I'm not entirely sure the benzos are helping. I certainly sleep more than I used to and to all the world I seem more composed, but there is a post sedation fog that I really don't like. A dampening effect on my words and thoughts that others seem to appreciate. But I am worried. There is probably a good reason for all the pain I'm going through and will probably emerge a better person for having gone through it. I am giving birth to a new me and a new future. Ask any doctor, give pain meds to soon in the process and the labor will stall. Ultimately becoming more prolonged and dangerous. Taking a shortcut to the other side is probably a bad idea. I find I don't dream on the drugs. No nocturnal defragmenting of my mind. But, no waking up in the middle of the night sweating and shaking either. My soul is simply a light turning on and off. Awake, asleep, then back awake again. No tossing or turning; no thinking or remembering. I don't know if it's better. I wondering if I'm just setting myself up for a harder fall. Mother nature has vastly more experience than I, and I don't like circumventing her. Perhaps, I need a series of small earthquakes to avoid the Big One. The fault line in my soul is certainly still there. Still active, and like a Southern California architect I continue to build my future on this unsteady ground. Betting that when the rumbling starts I will be spared.
I started taking them after my last visit with my daughter. We went to the zoo and horseback riding. Slept in the same bed, sharing the same breathe back and forth. Oh what beautiful sleep it was. Not this sugary sweet, artificially sleep concocted by pharmaceuticals. But it had to end and the goodbye was devastating. Devastating. Children have not been forced to suppress emotion, to acquire a public persona that hides pain and sorrow. No, when they hurt it is raw and real, and savage. Even now, partially sedated ,I can feel her hot sweaty fingers clinging to my neck as my sister peeled her off of me. "I wonna go wif you Mommy. I wonna go home" Oh baby, I want to go home too. I just don't know where it is. Despite her pleas I closed the door on her. Her face frozen in horror and shock with the realization that her Mommy left her. All she wants is to stay with me and I closed the door on her. Then we both broke down, sobbing. Me on one side, her on the other. The door shaking as she is throwing herself against it, trying to keep me there. My mother held me, but her mother didn't hold her. And my heart hurt. It's been years since I felt that tangible heartbreak, a dull pressure and squeezing in my chest. The physical manifestation of an emotional wounding. Driving to the airport I get the familiar buzz of my cell phone and I am so thankful because I have set up a friend to take care of me tonight. To not be alone and in pain. Because I knew that leaving her behind would be one of the hardest things I have ever done. And I am correct. But, he has called to cancel. As hard as I try to prevent these nights and these heartbreaks I keep failing. I have reached out above and beyond my comfort zone, clearing saying to all those who will hear me that I can not keep shouldering this burden alone. That I will carry my sorrow and tears away with me in the morning, if they will just hold them for me tonight. But I have failed to offer enough in the negotiation process to seal the deal. At some point I will have to trade sex for comfort, to fulfill the age old contract men and women have always penned in the wee hours. But not this night. I am still bound by my previous contract, the marital contract, if only because it is a bit of familiarity in this still foreign world.
Arriving at the airport, the flight attendants won't let me on the plane. I am a walking disaster. My face is flushed, tears continue to stream down my face. I can't talk without my voice squeaking, then cracking, and finally I dissolve into tears. There are some women who cry beautifully, like a motion picture, that solitary tear can contain their sorrow. But I am not one of them. I am a wet, snotty, sobbing mess and I can not fly like this. I make the other passengers nervous; as if my agony will infect the plane and bring us all down. So I start taking shots of vodka, trying to numb myself up. When I can hold a conversation without falling apart I return to the counter to plead my case. I board last. And as the wheels lift off the ground I feel my soul splintering. Half in one state, half in another. Some on her side of the door, some on mine. Some in the Before, some in the After. It is parcelled out like so much candy on Halloween. Until the bowl is empty and there is nothing left for me.
I will make this trip again in four days. And this time I drive straight from the airport to the ER. Where I am expected to be whole person, and a selfless doctor, instead of the comminuted fracture I have become. This is why I must be sedated. This is why I have the benzos. I'm not sure they're helping though. Deep down I know this is a shortcut I should not be taking.
Monday, March 02, 2009
Thursday, February 19, 2009
To sleep, perchance to dream
I've got to conquer the nightly struggle to sleep because I can't continue to lose this battle.. Everyday I stumble through an artificially slow world because I am just not sleeping at night anymore. No matter how tired I am, once I lie in this bed my brain refuses to shut down. I was doing so well too. Then he came back, unannounced. I had just finished an overnight shift and was crashed out in blissful sleep when I heard the door open. And there he was: He has stopped taking his medications and started drinking again. He is a crying emotional wreck that I have neither the time or personal reserve to take care of anymore. And so we fight. Nasty, screaming, drag down but not knock down fight. He left, and I haven't slept since.
I live on a busy street and can tell the time fairly well based on the traffic pattern outside. My arch nemesis is the 5:15 bus. Up until that bus passes I am still convinced that I have a chance to sleep that night. Then my hopes are dashed by the sound of the diesel engine straining to make it up the hill. I hate that damn bus. During the day when I'm post night shift those same buses travel by each and every half hour, steady as the recent rain. But at night the street is silent except for an occasional traveller or two. And then I hear that bus. Sometimes I cry, because I know that I have to leave for work in half an hour and my chance to sleep is over. Furious because sunrise follows that bus and for everyone else the day has just begun. For me, it has just not ended. I used to play with a friend of mine when I couldn't sleep. I would text him every morning when the bus went by. 5:19, 5:16, 5:22, and we would keep track of when it was late. If I didn't text it meant I slept, and my soul was still. But most of his days started with a text of a time.
When your day doesn't officially begin or end the edges of your sanity get frayed and the concept of yesterday and the day before getting stretched into one long continuum of hours. Your ability to sequence events is strained and it gets difficult to communicate basic information about past events. It's considered torture in most countries for a reason. I look at my charting later and see all the misspellings and mistakes, that is if I can find my charts. I lose them so readily and waste more time searching the same places because I'm not sure, Did I checked this rack today? Or was that yesterday. At this point they're the same day. The same miserable lonely day stretched infinitum
I'm approaching my limit soon for just how much sleep deprivation I can take. Everyone at work can see it on my face and feel it as get tripped up on basic conversation. I walked in the other day and heard the collective gasp as people could see last night's every toss and turn embedded in my face. We all know someone needs to put me to bed and hold me until I fall asleep, but instead I'm running the room. Hopped up on caffeine and Hawaiian punch, people throw information at me at a dizzying rate. "Irishdoc line 17", "we need a doctor to the radio room", "can Bed 14 eat?", "critical lab for Bed 2", "Respiratory Therapy ER Bed 2 STAT". Meanwhile there's a line of patient's to triage and I've lost control of midroom. There I am standing in the middle of it the tornado trying to process it all. Just white-knuckling my way through the day because I'm convinced that this night, this time when the sun goes down, I will get to sleep. Perchance to dream...
Except it's already well into the morning. The street is quiet. And I'm pretty sure I hear the 5:15 bus rounding the corner.
