So, it has been a year...

So, a year has gone by since my last entry, and save the multitude of calls and shelf exams and such, nothing too exciting has happened. Interview season has now come and is on its way out.  Mostly, the hospitals all blur into one; some combination of nurses, beds, sick people and a tour guide talking about the upcoming renovation.  It was remarkable same, regardless of which part of the country I was in. Hopkins was by far the most impressive, with a staggering number of residents and fellows all roaming around a gargantuan hospital with hallways all named after former chiefs of medicine.  So, directions were often given as such: Go down Nelson, turn into Halstadt, etc...  

As far as interesting cases goes, there were certainly two that stand out.  First was a middle aged man with rheumatoid arthritis who developed fulminant sepsis / septic arthritides (that's right, polyarticular septic joints) and an abdomen full of abscess all due to immunosuppressive therapy with immunomodulators.  The second interesting case was a gentleman who arrived in the ED with very labile blood pressures and a remote history of heart disease.  He developed respiratory failure with subsequent failure to wean and was finally diagnosed with FSGS with concommitant HCV infection.  Those two cases pretty much take the cake as far as zebras go.  

I'm still waiting on my first pheo...It's bound to show up one of these days.