A few days ago our office’s nurse cornered me “Zac, I don’t know what to do about the patient over in room 2. She was diagnosed with an ammonia over at the urgent care yesterday and was sent home… she just told me she’s having trouble walking, has difficulty breathing, feels nauseated, and has a horrible headache. Dr. S is in with another patient so I figured I’d ask you if you think we need to get him in there right away.”

Now, hyperammonemia is no laughing matter. Especially when it presents with gait problems, vomiting, and a headache you start to worry about all sorts of stuff, including alcohol withdrawal, drug overdoses, and liver diseases. Warning bells were going off in my head; I asked the nurse if the patient was a drinker; lo and behold, she was.

Rather than seeing my other patient, I waited outside the room for Dr. S so as not to miss him. I gave him the brief synopsis, and he dropped what he was doing immediately to walk over to room 2.

As we entered the room, he started smiling. The patient was sniffling a bit but looked just fine otherwise. She was 62 with a walker.

Dr. S: So they diagnosed you with a pneumonia at urgent care, huh?
Patient: Yep, that’s what I told your nice nurse.

My first pimp in all of medical school was on my first day of 3rd year. One of the residents asked me what I did for fun, in my free time.

The blood rushed to my head, my heart started beating fast, and I could feel my spine start to shrink in to the floor. “I can’t miss this one!” I thought to myself, “this is a question about me! How can I get it wrong?”

I’m fairly certain I started flushing… because quite frankly, I was embarrassed that I couldn’t answer. I mumbled something about not having any free time.

To be fair, I had just finished my grueling boards schedule, and my “free time” mainly consisted of zoning out with episodes of The Office and Scrubs with a few too many glasses of wine. But I distinctly remember feeling guilty, like I had somehow failed myself. I wasn’t proud of it.

Today my attending asked me the same question, and I smiled a bit before I answered, thinking back to my first day of 3rd year. Then, without hesitating, I responded “I do an awful lot of cooking for myself and my roommates, we’re landscaping and renovating the front of our house, I read books† (for fun!), try to hit the gym on a regular basis, and rock out on my Xbox”.

That felt damn good. I went up to my parents’ house for a long dinner tonight, which I haven’t done for months, and now I’m writing in this blog which has lain neglected for an inappropriately long amount of time. And now, I’m going to rock out on the Xbox.

†Kurt Vonnegut puts the laughter in slaughter!