It’s cold here again. Predictably off tempo the season has changed. Little things that I had looked forward to seeing blossom are gone. I don’t know where they went. But it’s always been me. Everytime. … those were the days.
Oh … and it’s finally getting cold in Michigan too. Winter is here now.
Enough of these thoughts I couldn’t say even if I wanted to … I’ve got a job to do. Let’s go.
Today I’m on call again. The next time I get a day off will be on December 20th, the day after my birthday! YAY!! …. yay.
[ … 12:26 PM … ] Apparently my attending, Dr. Kermit, is a computer geek. He “looks” like the kind of person who lives on BBS’s and still feels more comfortable in the DOS blacklands than anywhere else. I’ve made up my mind to not mention this site to anyone even if they ask. I’ll say the address is at “www.scottliles.com.” That’s a real URL but it’s not mine and it’s always under construction. This is a good plan. For the first time I’ve actually met an attending who would actually know how to find my site if he knew it existed. As far as coming up with questions regarding our patients, he is very good at that. So much so that it’s driving our team crazy. He’s also taken a liking to the hospital’s intranet email system. He sent me 6 emails within 2 hours yesterday regarding every thought that crossed his mind. It’s very annoying.
[ … earlier today … ] Conversation with other senior resident:
ME:”So when can you give me the beeper so I can start taking new patients today?”
OTHER SENIOR: “Probably later, Scott. I’ve only got four patients on my service now.”
ME: “Four? Must be nice.”
OTHER SENIOR: “Yeah, we had more but they died. I guess we have to read more. Haha!”
(She’s kidding. Really.)
[ … 2:50 PM … ] One of the patients I’m covering tonight has renal (kidney) cancer spread (metastasized) to his liver and lungs. His serum potassium level is so high, you’d think his blood was made out of banana milkshakes. He is expected to die tonight. We’ll see.
[ … 7:53 PM … ] My 20 year old college man is going home tomorrow. He’s still having fevers up to 39 C every night, but it looks like it’s probably just mono. Besides, he feels fine and he’s just sick of being in the hospital like most young active people are. The infectious disease specialist, Dr. LOUDER, told us in his usual humorously indignant bellow that he most likely has mono. Unfortunately, he’s seen two young people just like him in the past year who ended up having lymphoma instead. We’re not telling our 20 year old this though. The chances of him having lymphoma are extremely small. If we told everyone every possible thing they could have, the world would be living in fear. Of course, if we knew what he really did have, we would tell him. But we don’t, so unless he asks outright “Could this be cancer?”, we figure it out first. If he still has these fevers in a week, then we’ll have to tell him what may be horribly possible.
Besides that he’s really getting tired of being here, or maybe that’s just his mono.
[ … 11:40 PM … ] I had just got off the phone with my intern telling him there was nothing going on when the “CPR TEAM STAT” call boomed through the halls. I raced a nurse there and beat her at the last 20 yards. When I ran into the room I was more short of breath than the patient who was talking and breathing quite fine. The story was he was choking on something, turned blue, and the nurse called the CPR TEAM — that’s me. He was a surgical patient so the surgeons took over after I got there. The only casualty from that call was that I lost my two pens, which probably bounced out of my pocket during the sprint. My subtern/4th year medstudent, H.L., gave me his pen though, so he’s back on my favorite student list. STRONG work!
[ … 3:04 AM … ] I’m not really tired now. Four more hours and this call is over and I’m wide eyed and bushy tailed. Bring on the CPR’s! Give me something here! Train wrecks! Overdoses! Strokers! Anything but the lame malingerer I’ve gotten tonight. She does the world’s worst acting job of faking episodes of sudden weakness and seizures. Of course, she’s an ex-health care worker (it’s always ex-nurses or ex-medical assistants for some reason) with a subnormal IQ (documented) currently involved in a lawsuit. I have to be up at 3 a.m. for this? She’s like a freshman drama student compared to the Shakespearean fakers I had in October. Ah well, we’ll let psychiatry deal with it.
[ … 5:01 AM … ] Okay … NOW I’m tired. While dictating over the phone I must have yawned nearly 20 times. Our last patient is still wheezing up a storm in the ER. She’ll be fine though. My intern, Vas, seems quite protective of me. I try to help him write his daily patient notes and he says seniors aren’t supposed to do the notes — that’s the intern’s job. He tells me I should get some sleep and he’ll give me a call in the morning. He’s from an academic program (like myself) where the seniors are strictly there for advisory purposes and they don’t do the floor work.
Why am I typing this entry when I should be in bed? By the way, renal cancer guy didn’t die last night. That’s good enough for me.
[ … 5:16 AM … ] Walk down hall. Go into callroom. Remove whitecoat. Get in bed. Air conditioning is on for some reason.
[ … 5:17 AM … ] Beeper goes off. Fumble for beeper. It’s a CPR in the Unit.
Thoughts in the dark: **Why are they overhead paging the CPR TEAM to the ICU? They have their own CPR Team in the Unit. Maybe the other team is busy with another code. Better check it out.**
[ … 5:18 AM … ] Whitecoat goes on. Run down hall. Descend 6 flights of stairs. Arrive in ICU. Patient is already stabilized by nursing staff. **Damn, they already shocked her!** Sleepy ICU Captain (not me, the other one) shows up 5 minutes later. His hair refuses to obey the laws of gravity or composure. I watch for a while. I leave.
[ … 5:35 AM … ] Another intern taps my shoulder. She hands me my reflex hammer. It must have also fallen out on the jog downstairs. Resident coats should have zippered pockets.
[ … 5:55 AM … ] Back upstairs, typing this last entry. My intern asks, “Why are you still up? I thought you were going to sleep. Or are you afraid once you get back in bed they’ll have another CPR?”