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August 23, 2004 Internship Journal

One more night of call is under my belt. Once again, I hardly slept, but obviously that comes with the territory of being an intern. I had two admissions last night. The first one was for a kidney stone and the second one (which came at 4 a.m.) was an older gentleman who had had a change in his mental status over the last week and was found to have a stroke. Now, the family will have to decide if he can continue to live with them or if he needs to go to a nursing home.

Mrs. Adams is doing great. I am currently checking her blood cultures and if they are negative tomorrow, she might leave the hospital by the end of the week. This is her 10th week here, so we are all excited about the possibility of getting her out.

Mrs. Baker is close to getting off of the ventilator, but she is not quite there. One thing that I've not discussed about her is her morbid obesity. Those of you who know me well, know how I feel about this subject. I am proud of myself though for not letting those feelings affect my care for her. I do with that every morbidly obese person could see how much her size has complicated her conditions. Because of her size and her condition, working with the physical and occupational therapists is essential for her to get better. However, she rarely gives them her best effort. At least twice a week, she will ask me in the morning what she has to do to get out of here. I reiterate that she must work hard with the therapist's and she tells me that she will. Yet, later that day I will often here that she gave them minimal effort. This is obviously frustrating. I have been speaking with two of her brothers on the phone every couple of days, but Saturday I had the opportunity to meet one of them. Without even prompting him, he was telling her that she needs to work harder to get out of the hospital. Hopefully, this message will stay with her throughout the week.

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