My hours are super awkward right now. I was up at 4:30 am yesterday cleaning the fridge. I hope to wind down with this and get back to sleep for a couple of hours before work, but I have to share one thing at least. It feels wrong to post, but I will save it forever in my phone. Jason Muesse, we have been new text friends over the past couple of months, has amazing cases. There was one of a young guy that had a giant hemorrhagic lung mass that even Cleveland Clinic couldn't figure out. I asked him how the guy was doing last week at tumor board and he said ok. But two other docs were trying to talk to him he seemed distracted.
He texted me yesterday a video of a case he was doing I was talking to Staggs about C's bday - he had agreed to cover if there were late frozens (which happens a lot more lately with the advent of Sims) so I didn't look right away but when I did I almost fell out of my chair. This woman had a remote mastectomy and she had a hole in her chest wall - it was rimmed in greenish soft material. I could see the EKG lead on her - looked like she was in pre-op. It had eaten through her pericardium and her heart was beating in the background. He texted, "that's her heart beating back there." It was haunting, and chilling. He asked me to take the case and I said absolutely I'm on call and head of the gross room I can call Jessica and direct it to me give me her identifiers. Differential diagnosis - radiation necrosis vs. recurrent CA.
I ran to the gross room to see the specimen and show the girls the video they were equally awed and Jessica told me that since it had bone (rib) attached she would have to fix it o/n it won't be out until Friday I said that's fine. I can make it a go for Saturday since I'm reading out then. I shared with Jason. Michelle, one of my new hires, said I've never seen anything like that it's like TV. I said, no, it's better than TV. A window to the heart. We all wondered how she was walking around like that. Seems like you might get a deadly infection.
Later, after I picked up my daughter's cake and petit fours for the secretaries, I wandered around and showed my partners. They all were equally wowed and intrigued. I told Jason on text and he sent me more videos and pics from the OR of the WIP. We're gonna have to flap that, he said. See the gray area? That's exposed left ventricle. Please ignore the Strawberry Wine song in the background. Well I only heard static that's the state of my music these days freaking Satellite Radio is not working and NPR is not a good back up I don't want to listen to randomized controlled trials on the way to work or stories about euthanasia I just want music and Little Rock radio sucks horribly. Need to problem solve this weekend but in the meantime I'll probably listen to Spotify on my phone, which I have repeatedly tried to sync to my car, having been successful in the Forerunner in the past (I'm not a complete dumbass) to no avail. Even Jack failed. But I diverge.
90's country is a genre (he said that was the OR theme) I cannot relate to so I just haha'd I've nothing to say about that. But those videos. Exposed heart beating. Patient living through that. I promised to reciprocate with micro pics no matter how boring or bland. By the look of it I'm betting radiation it did not have a cancer look. I texted Fraley today about his parotid Melody showed me. I guessed on gross it was a Warthin and I told him that I was happy to be right but there were a lot of epitheliod granulomas that was bizarre and GMS highlighted possible histo so I told him to get serologies. That's not a COW that's a COY both are. Cases of the year.
Medicine is endlessly thrilling. Had a nice blended family dinner celebration. Even my ex was wowed by Jason's video. Quinn was texting me about it after work - it really leaves an impression - and I shared him some of the new intraoperative pics Jason sent. Looking forward to reading it out at the end of the week. Hope you are having a good week - it's fing long as hell but I'm starting to see the light at the end of the tunnel. Much love, Elizabeth