My Adventure Through Medicine Part 5: Cardiology

Where do I begin with this one? So much of what I knew and loved about anatomy came from the subject of cardiology. My dad, made it a point to imprint his fascinations on me. Cardiology was no exception. He loved learning about the subject. He worked in cardiology research for years. Even today it is still one of his favorite science topics. He gets excited talking about it. As a kid, I never fully appreciated this fund of knowledge. My dad went to great lengths to teach me everything he knew about the subject in hopes I would be interested. I knew what EKG's were before most kids who were 8. In high school, I had a general idea on how to read them because of my dad.

It is also because of my dad that I pursued a job in cardiology. If you remember back to the dietary part, my dad had enrolled me in an EKG reading course. He had hoped I would work as an EKG tech like he once did. After failing to get in at LDS Hospital EKG when I was 18, I had lost some interest. This interest was renewed after I got my EMT-Basic. I realized this could be the hands-on opportunity I'm looking for. I could learn so much from this and maybe decide what I wanted to do. I stumbled upon an EKG tech opening at the University of Utah Medical Center. It was PRN only. But the requirement was every Sunday, 3-11 PM.

Sweet.

I applied that day and got an interview the next. The interview went really well. After so many failed interviews in the past, I had mastered the art of the interview. Things started to go my way for once. I was getting jobs that I wanted. I got offered the job two days later. I was most ecstatic about it. Finally, something clinical. Patient care. Bedside manner. Stuff that really mattered.

My first week went well. I was so excited I could barely contain myself. Everything was so new. Everything was being experienced for the first time. I saw what an inpatient floor looked like. I saw how an ICU functioned. I saw how hard people worked. It was eye opening. It didn't take long to master the job though. Before I knew it, I was running the show by myself. Weekends were slow enough that there was only one tech on at a time on Saturdays and Sundays. This was nice sometimes. Other days, it was so busy I could barely keep up. Most of the time I just sat in the office watching movies, doing homework, or in some cases napping.

What made the experience great was the patients. I had barely quit the lab when I first started and only worked PRN in radiology. Even when I picked up my lab job again, this was the only job I truly enjoyed. I saw patients. I did diagnostic testing. I got to wear a fancy pager. It was all the stuff I wanted. It seemed important. I was at an important hospital. For the first time ever, I felt like I was going places. I was moving up.

Even when patients were assholes, I still enjoyed my job. I loved the feeling of getting the page for a code and running with the code team. I loved seeing sick ICU patients. I loved seeing stroke patients. I loved seeing floor patients. I saw every floor I ever wanted to see. The job was fascinating enough where I thought it might be fun to work in cardiac care. I considered getting a CNA job on a tele floor or cardiac ICU. However, nothing excited me more than getting a page to the ER. I knew when I was going down there, people were waiting for me to do something important. I saw everything. Traumas, STEMI'S, full arrests. Everything I had learned about in my EMT course but never got to practice.

After spending so much time in the ER, I realized how much my EKG job was lacking. It didn't have solid hands on care. No continuity. No extra skill. No teamwork. I also realized how I could never do ICU or floor jobs at the time. I remember an event that touched me deeply one night. I was walking out of the Neuro ICU. It had been a long night. I had been doing EKG's continually for eight hours. All I wanted to do was get back to my office and be left alone till my replacement got in. But as I passed the Neuro ICU I heard something peculiar. It sounded like singing. Couldn't be. I walked over there to investigate. My ears had not deceived me. It was a Polynesian family singing a hymn. There must have been 30 of them. They sang so beautifully and yet so solemnly. It struck a nerve in my somewhere. I was somewhat choked up. I heard them pray for the stuff to do their best. To be capable and competent in helping their loved one. I remembered why I even got into medicine. To help people. To be there because I was needed. I realized that my job was only a small part of the larger puzzle. I was helping patients, but not in the way I would like. I realized, that I had to get a job that was more hands on. Something where I could make a bigger impact. Be a bigger piece to the puzzle.

I saw and learned so much from my time there. Even if I only worked there for 9 months, for usually one day a week, it was the job I liked the most. Radiology and the lab were nice supplements to my failing income. I was out on my own struggling to make a decent wage to pay rent and pay for everything else. But I had come to think of UUMC EKG as home. I started to get to know the staff on the cardiac units and ICU's. I started to befriend people from the ER. I had lost interest in cardiology very quickly. Although the cath lab was intriguing and failing hearts exhilarating, it was nothing compared to what I thought the ER was. I wanted nothing more than to be in the ER. But that's a different chapter.