I live on a busy street and can tell the time fairly well based on the traffic pattern outside. My arch nemesis is the 5:15 bus. Up until that bus passes I am still convinced that I have a chance to sleep that night. Then my hopes are dashed by the sound of the diesel engine straining to make it up the hill. I hate that damn bus. During the day when I'm post night shift those same buses travel by each and every half hour, steady as the recent rain. But at night the street is silent except for an occasional traveller or two. And then I hear that bus. Sometimes I cry, because I know that I have to leave for work in half an hour and my chance to sleep is over. Furious because sunrise follows that bus and for everyone else the day has just begun. For me, it has just not ended. I used to play with a friend of mine when I couldn't sleep. I would text him every morning when the bus went by. 5:19, 5:16, 5:22, and we would keep track of when it was late. If I didn't text it meant I slept, and my soul was still. But most of his days started with a text of a time.
When your day doesn't officially begin or end the edges of your sanity get frayed and the concept of yesterday and the day before getting stretched into one long continuum of hours. Your ability to sequence events is strained and it gets difficult to communicate basic information about past events. It's considered torture in most countries for a reason. I look at my charting later and see all the misspellings and mistakes, that is if I can find my charts. I lose them so readily and waste more time searching the same places because I'm not sure, Did I checked this rack today? Or was that yesterday. At this point they're the same day. The same miserable lonely day stretched infinitum
I'm approaching my limit soon for just how much sleep deprivation I can take. Everyone at work can see it on my face and feel it as get tripped up on basic conversation. I walked in the other day and heard the collective gasp as people could see last night's every toss and turn embedded in my face. We all know someone needs to put me to bed and hold me until I fall asleep, but instead I'm running the room. Hopped up on caffeine and Hawaiian punch, people throw information at me at a dizzying rate. "Irishdoc line 17", "we need a doctor to the radio room", "can Bed 14 eat?", "critical lab for Bed 2", "Respiratory Therapy ER Bed 2 STAT". Meanwhile there's a line of patient's to triage and I've lost control of midroom. There I am standing in the middle of it the tornado trying to process it all. Just white-knuckling my way through the day because I'm convinced that this night, this time when the sun goes down, I will get to sleep. Perchance to dream...
Except it's already well into the morning. The street is quiet. And I'm pretty sure I hear the 5:15 bus rounding the corner.
Wednesday, February 11, 2009
After
It is a strange situation when you find yourself a stranger in your own life. I wake up in the same bed, drive the same car and yet every breath seems foreign to me. This is not the same life I have been living. There is no car seat in the truck, no lunch box to pack, everything is exactly as I leave it everyday when I return. After fourteen years of being with someone I am experiencing loneliness for the first time. I have envied so many single friends and only now do I understand what it is like to be all alone surrounded by a sea of humanity. I surf through Facebook and Myspace trying to find old friends and struggling to make new ones. I have been hidden for so long beneath this enormous lie that was our marriage and trying so hard to pretend like my life was the same as my peers that I don't know where to start sometimes. There is no twelve step program to stand up and declare "I am a battered woman. My husband is an alcoholic, a drug abuser, and suffers from a debilitating mental disorder. I chose him and I stayed with him until he almost killed me. Today is the first day of the rest of my life"
Everything still has the tainted feel of the previous life. I still park the car and sit gathering my thoughts and preparing for whatever I might walk into. In my old life I never had the luxury of stability or security. I used to sit in the garage trying to ready myself for the nights activities. Sometimes I walked in and all was well. Sometimes I walked into a war zone, shifting from the chaos that was work into the chaos that was home. It is amazing how quickly you learn to make those adjustments. How hard it is to let go of the known, even when it is cruel and cold, just to avoid the unknown.
I walk into her room and it is so cold. There's no need to keep the heater on if she's not going to be there. Dust is starting to settle on the windowsill. I still think I hear her chasing the cats through the living room. The last night she was here I slept in her room. Beside her crib, which is unusual because when things were really bad I used to sleep under it. God what a shitty mother I was to need my child to protect me from my husband. I slept under her crib, woke up the next morning and went to work like nothing was wrong. After living a falsehood so long you start to forget where the truth really lies. In my case, it was under a crib. I think I'm going to get rid of it soon.
I started cleaning the house. Removing the years of accumulated memories and disappointments. No need to hold onto birthday cards from a decade ago. I suppose there never was, but I did it anyway and now I'm not quite sure what to do with all the shoe boxes of promises and dreams that will never be realized. Do I keep them for her so she knows that we loved each other, that her history and birth was not a mistake. Or do I just let it all go. A past life that is gone and is never coming back. I suppose a lot of it depends on what happens now, in the After. If he breaks down, gets hospitalized, kills himself, or me then it will be all she will have to know her father. I think of all the freshly orphaned children I have seen in my job and I know they want to hold onto all those memories. Everything their parent ever wrote or even touched. I just don't know whether she will need these things. I don't know if I need them. I guess it goes back to the question I ask all the time. Am I widowed or divorced? Is the man I married dead or alive.
The painful part has been finding all the hidden parts of him. Trash bags of empty vodka bottles, 211 malt liquor, and remnants of drug abuse. Some of it explains the ups and downs, the times I knew he was high or drunk but listened as he lied to my face. The answers to the worst moments of my life hidden in cabinets, on top of the refrigerator, under the mattress. Hauling it all out into the light of day I realize just how far down the rabbit hole he has gone and why I can never follow him down. I've been cleaning for days now and I don't know if I'll ever get the stain of him out of my house, off my body, and free from my soul.
So I suppose this is After. Decidedly different then before. Better, but I don't know who I am anymore. Maybe I never did. I just know that there was a Before and an After. But right now it just seems like I'm still stuck in the middle.
Everything still has the tainted feel of the previous life. I still park the car and sit gathering my thoughts and preparing for whatever I might walk into. In my old life I never had the luxury of stability or security. I used to sit in the garage trying to ready myself for the nights activities. Sometimes I walked in and all was well. Sometimes I walked into a war zone, shifting from the chaos that was work into the chaos that was home. It is amazing how quickly you learn to make those adjustments. How hard it is to let go of the known, even when it is cruel and cold, just to avoid the unknown.
I walk into her room and it is so cold. There's no need to keep the heater on if she's not going to be there. Dust is starting to settle on the windowsill. I still think I hear her chasing the cats through the living room. The last night she was here I slept in her room. Beside her crib, which is unusual because when things were really bad I used to sleep under it. God what a shitty mother I was to need my child to protect me from my husband. I slept under her crib, woke up the next morning and went to work like nothing was wrong. After living a falsehood so long you start to forget where the truth really lies. In my case, it was under a crib. I think I'm going to get rid of it soon.
I started cleaning the house. Removing the years of accumulated memories and disappointments. No need to hold onto birthday cards from a decade ago. I suppose there never was, but I did it anyway and now I'm not quite sure what to do with all the shoe boxes of promises and dreams that will never be realized. Do I keep them for her so she knows that we loved each other, that her history and birth was not a mistake. Or do I just let it all go. A past life that is gone and is never coming back. I suppose a lot of it depends on what happens now, in the After. If he breaks down, gets hospitalized, kills himself, or me then it will be all she will have to know her father. I think of all the freshly orphaned children I have seen in my job and I know they want to hold onto all those memories. Everything their parent ever wrote or even touched. I just don't know whether she will need these things. I don't know if I need them. I guess it goes back to the question I ask all the time. Am I widowed or divorced? Is the man I married dead or alive.
