Back from Vacation and musings on hip pain

So I'm back from my oh-so-brief break, and start classes for my second semester tomorrow. I find it really hard to fathom that I've already finished one semester, and am on to my next one. In less than a year-and-a-half, I'll be finished here in the Caribbean, and will be on to my rotations...

For those of you who are interested, Hurricane Dean missed us almost completely. We got some wind and rain, and when I flew out during the storm the first couple of minutes in the air were a bit shaky, but overall, it was nothing really to worry about.

I had a good break. I went golfing for the first time in my life (I've been told it's an important skill for a doctor), went hiking, went swimming in Georgian Bay (significantly colder than the Caribbean), did a lot of gardening (my sister's front yard was a knee high weed collection), had two suspicious skin lesions removed, and spent some time shadowing in the local ER.

Although I saw a lot of interesting stuff in the ER, one patient in particular sticks out.

She presented with pain in her hip. "Is it sciatica?" she asked. The pain was in the back of her hip, radiating down the back of her leg.

It looks like sciatica to me, I thought, and expected the doctor to prescribe some muscle relaxants and pain killers. But the doctor ordered an xray.

When it came back, it was a really surreal experience to see the woman's prosthetic hip completely dislocated. The doctor I was following admitted to me that she hadn't expected it either, but that something had just "seemed wrong."

So instead of a few muscle relaxants and painkillers, the patient got a lot of muscle relaxants and painkillers, and got her leg yanked on for a few minutes until it went back into place.

What did I learn? I learned that sometimes, instinct will tell you what you need to know, even when it doesn't occur to your conscious mind. I also learned to be prepared for the unexpected; that sometimes, you will see crazy, off-the-wall stuff. I also learned that some of what you learn in medical school is relevant (in our last anatomy block, we had a discussion of the inherent weakness in the back of the hip joint, and it was interesting to note that the patient's mechanism of injury matched that little bit of anatomical knowledge perfectly).

So now, I'm waiting on that pathologist's report from my skin lesions, and am getting myself settled in ready to start classes tomorrow. Here we go again...