CJ - I spent another day in the burn clinic yesterday. They ended up having three surgeries to do, so the day started off early. The first involved a little girl who had suffered burns to her hands. It's important to clear away the dead skin (a procedure called dibriding), so Dr. Romero cleaned her up and bandaged her back up. The next surgery involved a little boy named Carlos (pictured). He's been at the burn clinic for a little over a week and a half now. His burns are on his neck, back, both arms, and also some on his legs. I got to scrub in for this one, which was great. We took off Carlos' bandages and removed the dead skin from his burns. Then we put on a pain-relieving/antiseptic cream over the burns and bandaged him back up. While we were bandaging him up, I got my gloves in the way of the nurse helping to put tape on his bandages. Contamination! I popped off my sterile garments and watched the last surgery instead. A little boy came in that had been in a motorcycle wreck a few days prior. He had torn his Achilles tendon and consequently had required surgery. However, after his surgery, some of the tissues in his lower leg had started dying. Dr. Romero went in and removed the dead tissue (taking about 3 in x 3 in). He bandaged him up and planned on grafting the skin at a later date.

Mark - Yesterday was another one of our double shift days. One in the morning as usual, and then one at 8pm. In the morning, Craig and I headed up to labor and delivery to see what was going on there. We got our scrubs and headed into one of the OR's to watch a C-section that was taking place. The doctor was very friendly and talked to us throughout the procedure, telling us what he was doing. After the C-section, there were no more procedures on the schedule so the two of us headed back to the burn center to spend an hour or so with the kids. I don't know what had taken over the burn center yesterday but almost every child in the place was smiling, laughing, and playing with us. It was awesome to see.

Craig - Yesterday morning I was back in the labor and delivery area for the first part of the morning. Right when Mark and I arrived there was a C-section about to start. We checked with the doctor to make sure we could observe and then stepped into the OR. Once again the doctor's speed and efficiency amazed us as he had the little girl out in under 15 minutes. We stayed and watched the abdomen being closed up and talked with the doctor as well as we could. There were no more patients in labor or scheduled surgeries for the day so we headed down to the burn clinic to play with the kids. It was as awesome time, especially getting to see little Juan walking around. Even though he still is unable to bend his legs due to the pain, you could tell he was just thrilled to be mobile again. I also got the chance to hang out with little Bianca and was able to get a smile and a laugh out of her for the first time since I first met her. Overall it was a great morning.

Mark and Craig's night - In the evening, it was the big man's and my turn in the pediatric emergency room. Once again, all of the students and doctors there were super friendly. Not only were we asked to join them for a little pizza in the ER, but they also had us performing physical exams on a some of the children. We were asked to take one of the new patients, perform and exam and tell them what we thought the diagnosis might be. Even though we didn't know all of the Spanish medical terms, we were still able to tell them that the child probably had laryngitis. Once 11pm hit, the action in the ER pretty much stopped. We spent another hour talking with the students and then headed home for some much needed rest.

Pete- As seems to be the trend after weekends, the PICU/NICU had a good number of new patients and only 3 of the 10 beds were empty. It still amazes me to look at how quick some of the kids are discharged and how some have been there for more than 2 weeks. We received a young girl with a staph infection of her knee that required her to be quarantined in a separate room as to limit the risk of transmission. Another, had suffered a blow to his head at his home and was about to undergo surgery for a subdural hematoma. The other 2 new admittances both had recent bouts of pneumonia. After a grueling session of rounds that Dr. Montoy asked some brutal questions of the residents and students we were afforded a small break. I opened the first English textbook I have seen in the hospital and read on pediatric emergencies. As soon I as I was 2 pages in Victor, a third year resident, grabbed me to take me into the quarantine room. We donned gowns, gloves and masks, and he produced 2 needles for a blood draw. At that moment, all that flashed through my head was Will discussing needle sticks with us before we left. It was my job to hold her arm down and allow Victor to do his job. She protested as much as she could, and Victor retrieved the needed blood. As he left the room, I sat there holding a cotton ball on the puncture site with one hand and holding her hand with my other hand. When I finally left the room, Victor told me that I would be performing the next round of blood draws on Wednesday. Afterwards, I found the chapter on drawing blood and started brushing up.

Pete and Cory- Cory and I wandered up to the Labor and Delivery area to grab our scrubs and start the evening out. As soon as we changed into our sterile scrubs we saw an intern and resident scrubbing in. We asked if we could observe them, and they happily agreed. They told us we would be seeing an emergency Cesarean. Cory has seen everything in Labor and Delivery, but all this was new to me. Upon entering the OR we saw a woman on her side with a RN checking her contractions. When the head physician entered she noted that the babies head had begun to crown and was too far along to do a C-section. Now, I was able to see a natural birth instead of a C-section. Cory told me not to look away as the birth can take place in only a few short minutes, and he was right. In less than fifteen minutes she delivered a little girl and was exhausted. The doctor said that her other children had been delivered via C-section and they needed to check on the uterus. As they did, they noted a failing and she consented to a tubal ligotomy. It was interesting to see how they made an incision through the patient's belly button and dug around to find both fallopian tubes and stitch, cauterize and clamp them shut. It was a procedure that took forty minutes that seemed much quicker. This happened to be our only patient we saw throughout the whole night, so we headed to the Pediatric ER to join Craig and Mark and talked for awhile and left for the evening.