The painful part has been finding all the hidden parts of him. Trash bags of empty vodka bottles, 211 malt liquor, and remnants of drug abuse. Some of it explains the ups and downs, the times I knew he was high or drunk but listened as he lied to my face. The answers to the worst moments of my life hidden in cabinets, on top of the refrigerator, under the mattress. Hauling it all out into the light of day I realize just how far down the rabbit hole he has gone and why I can never follow him down. I've been cleaning for days now and I don't know if I'll ever get the stain of him out of my house, off my body, and free from my soul.
So I suppose this is After. Decidedly different then before. Better, but I don't know who I am anymore. Maybe I never did. I just know that there was a Before and an After. But right now it just seems like I'm still stuck in the middle.
Thursday, January 22, 2009
Battle Lines
Sorry to be gone so long, I know you worry. Life has been thrown into full panic mode recently and I haven't had much time to regroup. My life is accelerating into the light at the end of the tunnel: and I'm pretty sure it's an oncoming train. My program has decided that I am not progressing into becoming a doctor at a sufficient pace. Apparently I am distracted at work. I am letting my personal life compete with my job as a doctor and like a spoiled mistress, work is having a temper tantrum. They're not willing to ask what they could have done to contribute to the complete and utter destruction of my personal life. Nope. I have a problem as they see it and I'd better fix it. I'm sure it had nothing to do with being allowed to get septic for a month. Nothing to do with the fact that the people who should have been there for me were no where to be found and the people they disdain were the ones risking their licences pumping me full of meds to keep me going. Interestingly, we didn't discuss that.
I also seem to have a chip on my shoulder lately. Again no huge mystery there. Let's see I've given medicine and my residency my marriage, my youth, my health, and the first three years of the only shot of motherhood I'll probably ever take. Sorry if I think it's somebody else's turn to feed the bitch. I got nothing left.
Regardless, I am not developing the right attitude to be a physician. I am more interested in hanging out with the nurses and clerical staff then I am bullshitting with my fellow physicians and engaging in the grand circle jerk called literature review. It seems I think that the people on that side of the window understand more of what it's like to live in the real world then those on my side. On any one shift I can talk to at least one or two nurses who are single parents or are going through a divorce. One my side of the window there are thirty year olds who are still living with their parents. There is not one resident in my program who is divorced (very few who are even married), and there is not one woman with a child. I don't know why we haven't really bonded like were supposed to. It can't be that aside from medicine we have nothing in common.
Apparently I am also not aggressive enough in getting procedure and ICU players. I do however have the highest conversion rate of turning ICU patients into DNI/DNR's. Instead of convincing my patients families to go all out on their 95 y/o grandma and do everything I tell them the truth as I've seen it a hundred times, tell them that it is time and stand with them after I've pulled the tube. You get points for intubating and CPR but not for pulling the tube and seeing the patient gently to the other side. I knew this was coming. I got in a fight with one of my attendings a few months back about a similar thing. We had a young GSW to the chest arrive and not two seconds later his mother burst through the double doors screaming and sobbing. And I grabbed her in my arms as she 's losing it and push her against the wall and down it. Just far enough out of the way where she can't see the action but I can hear it and it's not going well. The police arrive to drag her out by her arms and legs and I shoo them away, because she has every right to be in this state. Her only son is dying steps away from her, if there is any time to be hysterical, it is now. So you have this huge black lady whose world has come completely unraveled being held in the arms of this little white girl with glasses, while someone is cracking her child's chest. And I have to hold her in my arms because I know that they are going to come charging past our area, like a runaway locomotive. And if I don't block her view she will see him flayed open, blood streaming down the gurney rails, with 20 people wrapped in yellow gowns and splattered with crimson stains looking terrified as they run for the elevator. When she remembers her son (because I know he's not going to make it) every memory will be forever intruded on by this last horrible vision. And I'm not going to let her see it, so I'm on the floor with her, my body blocking her view as I hear them readying to make the mad dash to the OR. And as they start to run past, I tell her I don't think he will survive, so that she will collapse into me just as they make there way past us. She never saw them, was so engulfed in her sorrow that she never knew he was inches away from her dying. And she will never have a memory of her son bloodied and ripped open and dead. I go back to the big room and my attending tells me I missed a chance to put in a femoral line. A bullshit central line. I missed a procedure I could have gotten credit for. I remember thinking, I don't want to be that person. The one who sees people as procedures and diseases instead of mothers and sons. I don't want to be a doctor if that's what it means. Sometimes it feels like a battle for my soul in that room and I have clearly chosen the wrong side as far as their concerned. You can either be a person whose a doctor or a doctor whose a person. The job of residency is turn me into a doctor and I'm failing at that. And I don't see that as a problem.
So I have five months left to try to pass. To pretend like medicine is the wonderful all consuming process that they think it should be. To make it the central figure in my life and my first and only love even though I see it as corrupted and immoral. To pretend like the people on my side of the glass have all the answers and are morally superior just because they went to medical school. When I know that the people on the other side are my true friends. They have experiencing picking their friends off the floor and holding them until they can stand again. They were there when I finally started to ask for help, handing me their numbers for the nights I struggle being alone, keeping me going when my colleagues just cared about who was going to cover my shifts. I know who my friends are and they don't have MD behind their names. I've dusted off my long white coat, they one I've never worn at work except to give death notifications. And I will wear it everyday now, just to wrap myself in the moral superiority that is expected of me. I am sending my child to live with my parents, even though she is the only thing that keeps me grounded, because I have been told I have to focus. Despite three years of seeing her be my only joy, my job sees my daughter only as a distraction and not as my salvation. She is competition to them. I am going deeper in debt to get an apartment for my mentally disturbed husband, because I will not abandon him to the streets. After fourteen years, after all the horrors he's put us through, I still meant my marriage vows and I will take care of him until he dies. I'm okay with that, even if no one else is. My apartment is empty, medical books and journals strewn about, white coat pressed and clean. I am readying for battle these days. Because after everything I have lost I will not lose my soul, I will not become what I hate, and I'm not staying in residency one second longer than I have to. There is big bright world waiting for me, a light at the end of the tunnel. And I am ready to leave all this darkness behind.
I also seem to have a chip on my shoulder lately. Again no huge mystery there. Let's see I've given medicine and my residency my marriage, my youth, my health, and the first three years of the only shot of motherhood I'll probably ever take. Sorry if I think it's somebody else's turn to feed the bitch. I got nothing left.
Regardless, I am not developing the right attitude to be a physician. I am more interested in hanging out with the nurses and clerical staff then I am bullshitting with my fellow physicians and engaging in the grand circle jerk called literature review. It seems I think that the people on that side of the window understand more of what it's like to live in the real world then those on my side. On any one shift I can talk to at least one or two nurses who are single parents or are going through a divorce. One my side of the window there are thirty year olds who are still living with their parents. There is not one resident in my program who is divorced (very few who are even married), and there is not one woman with a child. I don't know why we haven't really bonded like were supposed to. It can't be that aside from medicine we have nothing in common.
