I didn't' worry too much when the economy started crashing; I'm in school, and on student loans, and I'm not as affected as the rest of the world. Nor did I seriously worry when I heard about the monumentous bailout given to Bank of America, with whom I bank. Part of the reason I wasn't so worried is that they've always made my life much easier, so I figured they'd be OK. I've never had any hassles with them and their services were always easy to use - the tellers were always friendly and helpful. Their fraud prevention is top notch - when I first moved to Miami, I got several calls to confirm that I was, in fact, the person who had been using my card. Needless to say, they stay on top of things.
Here's where the strange string of coincidences starts. I just received my new bank card, and couldn't call in and activate it - like one is supposed to be able to do. So, sometime this past week (maybe Monday), Nicole and I went down to the bank to activate it and deposit some checks and such. That done, I didn't think much of it - until I tried to use my cards at Au Bon Pain yesterday on our lunch break from class. Both cards were declined. I figured it was no big deal - one card expired this month, and the new one hadn't been used yet.
When I got home, I called the bank, and in addition to their continuing to monitor my account for fraudulent usages, they'd received word that someplace I'd used my card had had a security breach - and that the integrity of my card information had been compromised. That being said, they'd put a hold on the card, effectively shutting it down completely. This was only a minor convenience; I realized that I'd much rather have them freeze everything than be nonchalant with my accounts. I was told that I could just head to the bank to pick up a temporary card, and that would be that. So once again, Nicole and I drove down to the bank, and I hopped out at about 4:50. Apparently, they were already closed, even though some folks were standing in the door talking. It still wasn't a huge deal.....but it was an uncomfortable, lost feeling; there was a disconnectedness, almost as if I was in a foreign country, didn't speak the language, and didn't know how long I was going to be there. I wasn't panicked, but I was uneasy.
Nicole and I were back at the clinic today, and I figured we'd just stop on our lunch break. I'd spent some time google-mapping out a route from the clinic to the Bank of America in Homestead (I'm sure I've talked about wonders and horrors of streetview). We actually got out of lunch a bit later than usual today; the patients were all very talkative, and just seemed happy to have someone to listen to them. Generally, if the patient only speak Spanish, I'll take the interview, and let Nicole do the physical exam. Today, we had chatty patients in all languages. Once lunch rolled around, we headed straight for the bank.
When we parked, Nicole was just going to sit in the car and study (which I probably oughta be doing right now - we have our first test tomorrow), but I told her that I had a feeling she should probably come in, and she did. I signed in and waited around for a few moments, until I was called back by a very amicable, very friendly middle-aged woman. She began asking me questions to verify my account, and then she opened up completely when it came out that I was a medical student - she loved doctors, and had the best of relationships with her personal physician. As she typed away, she started telling me about how she still had to lose 5 lbs from her mother's cooking in Colombia, etc. etc, that she thought lawyers were all arrogant, etc. We went to take my picture for the new card, and on the way back, I saw Nicole waving me over from the chairs in the corner of the room.
I'd seen her over there on the way to get my picture taken, and from what I could see now, I figured she'd just found some cute kid and was giving free reign to her pre-pediatric instincts. Such was not the case, though - there was a girl sitting in the chair beside her, shaking like a leaf (it almost looked like she was seizing) and looking absolutely terrible. The bank manager was holding her infant son, while Nicole talked to her. I quickly went over and tried to figure out what was going on. She was having some strange lower abdominal pain, had her arms folded in what looked like Trousseau's Sign, so the first thing I thought was hypocalcemic tetany - about which there was not a single thing I could have done. She wasn't breathing rapidly, but her pulse was rapid, and she said she felt nauseous, light-headed, and numb. Luckily, Nicole had seen her when she had - she'd been in line for the teller, and had started to lose her balance. The bank manager took her son from her arms and led her to the chair, where Nicole swooped in, announcing that she was a 3rd year medical student.
Once I got there, we continued gathering the history - it was fairly obvious that she was stable. They'd called her mother, they'd called 911, and now were were just trying to calm her down. The story that came out was that she was probably pregnant, but didn't want to be - she'd just broken up with the father ( same father as the other son), and was struggling to work enough hours to pay the bills - quite a bit for a 22 year old to deal with. What with the morning sickness and the anxiety over suddenly having 2 young kids with no father, she hadn't slept or eaten much for a week, about the length of time this had been bothering her. As we talked, she stopped shaking so much, but she almost swooned once or twice. Nicole and the bank manager comforted her when she burst into tears. The differentials included ectopic pregnancy and appendicitis, among other things, but finding out that she'd gone through the exact same thing with her first son was certainly nice to hear.
911 took their time getting there; several tellers remarked that they'd never taken this long before. When they came, they kind of brushed us aside - but Nicole and I managed to corner one of them. We didn't announce that we were medical students, but I'm sure that, 99 times out of a 100, they don't arrive on the scene and hear things like "bilateral tetany" and "afebrile without rapid respirations".
We grabbed a quick lunch at Chilli's after that, and all I could think was that, after this near-emergency, I was going to go back to a very calm, very bureaucratically burdened community clinic. I started thinking that maybe I'm supposed to do emergency medicine - granted, this was no huge catastrophe, but when faced with a person who was obviously not well, surrounded by a building full of people who are less qualified to deal with it than myself, I reacted right away and did what I could. My first thought, though, was "what can I do?" It's not like there's anything actually useful in my medical bag; it's just a student's bag. I've got a stethoscope and a blood-pressure cuff and a pen-light. I don't need any of them to tell that someone's not feeling well, or to see that they may need help. If someone loses consciousness, I don't need any of them either - there's really nothing in there that can help anyone, and I realized then, that the true and honest benefit of paramedics - their whole purpose, essentially - is to get sick people to a doctor.
The rest of the afternoon wasn't perhaps as boring as I'd feared; I saw a patient who'd had 3 heart attacks and a quadruple bypass - a hell of a lot of heart problems. Last week, Nicole attempted a cardiac exam on a fat woman, but really couldn't hear the heart sounds - with all that adipose flesh, it's understandable. This guy, though, was probably 150 pounds, 5'8 - not a large guy by any stretch of the imagination - and I couldn't tell what I was hearing when I listened to his heart. Part of it was that his pulse rate was 40 beats a minute - but it all made more sense when he returned the strangest EKG I'd ever seen. Seriously - he had PVCs and PACs, pathological Q waves, inverted T waves, wide QRS complexes - I'd never seen anything like it.
And now, with that exciting day done, I'm going to go back to studying about childhood rashes. Speaking of heart attacks, though, I'm very, very sad to report that The King of Pop is dead at age 50. Remember what I said about famous people dying in twos? Farrah Fawcett is gone, too. It's suddenly a somber day.
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