Thursday, February 19, 2009

Mnemonic for EKG Lead Placement

Today in anesthesiology, I helped out with the setup for a patient undergoing a whipple procedure for pancreatic cancer. the surgery lasted all day (roughly 8-5pm) and was pretty complex, plus there was a really amazing resected specimen (part of the pancreas, duodenum, with a huge yellow globular tumor). slices of the tumor were sent to a tissue bank and the rest was sent to pathology. but i digress.

after the whipple man was well underway, i tagged along and observed four IVF procedures in which eggs were being harvested from hormonally primed women. then i bounced back to the OR to help set up 2 more patients for a D&C and TVH.

slowly, i am starting to learn how to think like an anesthesiologist. also, i am starting to figure out the myriad of procedures that have to be done in a hurry. during the IVF procedures, it was amazing to think about how marvelous noninvasive inventions like the EKG, pulse oximeter, and even an O2 nasal cannula with CO2 monitors can improve patient safety without harming the patient at all. anesthesia itself has always amazed can a person go to sleep, have their abdomen exposed, have a tumor resected with their plumbing all reconnected...and wake up with minimal pain (thanks to an epidural), alive and kicking? the miracle of anesthesia. amen.

oh wait, i forgot about the title of this post.

so the EKG leads in the OR have 5 leads. on the left side, the resident taught me the mnemonic "smoke over fire," meaning that the red lead is below the black lead (and the brown lead is in between, pretend it's wood if it makes you feel better). on the right side, the green lead is below the white lead, so I have decided to make my own mnemonic: "snow falling on cedars." okay, okay, I know that the biggest criticism of my MSP lessons (based on comments in Evalue) was that I was heavy on the mnemonics, but there are oodles of things in medicine that don't have any intrinsic why the white lead has to be white...and why i am spending time typing this ramble when I should be sleeping....zzzz...

Wednesday, February 18, 2009


Currently on a 2-week anesthesiology rotation at mount zion, and it's pretty cool so far. During grand rounds this morning, I got the impression that anesthesiologists seem happier than surgeons...! There's a lot of cool procedures (i got to put in an LMA today) and different medications to use, and there's a great emphasis on thinking through the patient's physiology.

Wednesday, February 11, 2009

family planning

Visiting the Family Planning Clinic in Fresno, California, was an important part of our Ob/Gyn rotation and of our medical education. Although most students have mixed feelings about elective abortions, the general consensus appears to be that most students are pro-choice, but would never be able to personally perform abortions. How can there be such a contradiction? It is almost impossible to be neutral or apathetic about the issue of abortion, because everyone has deeply held personal beliefs, personal experiences, and cultural or religious backgrounds that influence how we feel and act.
The doctor working at the Family Planning Clinic was extremely cordial and eager to teach medical students. He encouraged us to ask questions and made efforts to have us observe several procedures. After the embryos were extracted, the doctor had the samples placed in dishes of saline so that we could observe the villi, gestational sac, and parts of a 14-week embryo.
There were several moments during the visit when I was very grateful for the opportunity to visit the Family Planning Clinic to observe an important process that even doctors and hospitals will not openly acknowledge. It also made me aware of how difficult it is to be a woman with an unwanted pregnancy with few options, and how the stigma of abortion can be still be so potent. Overall, the experience strengthened my conviction that legalizing abortions is crucial to women’s health and well-being, because so many women would lose their lives to infection, hemorrhage, and dangerous procedures if safe, effective, and confidential medical procedures were unavailable.
Admittedly, there were also a few moments when I experienced twinges of sadness. Gazing into the saline dish, we could see the gestational sac and 2-centimeter body of the 14-week embryo. The embryo’s head had been ripped apart during the vacuum process, but we could still discern the legs, spine, and arms down to the tiny fingers. When we found the embryo head, the two small eyes seemed to be staring at us with a sad confusion that mirrored my own unresolved feelings.

Wednesday, February 04, 2009

My intellectual mother, part 2

Chatting with my 13 y/o brother....

Jeremy: Mom is too mad to talk right now

me: whoa...why is she mad ?

Jeremy: The book she read was the worst book she ever read


Jeremy: The series was called the dreamers
In the end, they went in the past and killed the enemy
Leaving all the books before useless