The Intern Blues (44 page)

meconium
The baby's first bowel movement; when meconium is passed while the baby is still in the womb, it often is a sign of fetal distress and can lead to respiratory problems if it is aspirated.

mediastinum
The central part of the chest that houses the heart.

membranes
The structures that contain the fetus, the placenta, and the amniotic fluid. Rupturing of the membranes, followed by a gush of amniotic fluid, often causes the onset of labor.

meningomyelocoele
A defect in the spine, present at birth, that often is associated with hydrocephalus, neurologic deficits of the legs, and urologic abnormalities. Also called spina bifida.

methotrexate
A chemotherapeutic agent used in the treatment of some cancers.

“mets to the brain”
Metastatic cancer affecting the brain.

mitral stenosis
Tightness of the valve that separates the heart's left atrium and left ventricle.

monilia
A type of fungus that frequently causes diaper rash in infants; also affects patients with immune deficiencies such as AIDS.

NEC
Abbreviation for necrotizing enterocolitis, a severe disorder affecting the intestines of some premature babies.

nephrotic syndrome
A condition affecting the kidneys that results in the inability to retain protein.

neuroblastoma
A relatively common form of cancer that affects children.

neurofibromatosis
A genetically inherited disorder that can cause abnormalities of the skin, the central nervous system, and other organs. Also known as the Elephant Man Disease.

NICU
Abbreviation for neonatal intensive-care unit.

night float
A resident who is scheduled to work the overnight shift in the emergency room.

NPO
Abbreviation meaning “nothing by mouth.” Ordered for patients with intestinal abnormalities and patients who are pre-op.

occipital hematoma
Hemorrhage into the back part of the skull or the underlying brain.

OPD
Outpatient Department, composed of the ER and clinics.

orthopods
Internese for orthopedic surgeons.

osteogenic sarcoma
A type of cancer affecting bones.

otitis media
Infection of the middle ear. Very common cause of fever in infants and young children.

oxacillin
A type of antibiotic.

painful crisis
A complication/result of sickle-cell disease; sickling of red blood cells leads to lack of oxygen reaching the tissues and results in development of severe pain.

pancytopenia
Deficiency of all types of blood cells, both red and white.

patent foramen ovale
An opening between the two atria of the heart. If untreated, it might eventually lead to pulmonary hypertension (
see below
).

Pavulon
A drug that paralyzes the recipient; used in patients on respirators who are agitated and said to be “fighting the machine.”

PDA
Abbreviation for patent ductus arteriosus, a congenital defect of the cardiovascular system that is common in premature infants.

perineum
The genital region.

periorbital cellulitis
An infection of the skin surrounding the eye. Dangerous because it can lead to infection of the eye (orbital cellulitis), which can lead to infection of the brain.

peritoneal dialysis
A procedure performed to “cleanse” the blood in patients with kidney failure, in which fluid is placed into the abdominal cavity and later drained out.

PFC
Abbreviation for persistence of fetal circulation, a complex physiological abnormality encountered in newborns who have aspirated meconium.

pH
Measure of acid in the blood. Determined routinely as part of a blood gas (
see above
).

phototherapy
A treatment for jaundice of the newborn in which the infant is placed under ultraviolet light; through a mechanism that's not clear, this therapy lowers the level of bilirubin in the blood.

physsies
Internese for physical examinations of the newborn performed in the well-baby nursery.

PID
Abbreviation for pelvic inflammatory disease, an infection of gynecological structures. Often caused by gonococcus (
see above
).

pneumococcal meningitis
An infection of the spinal fluid caused by a very virulent and damaging form of bacterium.

pneumothorax
Collapse of a lung; must be treated by placement of a chest tube that drains out the accumulated air.

PRN
Abbreviation used in medication orders meaning “as needed.”

prolapsed cord
Condition in which the umbilical cord passes out through the cervix before the baby. Dangerous because if the cervix narrows, blood flow to the fetus can be blocked, leading to hypoxia (
see above
) and brain damage.

pseudomonas
A virulent bacterium.

P
2
C
2
Abbreviation for Pediatric Primary Care Center, the clinic at Jonas Bronck Hospital.

pulmonary hypertension
Increased blood pressure in the pulmonary arteries, usually as a result of heart disease. Is a nonreversible condition that eventually will lead to death.

pyloric stenosis
Narrowing of the lower part of the stomach, leading to inability to pass stomach contents into the intestine. Occurs most commonly in first-born male infants during the first two months of life.

q4h
When written in a medication order, means “every four hours.”

QNS
Abbreviation for quantity not sufficient.

rales
A particular sound heard when listening to the lungs through a stethoscope and that implies the presence of pneumonia.

renal biopsy
A technique in which a needle is passed through the back or side and into the kidney. Allows sampling of kidney tissue and therefore diagnosis of specific diseases affecting the kidney.

