Crazy ER

Got a page from the ER to admit a multiple sclerosis patient who's been having "2 month history of worsening unilateral arm and leg pain and paresthesia", and diagnosed her with "MS exacerbations". I knew something is not right - after finding out more about the story, it turns out that she has been having the same symptoms for 2 months and were just a little worse this morning. She couldn't get an appointment from her clinic soon enough and decided to go to the ER instead.When we saw her, the pain has resolved. She doesn't have any neurological deficits and no visual changes or orbital tenderness. How this qualifies as an "exacerbation" requiring keeping the patient in the hospital is beyond me. A call to neurology confirms our plan, and the patient is sent home on oral steroid with outpatient follow-up.

Sometimes I am just amazed by how low some ER attendings' admission thresholds are.

It's Nice Being an R2

This month is my first month working on the ward as an 2nd year resident (R2), carrying my own team with an intern and medical students, and today is the first admission day. The fact that I am actually making decisions for my patients (and others actually following them) is kinda fun. At the same time, I am feeling that I am more directly responsible for the patients too.