Colorado is a little crazy!

So for those that dont read the NY Times on a daily basis, or decide to read some other paper like USA today, i have decided to spotlight an interesting article from the Nov 18th paper, "Proposed Colorado Measure on Rights for Human Eggs" please enjoy!

DENVER, Nov. 16 -- A proposed amendment to the Colorado Constitution that would give legal rights to fertilized human eggs may be headed for the ballot next year, raising the prospect of a heated local debate over abortion at the same time that Democrats are gathering here for their
national convention.



The ballot measure, which passed a legal hurdle this week when the Colorado Supreme Court upheld an administrative panel's ruling about its wording, would give Colorado perhaps the most sweeping language in the nation about the rights of the unborn, legal experts said.




The proposal must go through several other steps between now and Election Day 2008, including gathering of enough signatures to qualify for the ballot.



But both sides agreed that the measure, if it passed, would have immense ripple effects. The measure, just one paragraph long, would ask voters whether inalienable rights, due process rights and equality of justice rights as defined in the state Constitution should be extended to "any human being from the moment of fertilization."



The deputy director of Naral Pro-Choice Colorado, Toni Panetta, said state courts could be swamped by suits claiming specific rights for a fertilized egg that the broad language of the ballot measure did not clarify.



"All fertilized eggs could use the courts, and that lays the foundation for a potential onslaught," she said. She said the language would open up challenges to birth control, including oral contraception and intrauterine devices, which make the uterine wall inhospitable to the developing egg.



A lawyer who represented supporters of the proposal, Michael J. Norton, said the real impact of the proposal would be in its simplicity, asking a profound philosophical and moral question.



"The whole issue centers on when does life begin," Mr. Norton said. He said that though the word "abortion" would not appear in the language of the proposal, it would effectively make an abortion "the destruction of a person" and therefore illegal.



"Whatever rights and liberties and duties and responsibilities are guaranteed under the Constitution or other state laws would flow to that life," Mr. Norton said.



A spokesman for the Colorado Democratic Party, Matt Sugar, said he thought the measure was perhaps timed in an effort to highlight divisions over abortion in Colorado at a time when much attention will be focused here. But he said he thought it could play into the United States Senate race even more than the convention in August, by forcing candidates to talk about the subject. Senator Wayne Allard, a Republican, is not seeking re-election, creating an open seat.



Dale Schowengerdt, a lawyer for the Alliance Defense Fund, a legal organization based in Arizona that supported the ballot measure before the Colorado Supreme Court, said the timing of the proposal was "pure coincidence," to next year's elections.



"It's an important debate that people ought to have, and Colorado ought to have, about when does life begin," Mr. Schowengerdt said.




So, in going along with the argument that fertilized eggs will have right to due process and equality of justice and therefore be able to have appointed legal representation, will a woman be charged with manslaughter if she has a spontaneous abortion and in doing so kills the fertilized egg? Could a women be charged if through no fault or planning of her own, be charged for killing a "fertilized human egg" if her own body rejects the zygote that results in a miscarriage???

I think this is def going to spark some interesting discussion on the origins of life, and the implications of defining those origins in a constitution and therefore granting equal rights and protection under the constitution, esp because at the present time women still do not have equal rights under the federal Constitution??? but the possible future offspring will be able to have lawyer represent in a court of law.....really?? are they serious?? I know this is just semantics, but come on is this really necessary to define when life begins?


My personal thoughts on the subject of when life begins.....i like to call it viability. When the fetus can survive outside the womb in the most basic sense, able to breath, circulate blood. That is as simple as i can make it, and this is what i believe. if you chose to believe something else congratulations that is your right as an American living in a democracy where we can debate all viewpoints

Sometimes you just have to yell!

Just another day in primary care, trying to get patients to actually care about their health. I have finally found an aspect of primary care that I enjoy, in essence its something i have enjoyed for a long time, arguing. In the office today (and pretty much everyday) are patients that are not following the guidelines and suggestions given by the doctor, they inevitable feel bad and come back, and when asked why they didnt do what they were supposed to in order to feel better come up with ridiculous excuses.
"I just didnt feel like taking a pill in the morning"
"I am single, and do a lot of heavy lifting, so i cant diet"
" I started feeling better so i stopped taking my blood pressure medication"
" exercise is too time consuming, cant you just give me a pill?"
" both of my parents died of heart attacks, but i dont want to take medication"

So today, i tried to educate patients about the importance of their health with a little bit of yelling. When someone has triglycerides in the 800's and tells me he cant diet because he is single, i get to explain what will happen to him if he continues to let this go unchecked. For males the consequences of poor cardiovascular health is evident by the inability to maintain an erection or even have one at all. Sometimes a little scare tactic is what it takes to get through. He decided to try and stop eating fried foods, start taking fish oil supplements in addition to medication.

Another man comes in, with a diastolic blood pressure over 100. He has chosen to stop taking his blood pressure medication 3 weeks ago, because he said it may him pee too often, and he had been feeling better. Now he has constant headaches, his vision is getting blurry and he has sever neck pain. When i tried to explain how not treating his BP and allowing it to continue at the current state, he could have a stroke at any moment. He didnt really seem phased by any of this, but did mention how both parents died of massive heart attacks. We tried to explain that if he didnt start taking care of his BP then he would end up the same way, and his kids would be without a father. Still not fully understanding the gravity of the situation, instead his main concern is the pain in the neck and head, so he demanded to be placed on percocet and valium since it helps with the pain and relaxes him (ie lowers his BP in his mind). I am nearly shocked to see a man be more concerned with scoring some drugs to treat the symptom instead of treating the cause of the pain by lowering his medication. Once we made some calls, we realized he has been filling pain medication prescriptions all over town from 12 different doctors in the last month. He ended up walking out of the clinic with no meds, not even for his BP. He became agitated and irate with us for accusing him of doctor shopping and drug seeking. Seriously....drug seekers come in all forms.