'roids
Internese for steroids, an anti-inflammatory class of drugs.

scut
A collective term for the routine work that an intern must do.

sed rate
Short for erythrocyte sedimentation rate, a test used to determine if an inflammatory disease is occurring.

sepsis
Bacterial infection in the blood.

SGA
Abbreviation for small for gestational age. Used for babies who have not grown to adequate weight while in the womb.

sickle-cell anemia
An inherited disorder in which an abnormality of hemoglobin, the protein that carries oxygen, causes deformation of the red blood cells and serious consequences. (
See
painful crisis,
above
.)

sigmoidoscopy
Examination of a portion of the colon using a device called an endoscope.

spina bifida
Synonym for meningomyelocoele (
see above
).

status epilepticus
Condition in which patient is having constant, uncontrolled convulsions.

straight cath
Passage of a tube through the urethra into the bladder to obtain a sterile sample of urine.

strawberry hemangioma
A purplish birthmark; these often disappear by the time the child is six years old.

subarachnoid hematoma
A collection of blood between the arachnoid membrane and the brain.

subinternship
A two-month rotation in the fourth year of medical school in which the student acts as an intern.

suprapubic tap
Synonym for bladder tap (
see above
).

tachypnea
Rapid breathing.

thrombocytopenia
Deficiency of platelets, structures that aid in the clotting of blood. One of the features of pancytopenia (
see above
).

tight as a drum
Phrase used to describe a patient with asthma who, because of the disease, is having difficulty breathing.

tolazoline
A drug used in persistence of fetal circulation (PFC—
see above
).

tox screen
Short for toxicology screen. A test done on a sample of blood, vomitus, or urine obtained from a patient in whom ingestion of a toxic substance is suspected.

TPN
Abbreviation for total parenteral nutrition, in which all the nutritional requirements are supplied via an intravenous route.

transillumination
Technique used to “light up” a particular structure. Used to diagnose pneumothorax (
see above
).

traumatic arrest
Cessation of cardiac activity caused by a traumatic event, such as an automobile accident.

triage box
The place in the emergency room where the charts of the patients waiting to be seen are piled. Patients are triaged according to how sick they are.

trisomy 18
A condition caused by an extra No. 18 chromosome; patients with this disorder are born with multiple anomalies and usually die before their first birthday.

turf
Internese for sending a patient to another service.

UA
Two meanings: (1) abbreviation for urinalysis, a test performed on urine to see if a UTI (
see below
) is present; (2) abbreviation for umbilical artery, a blood vessel in the umbilical cord that carries blood from fetus back to mother.

URI
Abbreviation for upper respiratory infection. Also known as the common cold.

UTI
Abbreviation for urinary tract infection.

UV
Abbreviation for umbilical vein, blood vessel in the umbilical cord that carries blood from placenta to fetus.

vagitch
Internese for nonspecific vaginitis, an inflammation of the vagina.

varicella
The virus that causes chicken pox.

V-fib
An abnormal cardiac rhythm, the next stage after V-tach (
see below
).

VP shunt
A plastic tube inserted into patients with hydrocephalus and that drains excess spinal fluid from the ventricle of the brain to the peritoneal cavity of the abdomen.

V-tach
An abnormal cardiac rhythm that, if untreated, can lead to death.

About the Author

Robert Marion, M.D., a professor of pediatrics and obstetrics and gynecology at the Albert Einstein College of Medicine in the Bronx, New York, is the director of clinical genetics at both the Montefiore Medical Center in the Bronx and Blythedale Children's Hospital, Valhalla, New York. He is the author of six published books, including
The Intern Blues
and
Learning to Play God: The Coming of Age of a Young Doctor
. He lives with his family in Westchester County, New York.

 

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Copyright

A hardcover edition of this book was originally published in 1989 by William Morrow and Company.

 

THE INTERN BLUES
. Copyright © 1989, 2001 by Robert Marion. All rights reserved under International and Pan-American Copyright Conventions. By payment of the required fees, you have been granted the nonexclusive, nontransferable right to access and read the text of this ebook on-screen. No part of this text may be reproduced, transmitted, downloaded, decompiled, reverse-engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, now known or hereinafter invented, without the express written permission of HarperCollins ebooks.

 

First Perennial edition published 2001.

 

Library of Congress Cataloging-in-Publication Data

 

Marion, Robert.

      The intern blues : the timeless classic about the making of a doctor / Robert Marion.—[2nd ed.].

          p. cm.

      ISBN 0-06-093709-2 (alk. paper)

      1. Interns (Medicine)—United States—Biography.    I. Title.

 

    R153.M37 2001

    610'.71'173—dc21

    [B]

2001021502

 

Epub Edition © OCTOBER 2012 ISBN: 9780062243188

 

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