Wednesday, March 12, 2003

So, I'm sitting in class, in Medicine, thinking to myself, "How am I going to survive an hour and a half of potassium balance lecture from a Chicago-bred nephrologist?" And I'm playing euchre on Taika, and getting my butt kicked because my partner's aggressiveness is set too high so he's calling trump on a King-Queen-Left if I'm lucky, and thinking that maybe I should switch to Solitaire because at least maybe I can win then, but I have to keep pausing to write notes because his idea of a "handout" is providing us with the topic headings. And he talks so damn fast that you can't write everything down, and if I do try to write it all down I forget what he's talking about, and then he's looking around the room: "Boersma?" And I feel stupid at that point, always do. He goes through and asks us questions in alphabetical order. Nothing like it. So I might as well play games, jot a few cryptic notes, and know what he's talking about. And then, just then, darling Lowene comes into the room and says "Excuse me for interrupting, but I need Asher, Rachel, Scott K, Andy, Ryan, and Nykki immediately. They need to go to an autopsy." You have never seen six medical students pack their bags so fast. Forget coming back for Radiology this afternoon. Hell, we're gone. Over to the hospital, where we were told to park in the doctors' lot. Mind, the doctors' lot has a security bar, and only Rachel (who was working there over the summer) has a keycard. So we pass it from car to car and get yelled at by Security for it, but what can you do? And up to the autopsy. Middle-aged man, 310 lbs, came in for a TURP (trans-urethral resection of the prostate), which is a pretty standard procedure. But it's done under anaesthesia (aren't you glad, guys?), so they needed cardiac clearance. And then they didn't get it. Off to the cath lab he went, found 95% occlusion of the LAD - a heart attack waiting to happen, more or less - and took him to put a stent in. That's when the problem happened. Rare but normal complication of stenting is perforating the artery. They put a balloon in there, took him out of surgery, looked good. Then he started feeling bad - BP 62/54, HR 152...things like that. And developed cardiac tamponade (fluid in the pericardial sac compresses the heart so it can't beat) and died. Enter Lowene calling us out of class to come see the autopsy. It was interesting. I could have done forensic pathology, I think. The smell of the inside of a human being is...strange. The layers and layers of fat instilled in me a burning desire to exercise. We saw a diaphragmatic lipoma, a kidney cyst, and the cardiac tamponade. All 200 cc's of clotted blood. And then there was the rose. The funeral home puts a rose on the body bag when they bring it in. A plastic one. The tech said if we wanted it, we could have it. So I took it. Asher: That's just bizarre. Me: The rose, or keeping it? Asher (mouthing exaggeratedly): (Both). Me: It's a souvenir. I got some strange looks for that one. But it's taken me this long to creep anyone out in the class, so I think I'm doing good.

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