But at least today went a little better, i am starting to think my doctor doesnt hate me, and instead is just harsh by nature. My mantra, "i can do anything for a month" is working really well, and so is blanking out when she yells and talks to me in a degrading manner in front of patients. I just sit there quietly with a smile, suck it up, write some notes down and go home and look up the info, so the next day she cant yell at me for the same reason. Unfortunately, i feel she looks for minor details to pick out and tell me where i am wrong....i wonder if she had a bad experience as a medical student?? hopefully i will not treat my medical students this way.

on a side note, i got to drain an abscess on a breast today and it was AWESOME!!! hope i see more pus tomorrow....

number of strep throat cases seen so far in 3 days at a family med office = 12 and counting

Sorry I dont speak Spanish

So i started my family medicine rotation on thursday and so far its been a nightmare. I am convinced the doctor hates me, and wont give me straight answers about anything.

i show up the first day and ask the doctor what she expects of me, what my hours will be etc. She mentioned that i am to get there first thing in the morning and work until i am done. What does that mean?? could she possibly be more vague?? So i am still not sure what hours i am going to have while on this rotation, there are 3 doctors in the office, all with different schedules, and they see an average 75 patients a day (thats a ton!!, they see peds - geriatrics)....

then yesterday i showed up to the office at 8:30am, and worked with a different until 2pm when my doctor finally showed up. I saw patients all morning, and when i came out of a patient room and my doctor sees me, i get yelled at for not seeing her patients.

Then when she asked me to go and see the patient in room 4 i mentioned that i dont speak Spanish and the patient is Spanish only, so i could see the patient in room 3. I then got a speech (in front of patients, other doctors and the office staff), "you have lived here for over a year, what do you mean you cant speak Spanish?? Its a disgrace and I need to learn Spanish if i plan on living in south florida."

----seriously, I need to learn Spanish, to accommodate people who moved to this country?? I can learn Spanish and i am practicing, but my vocab is not nearly good enough to see patients on my own because i have a hard time understanding what they say in response to my questions.

but really, these people have moved to America, why are they not expected to learn English?? i have lived here a year and should speak Spanish, some of the patients have lived here over 20 years and speak NO English! why is that fair, and why am i the one who gets yelled at for it...It probably sounds really bad, but i am not against immigration, i am just not sure why we need to make it so easy for them to not assimilate to the new country they live in...if i moved to Spain, i am expected to learn Spanish i do not expect people to speak to me in English. I think we may it too easy for people to get away with not having to speak English.

enough of my rant.....there will be more i am sure in the coming weeks.....

"i can do anything for a month!" this is my new mantra....


i am going to DC for the next few days and will be back monday evening.

just call me Surgeon!

I know i havent updated in a long time end of the rotation got a little crazy, a little busy and full of evening activities for the trauma team (visiting professors, journal club, happy hour etc). The last month of my surgical rotation included critical care management. Each day i spent in the ICU managing neurosurgical patients and other trauma patients, and LOVED it more than i ever thought i would, the patients were complicated, interesting and involved lots of procedures!!

We had a patient who decided to get drunk and drive a boat into an overpass, smashing his head. The NS team declared his injuries incompatible with life, on his license he identified himself as an organ donor, so the transplant team went into full speed. The night before the harvest i had been on call, and around 2am rounded through the ICU and it turned out the patient needed to have 2 central lines put in for IV access for the harvest. I asked if i could do them, thinking they would say no, and to my surprise they said, "sure, get all the supplies and be in the room in 10min." That night i put into two subclavian central lines, without causing a pneumothorax and did it on the first stick! After those two lines, they let me put in any central line i asked to do...

The last month had some interesting cases come through the door, and most of them involved interesting lessons:

1. dont break up fights
2. dont sleep with another mans wife
3. dont drink and __________.
- ride a motorcycle, lift weights, work construction, drive a car, ride a scooter
4. dont rush to the IKEA grand opening on a scooter on I95
5. dont drink red bull while doing cocaine
6. dont misuse hardware
7. if you are going to try and kill yourself, at least know where the arteries are located
8. dont fight with your little brother around glass doors
9. "never sit on the stoop of church reading a bible minding your own business, you may get shot." - trauma patient


Some of the other things i have learned on my surgery rotation:

- only go into a patient room if you have to
- if you can smell the patient down the hall, dont go into the room alone
- ALWAYS double glove!
- surgeons are not doctors, so call medicine!
- ICU nurses are the backbone, dont piss them off
- cover your own ass at all times, because someone will always be there to make you look bad
- know everything about your patient!
- take some time for yourself
- keep a change of clothes in your car at all times
- smile, laugh and keep it fun or else you will go nuts
- call the attending only when you have too
- know when to use lidocaine with epi
- be nice to the triage nurses in the ER they can make or break your night call


At the end of the rotation, the chief of surgery called me into his office, and told me he sees me as a surgeon. He also mentioned that he would be willing to make some calls, and write me a rec letter for residency. Every student coming out of this rotation that wanted a spot in surgery got a spot in surgery. The chief knows people everywhere and is a big name in the world of trauma and surgery...AWESOME!!!

just glad i have found an area of medicine that i loved and could see doing every day for the rest of my life....not sleeping and living life in a chronic state of fatigue is awesome! currently i am on family med and my hours are so boring, 8:30-5 monday -fri...i have so much free time i am not sure what to do with it...

anyways family med is another post entirely!