Apparently I am also not aggressive enough in getting procedure and ICU players. I do however have the highest conversion rate of turning ICU patients into DNI/DNR's. Instead of convincing my patients families to go all out on their 95 y/o grandma and do everything I tell them the truth as I've seen it a hundred times, tell them that it is time and stand with them after I've pulled the tube. You get points for intubating and CPR but not for pulling the tube and seeing the patient gently to the other side. I knew this was coming. I got in a fight with one of my attendings a few months back about a similar thing. We had a young GSW to the chest arrive and not two seconds later his mother burst through the double doors screaming and sobbing. And I grabbed her in my arms as she 's losing it and push her against the wall and down it. Just far enough out of the way where she can't see the action but I can hear it and it's not going well. The police arrive to drag her out by her arms and legs and I shoo them away, because she has every right to be in this state. Her only son is dying steps away from her, if there is any time to be hysterical, it is now. So you have this huge black lady whose world has come completely unraveled being held in the arms of this little white girl with glasses, while someone is cracking her child's chest. And I have to hold her in my arms because I know that they are going to come charging past our area, like a runaway locomotive. And if I don't block her view she will see him flayed open, blood streaming down the gurney rails, with 20 people wrapped in yellow gowns and splattered with crimson stains looking terrified as they run for the elevator. When she remembers her son (because I know he's not going to make it) every memory will be forever intruded on by this last horrible vision. And I'm not going to let her see it, so I'm on the floor with her, my body blocking her view as I hear them readying to make the mad dash to the OR. And as they start to run past, I tell her I don't think he will survive, so that she will collapse into me just as they make there way past us. She never saw them, was so engulfed in her sorrow that she never knew he was inches away from her dying. And she will never have a memory of her son bloodied and ripped open and dead. I go back to the big room and my attending tells me I missed a chance to put in a femoral line. A bullshit central line. I missed a procedure I could have gotten credit for. I remember thinking, I don't want to be that person. The one who sees people as procedures and diseases instead of mothers and sons. I don't want to be a doctor if that's what it means. Sometimes it feels like a battle for my soul in that room and I have clearly chosen the wrong side as far as their concerned. You can either be a person whose a doctor or a doctor whose a person. The job of residency is turn me into a doctor and I'm failing at that. And I don't see that as a problem.
So I have five months left to try to pass. To pretend like medicine is the wonderful all consuming process that they think it should be. To make it the central figure in my life and my first and only love even though I see it as corrupted and immoral. To pretend like the people on my side of the glass have all the answers and are morally superior just because they went to medical school. When I know that the people on the other side are my true friends. They have experiencing picking their friends off the floor and holding them until they can stand again. They were there when I finally started to ask for help, handing me their numbers for the nights I struggle being alone, keeping me going when my colleagues just cared about who was going to cover my shifts. I know who my friends are and they don't have MD behind their names. I've dusted off my long white coat, they one I've never worn at work except to give death notifications. And I will wear it everyday now, just to wrap myself in the moral superiority that is expected of me. I am sending my child to live with my parents, even though she is the only thing that keeps me grounded, because I have been told I have to focus. Despite three years of seeing her be my only joy, my job sees my daughter only as a distraction and not as my salvation. She is competition to them. I am going deeper in debt to get an apartment for my mentally disturbed husband, because I will not abandon him to the streets. After fourteen years, after all the horrors he's put us through, I still meant my marriage vows and I will take care of him until he dies. I'm okay with that, even if no one else is. My apartment is empty, medical books and journals strewn about, white coat pressed and clean. I am readying for battle these days. Because after everything I have lost I will not lose my soul, I will not become what I hate, and I'm not staying in residency one second longer than I have to. There is big bright world waiting for me, a light at the end of the tunnel. And I am ready to leave all this darkness behind.
Saturday, December 27, 2008
Those Patients
Stripped down the first thing you see on the patient is the purple and back bruise on the left bicep. It is raised and angry, and you can tell with out asking that it hurts. But that it hurt much worse the moment it was created. It has a matching circular hematoma on the right, but it was the left side that took the most force. Every physician and police officer can recognize these bruises. They are thumbprints from being grabbed, and shaken. Behind the deltoid you can see the matching fingerprints that go with each thumb. Fingerprints always leave that distinct pattern of one large bruise and 3-4 smaller ones close by. Travel down the arm and you find the bruises around the left wrist, same pattern, same story, different day. No defensive bruises along the forearms, she either didn't fight back or couldn't. Sometimes defending themselves these patients will be covered with bruises from elbow to wrist. Hit hard enough they'll get a nightstick fracture, an isolated broken ulna usually seen when you get beaten by the cops. The back is free from any physical evidence, maybe an abrasion on the scapula from being thrown against the wall. Even though you can't see anything she complains that her back is twisted up inside, the muscles ache when she stands. Moving to the abdominal exam, there are three raised fresh scars from a recent surgery. The superficial stitches are intact though from the way she gets up, holding her stomach tightly, its fair to assume the internal ones may have stretched or snapped. Scattered bruises down the shins round out the significant findings. She assures you that her face is fine, it happened Christmas night, and he knew people would be taking family photos. It is important to him that she still looks beautiful to everyone else, regardless of how broken and battered she feels inside.
Everyone hates these patients. We pretend that we don't, we say the right things to their face, how its not their fault. Even though in the back of our minds we wonder what she must have done to deserve it. Why she can't just leave. She says she's afraid, afraid it will push him over the edge and he will come back and kill her. And I reassure her that he won't, though in the back of my mind I can picture all the dead women I have seen after they made a run for it. The ones who were beaten to death, or shot in front of their families. The ones who make it to the hospital still alive with their throats slashed, the ones covered in multiple stab wounds. I try to pretend she is wrong when my work shoes are stained with evidence to the contrary. I try to tell her that the police can protect her. That she will be safe. I try, but we both know the truth.
It's two days after Christmas. I just got out of the shower and I'm drying off with a towel. And that patient, and those injuries, are just my reflection in the mirror.
Everyone hates these patients. We pretend that we don't, we say the right things to their face, how its not their fault. Even though in the back of our minds we wonder what she must have done to deserve it. Why she can't just leave. She says she's afraid, afraid it will push him over the edge and he will come back and kill her. And I reassure her that he won't, though in the back of my mind I can picture all the dead women I have seen after they made a run for it. The ones who were beaten to death, or shot in front of their families. The ones who make it to the hospital still alive with their throats slashed, the ones covered in multiple stab wounds. I try to pretend she is wrong when my work shoes are stained with evidence to the contrary. I try to tell her that the police can protect her. That she will be safe. I try, but we both know the truth.
It's two days after Christmas. I just got out of the shower and I'm drying off with a towel. And that patient, and those injuries, are just my reflection in the mirror.
Thursday, December 25, 2008
Merry Christmas
It's Christmas morning and I am where every loving mother is on her daughter's third Christmas. I am at work. Where I've been for every major holiday and social event since the day she was born. I'm living in the Pediatric ER this month so now I get to bring all the coughs and colds home to share with her. Who says I never bring her anything nice. We have been rocked and rolled as usual for a holiday, but not as bad as the big room. They've been turning over the Trauma Bay all night long. 18 traumas, four GSW's, one pediatric full arrest and a partridge in a pear tree. Oh wait, that's not how your version goes.
It's never a holiday without at least one dead kid. Every holiday goes horribly wrong for at least one family. There was last Mother's Day when dad was drunk and turned in front of a car. Killed mom and the kid in the back, the other kids survived to be shipped off to grandmas and watch their Dad get taken away for vehicular manslaughter. I'm guessing no ones going to forget that little Kodak moment. And forget about the commercial. This Thanksgiving I intubated two kids, one lived, one died. Ahh, the stories I could tell. I probably will tell given enough time. That Pediatric resuscitation room has put more cracks in my soul then anywhere else in this hospital. It is the one place that reminds me of how much I still have to learn and of the fleeting nature of life. The holidays, they just shatter you.
