In the emergency room there are interns and nurses and then an internal medicine physician who acts as a consultant for the adults and a pediatrician for the children. Even though I'm in anesthesiology, they still ask us to fill this role as internal medicine consultant. I've already alluded to the fact that seeing patients in the ER is different here because of a relatively low level of malingering (compared to the US). It is also different because the pathology and presentation is a lot different than what I was used to as a medical student. I just admitted a young woman last night with a hemoglobin of 3, low platelets and white count--probably a myeloproliferative disorder but I'll leave that for the hematologists. She had just been 'dealing with it' for a few months. Her aunt finally brought her in when she could no longer stand because of the anemia.
I was seeing so much great pathology that I started taking pictures on my last night of call:
|Cardiac tamponade physiology - I didn't know what was causing it.|