However, every place I've been to has it's stories. What I remember most about UUMC cardiology is a guy I worked with. He always came in as my relief every Sunday night at 11. At first he seemed nice and harmless. But it soon became apparent that he was weird and homeless. I came to find out that he had been living in the hospital for months. Security was always looking for him trying to route him out of the place. This explained a lot about this guy. Every time I would work there, I would see him in his scrubs hours before his shift started. He would just be aimlessly wondering the hospital. To the untrained eye, it looked as though he had somewhere to go and something to do. But to the people that knew him, everyone knew he was just walking around for 8-10 hours at a time until his shift started. He was most certainly crazy. He would yell about how things were a mess and how everyone screws him over. It was quite absurd. He would supposedly go on expensive vacations to other states to see his family all the time. Yet, he lived in the hospital under everyone's nose. I never managed to find the rats nest he had made home somewhere in the hospital. On my downtime, instead of editing EKG's or paperwork, I would wonder the hospital trying to find where he might be living. I tried to think, "If I was homeless and had to live in the hospital without getting caught, where would I go?"
 I thought he would get fired for this. Turns out he never gets in trouble. I would run into him 2 years later to find out he was still working in EKG. 

But none of that mattered. Soon I was going to quit all three of my jobs and work in an ER.

This picture was meant to be a joke sent to my friends. But it's the only picture I can find that documents I was even an EKG tech.

My Adventure Through Medicine Part 4: Radiology

Radiology had always been an interest of mine since I was a kid. My mom worked in radiology as a receptionist at Cottonwood Hospital for years when I was a kid. One day she had to take me to work with her because she had no other choice. During her time at work, she walked me back to where someone was getting an MRI. I remember seeing the massive piece of equipment in there and almost being scared. I'm not sure why I was scared in the first place. The tech showed me around the computers which were all touch screen. This was cutting edge technology since touch screens were only available in multi-million dollar pieces of equipment in the 90's. I remember the screen just being orange and black. The tech let me hit the scan button. I saw the images print out on the computer. I was amazed by everything. At a simple touch of a button, we could see images inside of someone. I didn't think it was real. But honestly, I was more fascinated with the touch screen. That technology seemed so far away when I was young. I love star trek and longed for touch screen technologies. Being 8 years old at the time, all I could think about was "why isn't everything like this touch screen?"

As I got older, my dad started to imprint in my head how great of a career radiology was. The cool stuff you would get to see. The insane amounts of money you would get to make. I ate right into it. The more I heard about it. The more I liked it. I liked the idea of diagnosing things from advanced imagery. It seemed so futuristic and complex. While working in dietary, I always did research on ultrasound techs, or x-ray techs. Anything. I just wanted to know more. By the time I reached the lab, I was starving to know more about the field of radiology. I applied several times to be an x-ray tech assistant with no success. It bummed me out that I was being blocked from a field I so greatly desired. I wasn't sure why, but that was one of the moments I thought about medical school the hardest so I could be a radiologist. I knew nothing about what a radiology doctor did. All I knew it was advanced and seemed cool.

My parents once again stepped in to help. They knew people who worked in radiology and heard they were looking for people to help out on the schedule. They recommended me and I got a chance to shadow someone. I wasn't sure what the job entailed once again. It was just another vague description. All I knew for sure was that it paid well. I thought this would be a sweet gig to make some extra cash when I wasn't working at the lab. It would also give me an opportunity to learn more about the field I wanted to possibly go into. I was so excited. I learned that I would be working at LDS Hospital where my dad used to work. I thought it was funny how things were coming into full circle. I would be working at the hospital where my dad had worked for so long and formed his medical career. It was the big hospital. Completely different from the others since it was a trauma one center at the time. During this time I was taking my EMT course, so the fact I was at a trauma hospital excited me.

I had to be there early in the morning for my first shadow. Which was fine, but I had no idea how to get to LDS Hospital on my own. I had only been there with my mother when I was a kid to visit my dad. Needless to say, I wondered the avenues forever till I finally found it. I ended up being 10 minutes late because of it. It was embarrassing. I'm trying to make a good impression so I can get this sweet new job, and I'm late right off the bat. Great.

I wasn't sure what to expect. But they told me to dress as if I was going to an interview. I was dressed with the usual shirt and tie for the occasion. I've always hated dressing up. It's always uncomfortable for me. Which sucked because I would be shadowing for about 4 hours. Since I was dressed up, I guessed that no patient care would be involved. I was disappointed by realizing this. Maybe this wouldn't work out....