I've learned to control a lot of how I feel and react. I've taught myself to toughen up. There are so few things that get my adrenaline to flow anymore but half dead, sick as shit kids rattle my cage,. There's so many different tube sizes and equipment, their vital signs are all over the place. Every drug you give is based on how much they weigh and as if that isn't bad enough their weight is calculated in kilograms. Are you kidding me, in the middle of this grand cluster fuck known as a Pediatric trauma, I have to deal with the metric system. These are the moments your high school algebra teachers never told you about.
So what to tell you . The kids seized, then stopped breathing then died. Just like one did in ER's all across this country tonight. It doesn't ever stop in my world, not even for the holidays. Merry Christmas. I'm going to go open presents with my daughter now.
It's never a holiday without at least one dead kid. Every holiday goes horribly wrong for at least one family. There was last Mother's Day when dad was drunk and turned in front of a car. Killed mom and the kid in the back, the other kids survived to be shipped off to grandmas and watch their Dad get taken away for vehicular manslaughter. I'm guessing no ones going to forget that little Kodak moment. And forget about the commercial. This Thanksgiving I intubated two kids, one lived, one died. Ahh, the stories I could tell. I probably will tell given enough time. That Pediatric resuscitation room has put more cracks in my soul then anywhere else in this hospital. It is the one place that reminds me of how much I still have to learn and of the fleeting nature of life. The holidays, they just shatter you.
I've learned to control a lot of how I feel and react. I've taught myself to toughen up. There are so few things that get my adrenaline to flow anymore but half dead, sick as shit kids rattle my cage,. There's so many different tube sizes and equipment, their vital signs are all over the place. Every drug you give is based on how much they weigh and as if that isn't bad enough their weight is calculated in kilograms. Are you kidding me, in the middle of this grand cluster fuck known as a Pediatric trauma, I have to deal with the metric system. These are the moments your high school algebra teachers never told you about.
So what to tell you . The kids seized, then stopped breathing then died. Just like one did in ER's all across this country tonight. It doesn't ever stop in my world, not even for the holidays. Merry Christmas. I'm going to go open presents with my daughter now.
Friday, December 12, 2008
Random Ramblings
I spent the day today like a normal person and it never ceases to amaze me how the most mundane moments can give me such pleasure. My daughter had her Christmas pageant and was chosen to be the Christmas angel. She was just a vision with golden curls and enormous blue eyes. It was such a pleasant hour, of just being able to sit in the audience, not have be a leader or have any level of responsibility. Not having to think about my job or my marriage, for the most part. To just blend in as part of the crowd. Every few moments the curtain would open and another group of kids would get ready to give it there all. Its always funny to see which ones will freeze up and then watch the other children try to adjust their dance for the three of four kids who become stunned little statues. Some kids just dissolve into tears while some get that special glint in their eyes, get an extra shimmy in their step and steal your hearts. I love to watch the teachers in the corner exaggerating the dance moves and then you can see which kids are even remotely in sync. Sometimes I like to watch the parents who are intensely wrapped up trying to get their kids to smile or wave. It's so beautiful how we want so much for our children, even though they won't remember any of this. There so young and yet we want to package the world for them and say "Here it is, take it all and make it yours". When they're young we encourage their greediness, to want it all to see it all, to be it all. I don't know when that changes but how different the world would be if we could hold onto that innocence and the blind faith in everyone. Of course, how different would the world actually be if there was a Santa Claus and every boo-boo was healed with a kiss.
I'm feeling better because I'm sleeping better the last few days, so you guys can cancel the suicide watch. What a difference a good night's sleep brings. I also have been getting a lot of support from some one I never thought would have become the friend he has. It's strange that you can meet some people who the instant you speak to them, you feel like they know who you are even when you don't know yourself. One of those people who you never feel the need to lie to because it would be like lying to yourself, and really, what's the point of that. I have one of those to thank for getting me writing again, and I'm glad I am, even if it is painful and is scarring the shit out of you, dear readers. But this other person, I never saw coming and that makes his presence all the sweeter because I never expected anything from him and yet I've gotten so much. We had worked together for awhile, he tolerated my cynicism in the alcove, and I tolerated and lets be realistic, encouraged, his blatant flirting. He also accidentally caused me to have my first flashback, one that I didn't handle well because I had never experienced it before. After I pulled it together as best I could, I explained things and we became fast friends. I was transferred to a different ER for month and would occasionally think of him. The first time I saw him again I was intubating a patient and I looked up to see him looking intently for me because he had heard I was back. It was one of those times when you watch someone and they don't know your looking at them, so there not trying to hide anything or be someone or something else. And sometimes when I have a bad day I think of the look on his face as he was trying to find me and it reminds me that even though I don't always realize it, I matter to someone. And now he and I text everyday, at least a line or two, just because. He was the only one who responded to my text the day my heart was breaking over my son. I haven't seen him since last month and I'm very conflicted because I worry so much about screwing things up somehow if we go out for dinner or hang out together. I'm a pretty damaged person, I freely admit it, and I have forgotten how to have normal friendships and normal relationships. I feel like everything I touch I ruin these days so I'm constantly pushing people away. And I don't now how to be a good friend to anyone because I have spent so much time this last year avoiding people so I wouldn't have to answer personal questions. I feel bad because I don't think he ever planned to meet someone he would need to worry about, worry about me getting hurt and worrying about how I'm doing emotionally. It must be an awful big weight to be responsible for redeeming one broken girls faith in men again. But so far..... he's doing a really great job.
I'm feeling better because I'm sleeping better the last few days, so you guys can cancel the suicide watch. What a difference a good night's sleep brings. I also have been getting a lot of support from some one I never thought would have become the friend he has. It's strange that you can meet some people who the instant you speak to them, you feel like they know who you are even when you don't know yourself. One of those people who you never feel the need to lie to because it would be like lying to yourself, and really, what's the point of that. I have one of those to thank for getting me writing again, and I'm glad I am, even if it is painful and is scarring the shit out of you, dear readers. But this other person, I never saw coming and that makes his presence all the sweeter because I never expected anything from him and yet I've gotten so much. We had worked together for awhile, he tolerated my cynicism in the alcove, and I tolerated and lets be realistic, encouraged, his blatant flirting. He also accidentally caused me to have my first flashback, one that I didn't handle well because I had never experienced it before. After I pulled it together as best I could, I explained things and we became fast friends. I was transferred to a different ER for month and would occasionally think of him. The first time I saw him again I was intubating a patient and I looked up to see him looking intently for me because he had heard I was back. It was one of those times when you watch someone and they don't know your looking at them, so there not trying to hide anything or be someone or something else. And sometimes when I have a bad day I think of the look on his face as he was trying to find me and it reminds me that even though I don't always realize it, I matter to someone. And now he and I text everyday, at least a line or two, just because. He was the only one who responded to my text the day my heart was breaking over my son. I haven't seen him since last month and I'm very conflicted because I worry so much about screwing things up somehow if we go out for dinner or hang out together. I'm a pretty damaged person, I freely admit it, and I have forgotten how to have normal friendships and normal relationships. I feel like everything I touch I ruin these days so I'm constantly pushing people away. And I don't now how to be a good friend to anyone because I have spent so much time this last year avoiding people so I wouldn't have to answer personal questions. I feel bad because I don't think he ever planned to meet someone he would need to worry about, worry about me getting hurt and worrying about how I'm doing emotionally. It must be an awful big weight to be responsible for redeeming one broken girls faith in men again. But so far..... he's doing a really great job.
