Therapeutic stabbing

I just did my first arterial blood gas draw! It's the thing about firsts, about being a beginner at everything: I want to be able to do it, but I don't want to do it before I know I can. And I don't know, the ABG is so built up to be difficult and painful. I just watched a Hopkins episode where the third year couldn't get it drawn, and the patient was all pissed off. So that was looming in my mind as the needle was poised... Now it's demystified. But the attending was an awesome, understanding teacher, which makes such a big difference. I love that he threw me in there but saw it through with me. Insert sigh of relief here. I'm glad I didn't have any coffee beforehand a) so that I didn't shake more than I already was and b) now I'm totally awake. On to the rest of my morning.

The Internet

My first neuro clinic last week ruled. The appointments are an hour long! And I finally get to start researching part two of my screenplay, which involves a character with some type of dementia. My favorite patient was this Spanish-speaking man who started having auditory hallucinations after starting chemo for lymphoma. He refers to the voices he hears as "the Internet." Like he says, "The Internet gave me the nickname Pito Loco." Or when he wife says that she doesn't hear what he hears, he says, "You don't have the Internet." I must sound like I'm making fun of him, but truly, I just found him to be creative and good-humored. He used to work as a dental technician and apparently invented some device to help people stop snoring by moving their tongue out of the way. People's lives are so much more rich than you expect at first look.

I really respected his wife because he kept relating dreams he had about beautiful young women who were in love with him and kissed him and wanted to marry him. She seemed very clear that it was a disease talking, very patient. Maybe it privately upsets her, but they also seemed like a long-time couple who had been through it all

Then I felt a lot of compassion for a woman we saw with a rare condition called formication. That's forMication. As in formic acid. As in ants. As in the sensation that ants are crawling on/under one's skin. It is seen more commonly in, like, opiate withdrawal, but as a primary thing, it's not often seen. The sensation is somehow a biproduct of her progressing dementia, and she truly believes there are larvae that go in her pores. It was sad to see the fear in her, and how much it simply drives her nuts. She says it is the cause of her depression and that all she wants is a doctor who can cure her "bichos." Dr. K. thinks that Lexapro could help her. I think he convinced her to stop seeing a dermatologist, even though apparently we have like the world expert in formication in the derm division. Surprise surprise.

And I learned that the UCSF neuro department is The Place for Cruetzfeld-Jacob (prion disease like mad cow). Random.