When I got there, they greeted me and showed me to the second floor where outpatient radiology was. I was taken to a dark room full of cubicles. Large computer screens were lit up with x-rays and other things I had never seen before. People in white coats talking into a microphone as they looked at the images. What the hell were they doing? I had never seen anything like this before. I was sat in a cubicle with the person I was shadowing. We had access to all the images, the reports, everything. The person I shadowed showed me every radiology modality. I was awe struck. I had never seen CT scan images before. I had never known what nuclear medicine was until that moment. It was so much to take in.

But what was my role for this job? I soon found out. The job was nothing more than a glorified secretary for lazy radiologists. If someone tried calling the radiologist, it was our job to answer the phone to see if we could help them first or pass on a message. If the system went down, it was our job to fax reports to the departments where the reports were needed. If the radiologist had to talk to a doctor, it was our job to call them. I also learned that although we were working in IHC hospitals that we were contracted by another company to work in IHC hospitals.

I was disappointed. Yet another job where I'm separated from the clinical setting. But the intrigue of learning more about radiology is what made me stay. The extra pay was a sweet bonus. I only had to work one day a week for only 4-8 hours. It was a sweet gig while working in the lab. It was an easy job. I could do homework. It was a PRN only sort of thing so my obligations were little. I was stoked about it. When I quit the lab, it was the only job I had. I learned quickly that I couldn't get by with school and gas by working 2 days a month.

Working there answered all my questions about radiology. I found that most of the radiologists I worked with were incredibly smart. But many were also socially awkward and rude. There was practically no patient care involved unless a procedure had to be done during the day or on an emergent basis. Either way, the radiologists acted inconvenienced and bothered that they had to even had to talk to a patient. However, not all of them were like this. Some of them were really cool and normal. I learned so much from them about how to read x-rays and CT's. It's an amateur skill that has helped me immensely today. For the most part, I didn't mind the job. Working at LDS Hospital or Cottonwood Hospital, depending where I wanted to be, was not a bad gig. When I moved out on my own to Murray, I mostly stayed at Cottonwood where I was most familiar with things. I saw old friends all the time there. I knew my way around the hospital. It felt like home. A small ego bonus was running into people that I used to work with in dietary. With my pager and my important seeming job, it looked as though I had moved on to bigger and better things. It seems rude. But it was nice to be reminded that I made it out of there and did something.

Most of the days at this job were uneventful aside from occasionally getting yelled at over a phone call. But one day, I saw something that would change my life.One day when I was working at LDS I saw a group of people running to angiography with a patient on a stretcher. They were doing chest compressions on the way up. I glanced in the room to see what was going on. The radiologist was setting up to try to put a stent somewhere from the femoral artery. It was a noisy chaotic mess. Orders where being shouted left and right. People running to one place or the other to get a piece of a equipment. People trading out doing compressions. I watched with fear and intrigue as the patient coded and died. They never revived the patient. I learned a couple of hours later that those people who rushed the patient up were from the ER. I thought that was amazing. I thought to myself that maybe, it would be fun to do something like that, if I wasn't scared. I had my EMT-Basic by this time. I wondered if there was anyway I could work with them, instead of the ambulance. From that point on, I did everything to try to immerse myself with emergency medicine. Every time I heard the alarm for a code blue or a code trauma, I wanted to be there. I wanted to see it. I wanted to be a part of it. I wanted to find excuses to try to be in the ER.

Radiology, was not for me.

My Adventure Through Medicine Part 3: Pathology

The interview for this job was ridiculous. I had no idea what the hell the job entailed to begin with. What the hell was a "Clinical Lab Assistant" anyway? I was sat in a room of about 9 people where we worked out a fictional group scenario. The scenario was that you crashed in the desert, and had 15 items to organize from most useful to least. They separated us into two groups and studied our performances carefully. The people in the interview were nothing like me. The only people I remember was a blonde woman who was obnoxiously loud, not particularly bright and quite enamored with herself. The other person was this Asian kid who was overly assertive, condescending and came off as a "know-it-all." I thought one of those two was going to get the job. They seemed to attract the most attention. To this day, I'm not sure how I stood out. I was not assertive or in a position of leadership. I was mostly quiet and gave my 2 cents when possible. I left that interview crushed. For the billionth time, it felt like I was overshadowed by condescending douchebags.