Wednesday, December 10, 2008
Missing him...
I'm having a hard time tonight and I don't know where to turn so an anonymous blog it is. I miss my son. I miss him and everything that he represents. I think about what he would look like, and smell like. I wonder what he would be doing right now. I covet an ultrasound picture I took of him before I went to the clinic. I know, it was stupid, but I snuck an ultrasound picture of him before he died. I have a crystal clear picture of exactly what I did and exactly what he was. Not a piece of tissue, not something that didn't exist. He was my son and he is dead and I miss him. When I feel like this I have no where to go because except for you, dear readers, a very select group of friends ( only one of which have responded to my Hail Mary text tonight, fuck you very much to everyone else) and my soon to be ex-husband, no one knows he ever was. If a child dies in your womb and no one knows he exists, does he make a sound? I don't know but he is definitely missed. I know life would be infinitely worse with him here but what I wouldn't give to hold him just once. I had no say in his conception, its a story I refuse to tell, but I had NO say in it. But I alone made the decision to abort him, drove myself to the appointment, (after showing up early to work of course, no day off for me, before or after), and I'm pretty sure I'm the only person on earth who mourns his passing. And most days and nights I forget that he ever was. And then I have nights like tonight where it hurts to breathe. I cry and cry and cry and I don't know how to fill the emptiness inside. An emptiness I have felt from the moment I came off the Propofol drip and knew he was gone. A mother knows when her womb holds a life inside it, and conversely when it does not. Sometimes I just drink, until I pass out. Because I know tomorrow will be another day and I won't have time to think of him. That of course leaves me with tonight and I'm a wreck. My emotions are raw and I know I would make the same decision if two little pink lines popped up on that test instead of one, but it puts me in an awkward place doesn't it. How do you mourn the child you killed and would kill again without being a hypocrite? How are any of my emotions justified? And will writing this post again expose me to the hateful world of the pro-lifers, who will use this as a rational for outlawing abortion when the fact is my husband would have likely killed me had I stayed pregnant again. The last pregnancy pushed him over the edge of insanity and there's no telling where he would have gone with this one. I chose my life over my sons. This of course makes me a bad mother because in America, the definition of a good mom is one who chooses her child's life over her own. And I also chose my daughter's future over his. The living one over the unborn because I don't care what the religious right has to say: they are not the same, they are not equals. But I miss my son. His ten little toes, his tiny little fingernails. Whether he would have had brown eyes or blue. What gifts I would be picking out this Christmas for him. Maybe Thomas the Tank Engine. Who knows? That decision has already been made and it can not and should not be undone. But I miss my son tonight. And I know I will miss him a thousand other nights to come.
Tuesday, December 09, 2008
In sickness and in health
I have to return to work in a few days and I am of course dreading it. It's not that I dislike my job all that much, contrary to some opinions. I'd say I dislike 60% and all out loathe 30% which means the remaining 10% has a shot at getting a compassionate, caring doctor like on TV. Do you feel lucky today? Yeah, me neither. By the way these odds are pretty much in constant flux so some days my patients are fucked the moment they cross the double doors.
I've been out of work for over a week now because I finally got sick enough to get myself admitted to the hospital and get surgery. There's an old joke that says that residents don't call in sick, we call in admitted. Unfortunately, it's fairly accurate. I've had gallstones for three years now that intermittently bothered me, not enough to do anything about. I've been dreading surgery because I'm afraid of the anesthesia and what I'll say or feel when I wake up. The last time I was sedated they were scrapping my son out of me and I haven't really recovered from that ( See my post http://erdoctor.blogspot.com/2006/12/whered-you-go-i-miss-you-so-seems-like.html) Then three weeks ago I spiked a temp, started vomiting and have had constant pain. we've been treating me as an outpatient because I have vacation in February and like all residents I am expected to save all family and medical crises for when I have spare time. How dare I expect time off, medical care, or compassion. This is a hospital dammit! Go somewhere else for that. We tried treating me with antibiotics, anti emetics and pain control in an attempt to keep me working. When I nearly fainted a work , we just hooked me up to an IV pole and I kept seeing patients. Some of you dear readers are laughing because you think this is in jest. NOPE, the jokes on you because I ran the ER strapped to an IV pole one night rather than getting sent home. In the last three weeks I have been shot up with Toradol and Zofran in every intramuscular spot imaginable. It reached the point where when I would drink a glass of water it would stream out my hips, buttocks and shoulders like a sieve. So I've been slowly getting sicker and sicker as everyone in the ER watched me get thinner, more pale and finally begin to make serious mistakes. The day before I was finally allowed to go home sick, I missed a pelvic fracture on an old man hit by a car. A nurse saved my ass when she insisted I walk over there to re-examine him as his blood pressure kept slowly dropping. This was her third time coming to me and I kept telling her to "just put up another liter" because I didn't want to walk all the way over to Bed 3. He was 80/60 despite three liters when I finally went over there and as soon as I touched his belly I knew he was in trouble. He got emergent embolization, transfused two units and sent to the ICU. All because I fucked up. Because I had no business being there in my condition. I knew it, all the nurses knew it, my bosses knew it. But such is the nature of medicine. We care for the tired, the sick, the huddled masses. We are here twenty four hours a day, seven days a week and all major holidays: Our doors never close. We don't turn anyone away regardless of ability to pay or country of citizenship. We are the place of last resort, the quintessential safety net. We will help you when no one else will....unless you happen to be wearing a white coat. Then you need to suck it up and get your ass back to work.
Our program in particular should have known better, had swore that we had gotten better after what happened last year. You see last year, one of residents had been getting more and more tired, had been getting slower about picking up new patients. Just not carrying her fair share, it had been agreed. Her co-workers of course did what we were expected to do. We rode her harder, picked on her, and threatened her with failing the program if she didn't get it together. She didn't. She ended up in another hospital's ICU on a ventilator, almost dead, with a diagnosis of leukemia. I still wonder what that meeting of attendings most have looked like when that tidbit of information came out. Did they feel like shit for even one minute or were they just worried about covering her shifts. I have my own personal thoughts on that one, but hey I'm a cynical bitch. She is doing okay now. If by okay you mean she will never have kids, she lost her house, and she has to finish her final year of residency or she has no source of income, no health insurance. She has trained her whole life to do one thing. And now everything she had been putting off and waiting for since medical school is gone, that the dream she had been reaching for disintegrated right when she could final touch it. She gave everything to medicine and like the selfish bastard it is, it just kept taking. Her heart is not into medicine anymore, not that I blame her. I know a little about what it's like to give yourself heart and soul to something and almost have it kill you, oh yes, I do. I imagine her story starts in a bright white room to the sound of a ventilator slowly pushing air in and out of her diseased body. But it is her story to tell, not mine.
