Found this on Shadowfax’s blog today (boy, I should get over there more often): The Wrong Juice, in which you can see the EKG of a patient with bad hyperkalemia; read through to find out what the wrong juice was. I knew, theoretically, that hyperkalemia (high potassium) produces peaked T-waves and widened QRS complexes; but I couldn’t recognize them until Shadowfax named the problem.

Which demonstrates that knowing the right answer is very different from knowing how to take care of the patient. I think I’m almost ready to graduate, because I’ve mostly realized that there are an incredible amount of things in medicine that I don’t know, and that I’ll never have the time to understand properly. The moral being not to scoff at another doctor’s treatment plan unless you know what you’re talking about.

(Also thanks to Shadowfax for explaining the regrettable disappearance of Barbados Butterfly, a female surgical registrar (British semi-equivalent of resident, maybe a little higher on the scale) in Australia, whose hospital disapproved of her blogging. I’m sad to see her go, because her writing was tremendous and she was a role model for me, as much as you can do that over the internet. I can’t imagine why her hospital would disapprove, other than from bureaucratic dislike of openness and communication, because she had a great attitude and usually found things to praise even when discussing conflicts with other staff members. Maybe they didn’t like her frank discussion of the toll that long work hours and sleeplessness take on residents. I don’t think they’ve heard of 80-hr weeks Down Under.

Thanks for what you taught me, Barb; I hope you can come back some time.)