Santa Clara Valley

This month, I'm rotating down at Santa Clara Valley Medical Center. We only spend one month of our ICU rotation down here but I've really been enjoying it. Coming back to Valley brings back a lot of memories even though I've only spent a month or two each year here as a resident. It's really a unique and wonderful place. In particular, I miss taking care of the underserved. The county hospital takes care of so many people in need, and this month, I've seen many homeless patients, victims of domestic abuse, and undocumented migrant workers. The underserved patient population makes the medicine fascinating as well; this call, I admitted three patients with HIV. It surprises me that I can so easily forget about the underserved. After spending most of the year at the mothership, Stanford, where tertiary care problems abound, I forget what the community and county setting is like.

The month is exhausting because along with the commute, we spend a lot of time here including taking thirty hour calls. The service usually totals 10-20 patients but it is very much resident run. There are four teams with a resident and intern each, and two fellows who help out. It's a fun role to act as a consultant, supervisor, and teacher. We also help out with cardiac patients which gives me exposure to cardiac ICU problems like heart attacks and arrhythmias. The cases are quite varied, from unusual infections (M. kansasii in the blood) to uncommon overdoses (beta blocker) to rarely-seen end stage diseases. Overall, it's a great exposure for our training.

Image is in the public domain, from Wikipedia.