Two weeks later, I was offered the job. I was shocked. I was so sure I wasn't going to get it that I forgot about the interview entirely. The phone call came just in time. I received the call the day after I got into a huge argument with my manager in dietary. I had woken up early that day to type up the entire argument that had taken place and turn it to human resources with my immediate resignation to quit. I was fed up with that place. I was fed up with the people. I was fed up with feeling terrible about myself every day. It was literally no more than five minutes after finishing this letter that I was offered the job. I was so happy that I was beside myself. I took one last look at the letter then deleted it. I knew that if I was going to take this job that I could not leave on such a bitter note. I held this job for 3 years. Future employers would be calling this place for a reference for a while. Last thing I need is for them to bring up the letter I wrote on my last day that ended with "Fuck You!"

I gave a respectful 2 weeks notice. But not before pillaging the place for free food for that couple of weeks. At the time I had a yellow VW Bus full of compartments for me to store my "borrowed" goods. I filled my bus with as much junk food that I could possibly carry out. It was my way of sticking it to them before I left. Nobody noticed.

It was odd leaving the place that last day. Everyone shook hands with me and said "Good luck." As if they believed in me all along when it felt like the past 2 years they were out to destroy me. I was overwhelmed with how happy everyone seemed to be for me. Although, I was extremely overjoyed to leave that place, a part of me was sad to depart. It was the hand that fed me so well during high school, fueled my ambition, and gave me a new perspective on what I wanted to do with my life. I had thought about staying PRN there just so I didn't feel like I was being "above" them in any way. I knew that wouldn't work. I would always be grateful for the experiences and people that helped me along my path there. But I had grown out of the job and was ready to move on. I got in my VW bus, started the engine and let out a loud whoop of joy as I drove away.

I had 5 days of downtime before I started my new job. I took the time to relax and buy my first pair of scrubs. I felt like a professional. As if I was part of the medical staff. I also celebrated my leaving of the department. My friends put together a party out in the desert that would turn out to be the most awkward party I've ever attended. (Another long and different story.) I was scared for this new job. I still had no idea what it was that I would be doing. The job description on the website told me nothing except statistics on Alta View Hospital, which is where the job was at. The interview didn't really say much about what it was except that it was in the medical lab.

My first day was scary. I wasn't sure what to expect. I walked into the lab where everyone there greeted me with smiles. I was fitted for a lab coat (before they made the lab switch to the crappy paper ones) and briefed on the job. It was nothing like I thought it would be. The job entailed tracking and sending lab tests to appropriate stations or hospitals. This was before IMC opened so lab tests went everywhere across the valley at the time. I had to memorize so much. I struggled with this job for the first few months. At first it was because I didn't get the job. Then I met a co-worker who I thought was a huge douchebag at the time. As far as training went, he was mean, condescending, and impatient. Nothing I did was right to him. Rightfully so, I wasn't doing anything right. Still, he wasn't nice about it. It was awful. I hated my job all over again because of this guy. He had a reputation for this sort of thing I had learned. He was an Iraq veteran who had been working at the lab while going to school to be a medical lab tech. He was a little burned out at his job. I soon came to learn that his hard nose approach to everything wasn't necessarily intentional. In a lot of ways, it was just the way he was. As I got better at the job, we got along a lot better. I really liked working with him in the end. When I look back now, I realize how much he taught me about my own sense of work ethic. I was so timid back then. I thought it was unfair how I was being treated. And maybe I was right to some degree. But for the first time ever, I was being trained to do a job that mattered. I was pushed to do it right. I was pushed to be good at this time. No one since has pushed me that hard to be good at a job. He was so good at it, knew everything about it. He was the go to kind of guy. I was nothing like that. But after that whole experience, I became a lot more like that. I didn't have the same type of bitter, condescending tones as he did. But every job I have taken since then has always been a huge push to be the best. When I train new people at jobs I find many of those mannerisms surfacing. I try to be nice about it though. But after writing this, I realized how much it formed me as a person.

Anyway, I got pretty good at the job after a few months. I knew what every test was for blood, urine and stool. I knew how to process them quickly. I had no problem handling urine, stool, and other fluids. (That took a lot of time to adjust to since I had no idea I would be handling that stuff on a regular basis.) It wasn't a bad gig. I was getting paid more, most of the people liked me, and I felt it had some importance. But it lacked hands on patient care that I had so craved. I had no contact with patients whatsoever. Also, my job felt boring and monotonous fast. I had to do something. But what?

