Monday, July 28, 2008

Ball O' Stress

So, fellowship has been busy for sure!

I've been at work most days from 7:30a-6p, if not later. It's a lot of work, and it's pretty much nonstop. But, I'm enjoying it immensely.

However, it caused me to miss a dear friend's bachelorette party in Vegas. I had booked my flight, arranged a hotel room, etc. Then, I got so overwhelmed that my back went out. I think it's from both a white coat with too many things in the pockets as well as poor posture while reading a million pages of ID material. I'm working on both now.

Nonetheless, I had to tell my good friend, "So sorry, I think I may have a mini-meltdown if I try to go to Vegas and still do the mountains of work I have left to do." It wasn't pretty, and I felt awful for it.

Another casualty of fellowship. Fortunately, the good friend is actually an awesome friend and didn't make me feel worse than I already did. I owe her a bachelorette drink before her wedding. Some quality time with her and the rest of the girls will do wonders for my current mood.

Sunday, July 6, 2008

Last Word

I was moonlighting last night, and I got a call from one of the nurses to pronounce a patient at 6:30 this morning. Doctors don't have to be the one to pronounce patients as dead, but nurses for some reason think we have the ultimate power.

Or perhaps it makes them uneasy.

So, I got out of bed and walked up the stairs. I went into the room where the patient -- an elderly woman who had survived 10 years after a liver transplant (no small feat) -- lie dead in her bed.

There's an eerie sort of air in the room of a dead patient. I don't know how to explain it. Perhaps it's because you know going in that the person is dead. Maybe it's the void of life you can sense. Whatever it is, it's unmistakable.

I went through the formalities of listening to her heart ("absent heart tones") and her lungs ("no breath sounds"). I also checked for corneal reflexes ("corneal reflexes absent"). I then called her primary doctor to tell him the not-so-surprising news. The patient was DNAR -- Do Not Attempt Resuscitation. That means no heroic measures, no intubation, no chest compressions and cracking of ribs.

The primary physician said he would call the family, since he had a relationship with them. I wrote my note in the chart and went back to bed. My note will be the last written word in her medical history. "The patient was pronounced dead at 6:30a on 7/6/08." No hoopla. No fanfare. Just a simple testament to the ultimate change in condition. I hope to leave this world as peacefully.

Saturday, July 5, 2008

Big Bad Fellow

That's how two of my friends have, individually, referred to me in recent days. One is a fellow herself. The other soon will be. It's a different sort of feeling, mostly because you realize that people see you as a "specialist" and you have no idea what you're doing.

Thank goodness for Attendings.

So, I had two days of orientation, harmless enough. Oh, except that I got lost traveling up to a hospital affectionately known as The View. I took another expressway up there, and it threw me off. So, here I am, a big bad fellow, about to cry because I've just passed my exit, I'm about to be late to orientation, and I have no idea when the next turn around is going to come. Rest easy, it all turned out OK.

Then, I had a day of on-the-job training. The old fellow, and residency classmate of mine, helped me learn the ropes. He's rounding this week, then I officially take the reigns on Monday. He'll be there Monday to make sure I don't make a complete debacle out of things, and then the job is mine.

Let the games begin.