Life in PRISON...

Well not so much for me but those are the people who's care I am now responsible for. So here I am on my Internal Medicine rotation at the Carole Young Medical Facility (CYMF). So I figure I should start off with a little about the prison itself. CYMF is a minimum security prison facility for inmates with chronic diseases, terminal conditions or post-op wound healing. It also houses 300 female inmates most of whom work in the hospital doing house keeping, janitorial and kitchen work. There are 5 "pods" or wings of the hospital with roughly 50 - 100 inmate/patients per pod. I was surprised to learn that most of the patients are men, there is only 1 pod for females and most of them are post op for some kind of surgery or are cancer patients in between rounds of chemo/xrt (radiation treatment). I was a little apprehensive knowing that most of the patients I'd be treating were going to be male, until I saw the patients. Most of the male inmates are seriously sick, 70+ and look emaciated, amputee's or can barely walk... needless to say they aren't very intimidating. However that doesn't mean I'm not uneasy or stay vigilant while in the room with them. When I see patient's I always have a guard with me and the door is always open. I have never felt unsafe, threatened or really had any trouble with a patient at all. According to our Preceptor staying at this facility is highly coveted, apparently its one of the nicer facilities and so inmates don't act up for fear of being transfered. So now you know a little about the place, here's a little about what I'm doing.

This place is FANTASTIC! I'm getting to see all kinds of crazy stuff!! These people are really, seriously ill and dying. A little morbid and kinda sadistic I know, but you have to look at it from where I'm at... I've never seen any one with Hep C in liver failure with a gigantic belly that needs to be tapped, and then I get to help do the paracentesis! I have seen Myasthenia Gravis a disease so rare only 10 in 1 million people have. I have a patient with Schizophrenia (and you all know how much I love the crazies!!) a patient with TB and AIDS another with Hodgkins lymphoma. It's amazing to see so much pathology, every patient I get has some kind of seriously horrible disease. Most family med practitioners, in their entire career might see, if their lucky/unlucky enough, one or two of the patients I've seen just in the two weeks I've been here. I'm learning soooo much, how to treat really sick people, rare diseases, how to admit, discharge and some of the outrageous ways our tax dollars are spent on inmates. Like the illegal alien who is basically a vegetable. When prisoners are brain dead, terminal and close to death they are paroled to hospice and the family takes over care and fee's for their end of life stage. However since the patient is an illegal he is not eligible for parole and the state will have to pay for his comatosed ass until he dies. Moving on.. There's also lots and LOT'S of wicked, nasty wounds to clean and dress. Now I'm a freak for the gross stuff, but there are a couple wounds here that made MY stomach churn, mostly it was the indescribable foul stench that got me. However I still loved it ;)

Well we have a long weekend coming up and I'm not sure what I'll be doing ( Austin? New Orleans? Oklahoma?) but I'll be sure to post when I get back.