It was during this time that I had started to take my EMT-Basic course. I fell in love with it immediately. I didn't like the instructors as much. But I loved how practical the knowledge was. It was scary for me. But I'll come back to this part later. I had an interest in radiology and eventually got a job doing that. I also got a job doing EKG's at the University of Utah shortly after. Both jobs were PRN. The lab was a part time job. I'll come back to both of those jobs later.

My job at the lab mostly had uneventful stories. I never really got close to anyone there. I mostly had to amuse myself in order to stay sane through the monotony. One way I kept entertained was as simple as abusing the privilege of the department label gun. My manager liked to label things for some reason. Just really ridiculous things like the drawers, files and computers. But I took it one step too far by labeling everything I could get a hold of. Pens, armrests, keyboards, desks, etc etc. I took it way too far and got in a lot of trouble for it. But it was totally worth it.

Another label gun related incident happened when I labeled my lab coat "Johnny Walker, MD". I thought this was funny as well since it was a sticky paper label on a cloth lab jacket. One day the fun of it ended. I went to the OR to pick up specimens. On my way out, a surgeon stopped me. He was an older man, with a scowl that just screamed "I hate everyone." He looked at the paper label on my jacket and said, "I don't think this is funny. Impersonating a doctor is serious business. You should be ashamed of yourself. You're lucky I don't call the police about this." He then proceeded to rip the sticker off my coat, throw it on the floor, and then step on it and grind his foot into it. It was a very dramatic gesture for a harmless prank. No one would have mistaken me for a doctor unless they were senile or just incredibly stupid.

Eventually, I decided to quit at the beginning of 2007 to focus on school. It didn't matter that much to me to leave a job this time. I wanted to be full time school and scrounge on the money I had. This idea would really fail when I decided to move out on my own 2 months later and realized how expensive it was to live on my own. My PRN radiology and EKG job would not support me. By chance of fate, I would run into my lab manager months later while looking for a job to support me again. She offered me my job again at the lab and I took it for just a few more months.

My real last day before I got hired in the ER was glorious. I was so burned out by the management there, I could have cared less what happened. That day wasn't supposed to be my last day, but they rearranged the schedule the day I got there so it would be. I was pretty sure they did it so they didn't have to tolerate and pay me for another 2 days of work. I was ecstatic of the news. So I made the best of it. To celebrate, I rummaged through the lab coat rack to see if I could find a new one. One that would signal to everyone else that I was going out in style. It wasn't long until I stumbled upon a chefs coat that somehow got mixed up on our rack. It had happened once before. The laundry service that washes the lab coats also gets chef coats from catering services. Every few months a chef coat would manage to wind up on the lab coat rack. I had worn it once but my manager caught me and wrote me up for being unprofessional. However, this was my last day. It had to have been fate that reunited me with this wonderful piece of cloth that was carelessly misplaced on our lab coat rack. I put the jacket on slowly to savor it. It fit perfectly. As the day went on, no one noticed my fancy chef coat. It was slow so I didn't care as much. Since it was my last day, I did something that I always wanted to do. I drank a tall cup of hot chocolate in the lab. This was a huge violation on so many levels. No food or drink in the lab! If I was caught, the worst they could do was fire me. The odds were stacked in my favor today. Fate was smiling upon me. They day was a couple of hours away from ending. I sat back in my chair smugly sipping my hot chocolate in my chef's coat. I reminisced about my past experiences there and how much I had learned. But my nostalgic moment was cut short. My manager and co-manager walked in to check my progress. I was able to sneakily hide my hot chocolate behind a computer. But they caught me in the chef coat. I got a stern lecture about professionalism and JCAHO regulations and so forth. I was forced to take off the coat and surrender it to the laundry service. I was helpless in the matter. I couldn't help but wonder if I had had the chef hat to complete the ensemble, things would have gone differently. They would have laughed and understood it was my last day. It was a comical one time thing that they could let slide. But no, I was screwed. That's not how things panned out unfortunately. With my chef coat gone, my happiness was in jeopardy. I then remembered I manged to hide my hot chocolate while they were lecturing me. It suddenly seemed to taste much sweeter since I had gotten away with it.

My last day came to an uneventful end. I said my last goodbyes and took one last look around the place. It had been awfully good to me. I went to the staff white board where notes of the day were taken to remind oncoming shifts of what to do. A smile crept across my face as I wrote on it in big bold letters:

"Johnny was here, Johnny was there, Johnny was everywhere! I'm watching you."