Day 194 - quite dull

Today because I do not have a time critical job and the snow was bad and I saw a car tipped over and off the expressway before I had even left Exeter, I decided to stay home. I'll work an eight hour day tomorrow. What did I do with my surprise day off? I read an NEJM on my ipad, played sudoku and set it up so that I can read the next Annals on my ipad. Each app is somewhat time consumingto get on the ipad, figure out how to use it, etc. Ellie is still sick so a lot of my day was also spent ferrying her ice cream, pizza and kleenex boxes, poor kid. Emily and I did two crossword puzzles and I did do a hill of laundry, too. I guess I did more than laze around all day, but it felt like a very lazy day.

The most recent NEJM has a couple of articles to recommend it to me. There was an article on continuous renal replacement therapy. Hennepin County Medical Center, where I did my residency was a bit of a renal center of excellence so I am always a little interested in things renal. We had two continuous renal replacement therapy machines when I was there and they were some of the busiest equipment in the hospital. The other article I found interesting was on amniotic fluid embolism which I think is the absolute most scary diagnosis in medicine. The fact that it hits women who have just given birth and has such a high mortality rate if not handled correctly is why it gives me the shivers. I suppose I also have some amount of identification with the victims and have seen a case of it (not acutely; I was covering for someone else and rounded on her several days out). Both of these make it seem much more real than say SARS or ebola which are also pretty frightening diagnoses.

The final article which might be of interest to more than me was about the on-going controversy about the "maintenance of certification" exam that those of us who are not grandparented into boards have to do. Many people complain that it is expensive, time consuming and not very relevant, that there is not a lot of evidence showing that doing MOC is actually a useful thing or that it improves people's practice. I have to do it in the next couple of years so I am following the discussion from a more informed and interested point of view than I might in three years when re-boarding will be 8 or 9 years off again. I am sure nothing will be done before I have to do it, but it's an issue that seems to get a lot of doctors a bit worked up so it's fun to watch.

Tomorrow, as I mentioned above, will be an eight hour day--my first, so I will wish for stamina and endurance for myself. For you, the energy to do what you want with your day.