster. The head circumference, measured around the eyebrow and ears, is larger than chest circumference--lots of space needed for that cute, mammalian brain.

Check front and back soft spots where cranial bones will meet at 18 months and 6-8 weeks. Eyes clear, ears aligned, nares patent, palate intact, upper airway clear. Movement and extremities symmetrical, abdomen soft and round, umbilical cord with two arteries and one vein clamped, all nether parts and orifices in standard locations.

Babies, like superheroes, come equipped with all sorts of cool reflexes.

Rooting: stroke baby's cheek, and she turns towards the touch, mouth open, wanting milk.
Sucking: insert a gloved finger (or nipple) in her mouth, and baby sucks.

Palmer grasp: the pull-baby-up-using-only-two-fingers trick: give baby a finger in each palm, and she will grasp. Pull her up gently.
Moro: lowering baby, allowing her head to dr…

Pokémon = Pocket Monster

To the person who stole my five-year-old's favorite Snorlax rock: yours better be a make-a-wish-foundation type of situation to justify your theft, because not only have you made a five-year-old girl cry inconsolably, you have quite possibly permanently destroyed her faith in humanity. She no longer believes it safe to display her beloved rocks in front of her home, because people are terrible and steal little girls' rocks. Also, have you any idea how much work it is to replace a Snorlax rock?

The Japanese believe that everything has within it kami, a spiritual essence, the energy generating the thing. Kami is present in all things under the sun: trees, rocks, animals, and places.

The first step to creating a Snorlax rock is to find a rock that's big enough, and which passes the stand test (will it keel over on its own, or on a windy day?) Really look at the rock; feel its essence. Turn its weight over in your hands. Note its imperfections and decide if they are unacceptab…

Pt = Patient

Doctors and nurses become patients, too. Being a patient usually involves nonspecific symptoms of pain, fever, or nausea as well as more specific symptoms, hopefully not exophthalmos (eyes bulging from their sockets). It also requires being patient, literally, because primary care doctors are overbooked and urgent care can be standing-room-only. ER is a whole different purgatory, and the lines at CVS remniscient of the DMV.

The good thing about being a patient who has her medical-surgical book in her bag is she doesn't have to strip and make the doctor play hide-and-go-seek-symptoms in every nook and cranny. Relevant symptoms are quickly reported: which lymph nodes are painful and swollen, like a string of pearls beneath the skin; what temperature fever; location, quality and duration of any pain. The necessity of diagnostic tests are discussed briefly, and then it's off to queue at Quest Diagnostics.
The bad thing about having received a partial nursing education is getting o…

老人 Z = Old Man Z (1991 Anime)

Memory is a funny thing--sometimes a powerful image is printed indelibly in one's mind (e.g. a scene from an anime), and some twenty-five years later one discovers that the mind had concocted the scene on its own.

I must have been somewhere between the tender ages of ten and twelve when I first watched Old Man Z* with some kids in a tatami-covered room at a friend's family property complete with forest, a cool creek we rafted across, brassiere factory, and living quarters (we didn't think too hard about it back then, but in retrospect, that family was loaded!)

I remember little of the film besides being struck to the core by the image of a young woman pleading with an old man as he towered over her in a robotic machine, his metal parts and wired tentacles waving. The image seemed to symbolize a young girl vs. the machine of patriarchy, as well as human mortality, the immortality and inhumanity of technology, etc.

Haruko is a nursing student who cares for old man Z, who in …