First Week at St. Luke’s

I’m on the gastroenterology consult service at St. Luke’s Episcopal Hospital (SLEH) for the second month of my internal medicine rotation. Last month, Ben Taub General Hospital (BTGH) provided me with the team-centered, primary caretaker view for the uninsured/homeless/EC population. Now I’m learning about the world of specialized consult services in a private hospital setting. 🙂

There are significantly more lectures/conferences at SLEH compared to BTGH, but both have a McDonald’s (oh the irony of having a McDonald’s in the middle of a healthcare-providing facility). That’s all that really matters, right? 😉

One of the drawbacks of SLEH – all the notes are handwritten. While that may sound trivial at first, you have no idea how difficult it is to decipher the notes left by other physicians and residents. “Plan is to asjdkhaskjda the patient per the cardiology consult. Also start on 40 mg po askdjaskjdajk.” It seems like the most difficult things to decipher also happen to be the most important parts of each note. 😯

The patients have been more than receptive and appreciative for my efforts. I’ve also had a chance to work more closely with the nurses; they are absolutely phenomenal at what they do! Within one week, I’ve seen things like a postcholecystectomy bile leak, NSAID-induced esophagitis, bowel perforation in collagenous colitis, and hepato-renal syndrome.

Though I was randomly assigned to gastroenterology, I’m so glad to be on a service which constantly addresses the chief complaint: “my belly hurts.” It’s a very logical work-up, but often therapies are hit-or-miss. Take irritable bowel syndrome (IBS). This is essentially a diagnosis of exclusion and its etiology isn’t well understood. How do we treat it? Well, one can try probiotics. Or some low dose antidepressants. Or some pro/antimotility agents like loperamide. There’s no guarantee that any of them individually or in combination will have an effect, so we move on to yet another treatment. *Sighs* Hopefully we’ll have a more efficacious treatments for diseases like IBS in the future.

I’m hoping the coming week brings even more opportunities for me to learn about medicine and the human condition. Happy Super Bowl-ing! 🙂