Saturday, March 03, 2007
A Night at the Grady Red Zone
prior to this night I have spent about a year or so at Grady and
thought I have seen how dysfunctional this place could. However, I was
mistaken. I truly witnessed a combination of extremely crazy patients
with severe neglect and inefficiency on the side of the staff and the
My patient was a guy with schizophrenia who got hit in
the head with a metal pipe and had a 2 inch laceration on his forehead.
In addition to that his left hand was shackled to his bed and he also
had to urinate every 20-30 minutes. He was in a room with 2 other
patients. I cleaned his face and his wound with some saline and
to saw up his forehead. I spent about 20 minutes finding the right kind
of suture and then another 30 or so finding a mayo tray (if you don't
know what a mayo tray is google it) to set up all my equipment.
10 minutes after I started to saw him up he started yelling that he has
to go to the bathroom, normally I would hold a plastic duckie (angled
container into which men can pee if they direct their stream right)
while he directs his stream, however at this time I was wearing sterile
gloves and was not able to help him. So I thought he was gonna urinate
all over my equipment and I would have to start over. Luckily I was
able to find a nurse to help him. Right after that was over this
patient's neighbour who was drunk decided that he needed to masturbate
right then and there (he was about 2 feet away from my patient and
myself...hidden from my view by a strategically placed curtain) - I
heard the nurses screaming at him to stop and then calling security and
that patient screaming back (obviously not stopping what he was doing)
that he had "to get it out".
A few minutes later I heard loud
screams from the third neighbour in the room (he was admitted for
snorting 4 grams of cocaine) yelling at the nurses to take off the
shackles from his hand and that he will kill them once the shackles are
off. He also then mentioned that he spent the last 15 years in and out
of the penitentiary system and that he is "a hard mothafucka whodoesn't
let shit slide easy" - especially if he is dealing with snitches or
some who is trying to steal his money or his "dope" - "you just got to
deal with it right then and there" he said. Then he started discussing
how he was able to have sex with women while in prison he then went
into more detail into that subject (of note there is noone there
actually talking back to him).
His screams woke up my patient
who was sleeping while I was suturing his forehead and he started
moving his head right and left not letting me do my work. As a result,
I had to tell him every 5 second - "don't move your head MR.
_____...Don't move your head". He then started talking to his voices
and went off on a preaching monologue directed at his screaming
neighbour (earlier in our conversation he informed me that he is a
reverend..). Finally, after about 30 minutes or so I was able to saw
him up somehow managing not to stick myself while putting in his 8
Then, I was lucky enough to get a malingering patient
who just got released from jail the day before and decided to us the
Emergency room as a hotel room - she called paramedics and told them
she had pain every where and then later admitted she smoked some crack
cocaine and drank a pint of wine a few hours prior - nvertheless she
was brought in to the ED. On review of systems (whenever I ask: "have
you had diarrhea?...chest pain?..headaches" in a list fashion) she
answered positively to every single question - it was quite impressive
that her story was changing every 5 minutes or so.
to make long
story short (i am tired of writng) - it was night of crazy patients and
nothing getting done to make it the most dysfunctional time I had at
that hospital to date. I would argue it is most dysfunctional and
inefficient hospital in the US.
Saturday, July 15, 2006
See the article I posted on this blog on the subject - It was not written by me but it is a great read about how a Western trained local politician is able to create possibly long lasting changes in a
developing country. Very impressive results:
"One of Mr. Saakashvili's first steps in office was to overhaul the country's corrupt and hated traffic police. He sacked half of the force's 30,000 officers, then gave the rest a tenfold pay raise and merged them into the regular police force."
Thursday, April 20, 2006
Today I attended a ceremony dedicated to Dr. Ken Walker and him being awarded the Outstanding citizen award by USAID. I must say that he is one of the most generous, smartest and inspiring people I have ever met. If you are a in the field of medicine and you reside in the South Eastern US you more than likely heard of him.
On December 17, 2004, President of Georgia Mikheil Saakashvili declared Dr. H. Kenneth Walker to be an Honorary Citizen of Georgia. The award ceremony, which was held at the State Chancellery in Tbilisi, was attended by U.S. Ambassador Richard Miles and Deputy Chief of Mission Patricia Moller as well as by Dr. Walker's Georgian counterparts. In his brief words of appreciation, Dr. Walker, who is a professor at Emory University in Atlanta, Georgia, said, "I’m a small man who stands on the shoulders of very tall people," pointing to his Georgian colleagues.
to find out more about the Atlnta Tbilisi connection check out the following link
Thursday, March 30, 2006
The plural form of the word mouse is mice. Hence shouldn't the plural of house be hice instead of houses? confusion ensues.....
Wednesday, March 29, 2006
Friday, March 24, 2006
Today I became an American Citizen after living for 7 and a half years in the US. The whole process took about 6 hours and included an interview as well as a ceremony with an oath of allegiance and an oath to the flag. Must say that I am proud to be an American and will try to be a good one. I'll finish this by quoting myself (I was more eloquent before medschool) from a college publication in my "younger days":
"The thing I like about the United States is, if you work hard enough, you’ll get what you want. In other places it’s not necessarily like that,"
said Lubarsky. It is still true.
With me there were 56 other people from 32 different countries becoming citizens as well. Was interesting to hear some stories of people living in the US for over 20 years before becoming a citizen. It was kind of exciting I must say.
Thursday, March 23, 2006
Taking the American Citizenship Test and getting Interviewed for the Citizenship tomorrow at INS offices in Atlanta.
Do you know the year in which the US constitution was written in (without googling)? Who was the first Commander in Chief of the US? What is the function of the Congress? How many justices are in the supreme court? Who is the head of the supreme court? If both the president and the vice president die who becomes the interim president? What ammendments to the constitution describe the voting rights of the US citizens? How many strips are on the US flag?
I will let you know how I do.
Sunday, March 19, 2006
from Dickens 1857 novel The
Lazy Tour of Two Idle Apprentices:
"A chilled, slow, earthy, fixed old man. A
cadaverous man of measured speech. An old man who seems as unable to wink, as
if his eyelids had been nailed to his forehead. An old man whose eyes – two
spots of fire – had no more motion that if they had been connected with the
back of his skull by screws driven through it, and riveted and bolted outside,
among his grey hair…He had come in and shut the door, and he now sat down. He
did not bend himself to sit as other people did, but seemed to sink bold
upright, as if in water until the chair stopped him"
Anyone have any idea what disease is described above?
Currently writing a review article on this disease for a Neurology journal.
Wednesday, March 15, 2006
Tuesday, March 14, 2006
One of my patient died over the weekend. Must say its a weird experience even though my team was only following her as consultants rather than the primary. Came in the morning, and she wasn't in her room. I checked on the computer and it said she was transferred to the ICU. Went to the ICU saw the cardiology fellow and asked him if she is in the ICU. He told me she was gone.... Made me wonder if I should have come in this weekend, not that it would have changed anything as she was checked on by multiple physicians throughout the day but still... Could I have done something different? I don't know. It will defintely affect the way I see my patients from now on.