After this we promised that we would be a more compassionate program. That we would have back up so that if someone got sick they could take time off to get better. That we could all attend funerals, births and weddings. Except we just failed our first test. For those of you who are confused about why this works this way let me explain. In our department there are only four true physicians who are working at one time There are two second year residents (R2's) and two third year residents (R3's) at any one shift and they are the work horses of the department. The R3's are one year ahead of the R2's and so can work pretty autonomously. I am an R3. I can intubate, run a Tier II trauma, run a code and stabilize critically ill patients by myself for the most part. I still fuck up a lot though, which is why I'm still in training. Compare this to an R2 who may or may not be able to put in a central line, may never have run a code by themselves, and have never seen a traumatic airway with blood and teeth and vomit obstructing your view. It's important to have at least two skilled docs on because multiple traumas pour in at the same time plus we get the sick medical runs. Now none of these people can wait, it is life or death right then and there. You need a doctor at the head of the bed for each of these and we barely make it with just four doctors on and only two seniors. If you take out an R3 then we have only one person on who has necessary skills to see sick patients and that's just not enough. Don't tell anyone, but We just can not do it. That's how we ended up with me running a trauma attached to an IV pole. There was no one else available at the time. Part of me understands it and part of me doesn't. There is no backup plan, no re-enforcements to call in when all hell breaks loose in the trauma bay, we just make do with what we have. And while that is happening fast track is being opened up and the charge nurse is having an aneurysm because the 20 year old with chest pain hasn't been seen yet, even though we all know they are not sick. Some shifts are a nightmare and some are no big deal and you never know what your going to get. That's why I'm dreading going back to work. I'm one week post-op and I' m not sure that I am physically up for the challenge.
And let's be honest, I'm angry. Angry that I was allowed to get that sick and no one gave a shit. My last shift I showed up to work febrile with a heart rate of 138. My white count was 19,000 and I was damn near septic. I was sicker than most of my patients and I still showed up for work because that was what was expected of me. Its hard to look at my attendings and not wonder why any of them did not put a stop to this sooner. Didn't put their foot down and insist that I go home. I feel like I've lost respect for people who I work for and that makes it hard to go back . Its hard to work for something that seems to care so much for everyone else but looks the other way when we need help. A system that works itself into a frenzy when a patient accidentally dies across the street but looks the other way when it's one of our own. Medicine is like a marriage, we take the good with the bad, faithful to it and nothing else. Putting it above our real families, our real spouses and our own children. But I'm pretty sure that last line, in sickness and in health, was never intended to be a suicide pact.
I've been out of work for over a week now because I finally got sick enough to get myself admitted to the hospital and get surgery. There's an old joke that says that residents don't call in sick, we call in admitted. Unfortunately, it's fairly accurate. I've had gallstones for three years now that intermittently bothered me, not enough to do anything about. I've been dreading surgery because I'm afraid of the anesthesia and what I'll say or feel when I wake up. The last time I was sedated they were scrapping my son out of me and I haven't really recovered from that ( See my post http://erdoctor.blogspot.com/2006/12/whered-you-go-i-miss-you-so-seems-like.html) Then three weeks ago I spiked a temp, started vomiting and have had constant pain. we've been treating me as an outpatient because I have vacation in February and like all residents I am expected to save all family and medical crises for when I have spare time. How dare I expect time off, medical care, or compassion. This is a hospital dammit! Go somewhere else for that. We tried treating me with antibiotics, anti emetics and pain control in an attempt to keep me working. When I nearly fainted a work , we just hooked me up to an IV pole and I kept seeing patients. Some of you dear readers are laughing because you think this is in jest. NOPE, the jokes on you because I ran the ER strapped to an IV pole one night rather than getting sent home. In the last three weeks I have been shot up with Toradol and Zofran in every intramuscular spot imaginable. It reached the point where when I would drink a glass of water it would stream out my hips, buttocks and shoulders like a sieve. So I've been slowly getting sicker and sicker as everyone in the ER watched me get thinner, more pale and finally begin to make serious mistakes. The day before I was finally allowed to go home sick, I missed a pelvic fracture on an old man hit by a car. A nurse saved my ass when she insisted I walk over there to re-examine him as his blood pressure kept slowly dropping. This was her third time coming to me and I kept telling her to "just put up another liter" because I didn't want to walk all the way over to Bed 3. He was 80/60 despite three liters when I finally went over there and as soon as I touched his belly I knew he was in trouble. He got emergent embolization, transfused two units and sent to the ICU. All because I fucked up. Because I had no business being there in my condition. I knew it, all the nurses knew it, my bosses knew it. But such is the nature of medicine. We care for the tired, the sick, the huddled masses. We are here twenty four hours a day, seven days a week and all major holidays: Our doors never close. We don't turn anyone away regardless of ability to pay or country of citizenship. We are the place of last resort, the quintessential safety net. We will help you when no one else will....unless you happen to be wearing a white coat. Then you need to suck it up and get your ass back to work.
Our program in particular should have known better, had swore that we had gotten better after what happened last year. You see last year, one of residents had been getting more and more tired, had been getting slower about picking up new patients. Just not carrying her fair share, it had been agreed. Her co-workers of course did what we were expected to do. We rode her harder, picked on her, and threatened her with failing the program if she didn't get it together. She didn't. She ended up in another hospital's ICU on a ventilator, almost dead, with a diagnosis of leukemia. I still wonder what that meeting of attendings most have looked like when that tidbit of information came out. Did they feel like shit for even one minute or were they just worried about covering her shifts. I have my own personal thoughts on that one, but hey I'm a cynical bitch. She is doing okay now. If by okay you mean she will never have kids, she lost her house, and she has to finish her final year of residency or she has no source of income, no health insurance. She has trained her whole life to do one thing. And now everything she had been putting off and waiting for since medical school is gone, that the dream she had been reaching for disintegrated right when she could final touch it. She gave everything to medicine and like the selfish bastard it is, it just kept taking. Her heart is not into medicine anymore, not that I blame her. I know a little about what it's like to give yourself heart and soul to something and almost have it kill you, oh yes, I do. I imagine her story starts in a bright white room to the sound of a ventilator slowly pushing air in and out of her diseased body. But it is her story to tell, not mine.
After this we promised that we would be a more compassionate program. That we would have back up so that if someone got sick they could take time off to get better. That we could all attend funerals, births and weddings. Except we just failed our first test. For those of you who are confused about why this works this way let me explain. In our department there are only four true physicians who are working at one time There are two second year residents (R2's) and two third year residents (R3's) at any one shift and they are the work horses of the department. The R3's are one year ahead of the R2's and so can work pretty autonomously. I am an R3. I can intubate, run a Tier II trauma, run a code and stabilize critically ill patients by myself for the most part. I still fuck up a lot though, which is why I'm still in training. Compare this to an R2 who may or may not be able to put in a central line, may never have run a code by themselves, and have never seen a traumatic airway with blood and teeth and vomit obstructing your view. It's important to have at least two skilled docs on because multiple traumas pour in at the same time plus we get the sick medical runs. Now none of these people can wait, it is life or death right then and there. You need a doctor at the head of the bed for each of these and we barely make it with just four doctors on and only two seniors. If you take out an R3 then we have only one person on who has necessary skills to see sick patients and that's just not enough. Don't tell anyone, but We just can not do it. That's how we ended up with me running a trauma attached to an IV pole. There was no one else available at the time. Part of me understands it and part of me doesn't. There is no backup plan, no re-enforcements to call in when all hell breaks loose in the trauma bay, we just make do with what we have. And while that is happening fast track is being opened up and the charge nurse is having an aneurysm because the 20 year old with chest pain hasn't been seen yet, even though we all know they are not sick. Some shifts are a nightmare and some are no big deal and you never know what your going to get. That's why I'm dreading going back to work. I'm one week post-op and I' m not sure that I am physically up for the challenge.
And let's be honest, I'm angry. Angry that I was allowed to get that sick and no one gave a shit. My last shift I showed up to work febrile with a heart rate of 138. My white count was 19,000 and I was damn near septic. I was sicker than most of my patients and I still showed up for work because that was what was expected of me. Its hard to look at my attendings and not wonder why any of them did not put a stop to this sooner. Didn't put their foot down and insist that I go home. I feel like I've lost respect for people who I work for and that makes it hard to go back . Its hard to work for something that seems to care so much for everyone else but looks the other way when we need help. A system that works itself into a frenzy when a patient accidentally dies across the street but looks the other way when it's one of our own. Medicine is like a marriage, we take the good with the bad, faithful to it and nothing else. Putting it above our real families, our real spouses and our own children. But I'm pretty sure that last line, in sickness and in health, was never intended to be a suicide pact.
Sunday, December 07, 2008
Its late, I'm tired and I'm scared as shit to fall asleep. I have a fairly long history of nightmares, I would suspect most people in my situation would, but the intensity has been ratcheted up lately. Most of my bad dreams occur with such regularity that they no longer have the ability to frighten me. I wake up from them and shrug them off as a marker of my current state of mind, like something akin to a nocturnal mood ring. More adventurous women can relate to my dreams like their stable of lovers. "Hmm... last night I was with John, I must be having body issues today" or "Rob again, guess I wanted comfort sex'. Same concept, different circumstances.
Except, in the last few days my nightmares seem to have crossed over into my waking moments a la Freddy Kruger. I wake up in my bed, sweaty, my heart pounding, and I know I'm awake but I'm still surrounded by this malevolent force. I don't know how to shake it off. With each creaking of the house I anticipate someone coming for me, hunting me. It's waiting, bidding its time for the assault to begin. When I give it a form it becomes a vulture perched on the footstool, hungry to pick over my carcass. When it lingers behind me it's so tall, it casts this enormous shadow over and around me, blocking out the light. It's Benecio Del Toro's character in The Cell come to visit in my sleep. Horribly and intensely violent, graphic and disturbing. The worst is when it's the dogs. This snarling, rabid pack that descends on me in a feeding frenzy and rips out my throat. I am pinned beneath this heap of anonymous teeth and claws, my face seared with their body heat and spurts of hot blood and I can't breathe. And I wake up gasping, hungry for air, thinking that its all over it, its just a dream. But its still there. And I know I'm awake. It's not as if I'm confused about that, but it's like the nightmare is following me out my dream state, stalking me. I wake up and I'm terrified to even turn over because I'm convinced that it's there, sneering at me. I can feel its breath on my neck just as real as I can feel the heat from my lap top right now. So I just lay in bed. Frozen. Listening. Trying not to breathe hard so it can't find me. I can't close my eyes either because even though I don't always remember my nightmares, I still know whats happening in my slaap is infinitely worse then what happens when I'm awake. And this goes on for hours and hours at night.
The inner psychologist in me would say it's because I'm starting to feel emotions again rather than living in perpetual numbness. And I'm sure some good will come out of this but for right now it is sapping the last bit of strength and dignity I have left. I'm 30 years old and I'm afraid of the dark. I'm shaking right now because I know I have to sleep tonight and I know what's going to happen. Sometimes I try to stay up all night but then I'm just exhausted the next day. I'm struggling against the bogeyman and he is winning.
A friend of mine who knows some of what I'm going through, enough to know that he should be worried about me, offered to let me sleep at his house with him. Nothing sexual, just a chance for me to get some actual sleep. I initially said yes, and now have backed out of it. And I don't know if I should or not. The idea of falling asleep in the arms of a man I trust is like Heaven to me. But what if he makes a move or tries to kiss me. What if I have a nightmare and flip out on him. Not just cry, but full on PTSD flip out. I was out recently and someone playfully grabbed my neck like they were fake choking me and I thought I was going to die. I froze up, I almost vomited. Luckily I didn't scream, but I was with people who don't know my current situation and there was no hiding my reaction. And that was an ideal situation: I was in a good place emotionally, I was in public with multiple people, I felt like I was in control. Counter that with me being in a one-on-one situation with a man ( and I am terrified of men, fucking terrified of them) and its a recipe for disaster. So he's a little upset with me for backing out, and I'm still alone at night with these nightmares. Sometimes I run through my phone book texting friends hoping one is awake and can keep me occupied for a few hours. But that is going to get old fast, and soon they're going to start asking questions, and I am not read to go public yet. I just don't know what to do. It's late, I'm tired, and I'm scared as shit to fall asleep.
Except, in the last few days my nightmares seem to have crossed over into my waking moments a la Freddy Kruger. I wake up in my bed, sweaty, my heart pounding, and I know I'm awake but I'm still surrounded by this malevolent force. I don't know how to shake it off. With each creaking of the house I anticipate someone coming for me, hunting me. It's waiting, bidding its time for the assault to begin. When I give it a form it becomes a vulture perched on the footstool, hungry to pick over my carcass. When it lingers behind me it's so tall, it casts this enormous shadow over and around me, blocking out the light. It's Benecio Del Toro's character in The Cell come to visit in my sleep. Horribly and intensely violent, graphic and disturbing. The worst is when it's the dogs. This snarling, rabid pack that descends on me in a feeding frenzy and rips out my throat. I am pinned beneath this heap of anonymous teeth and claws, my face seared with their body heat and spurts of hot blood and I can't breathe. And I wake up gasping, hungry for air, thinking that its all over it, its just a dream. But its still there. And I know I'm awake. It's not as if I'm confused about that, but it's like the nightmare is following me out my dream state, stalking me. I wake up and I'm terrified to even turn over because I'm convinced that it's there, sneering at me. I can feel its breath on my neck just as real as I can feel the heat from my lap top right now. So I just lay in bed. Frozen. Listening. Trying not to breathe hard so it can't find me. I can't close my eyes either because even though I don't always remember my nightmares, I still know whats happening in my slaap is infinitely worse then what happens when I'm awake. And this goes on for hours and hours at night.
The inner psychologist in me would say it's because I'm starting to feel emotions again rather than living in perpetual numbness. And I'm sure some good will come out of this but for right now it is sapping the last bit of strength and dignity I have left. I'm 30 years old and I'm afraid of the dark. I'm shaking right now because I know I have to sleep tonight and I know what's going to happen. Sometimes I try to stay up all night but then I'm just exhausted the next day. I'm struggling against the bogeyman and he is winning.
A friend of mine who knows some of what I'm going through, enough to know that he should be worried about me, offered to let me sleep at his house with him. Nothing sexual, just a chance for me to get some actual sleep. I initially said yes, and now have backed out of it. And I don't know if I should or not. The idea of falling asleep in the arms of a man I trust is like Heaven to me. But what if he makes a move or tries to kiss me. What if I have a nightmare and flip out on him. Not just cry, but full on PTSD flip out. I was out recently and someone playfully grabbed my neck like they were fake choking me and I thought I was going to die. I froze up, I almost vomited. Luckily I didn't scream, but I was with people who don't know my current situation and there was no hiding my reaction. And that was an ideal situation: I was in a good place emotionally, I was in public with multiple people, I felt like I was in control. Counter that with me being in a one-on-one situation with a man ( and I am terrified of men, fucking terrified of them) and its a recipe for disaster. So he's a little upset with me for backing out, and I'm still alone at night with these nightmares. Sometimes I run through my phone book texting friends hoping one is awake and can keep me occupied for a few hours. But that is going to get old fast, and soon they're going to start asking questions, and I am not read to go public yet. I just don't know what to do. It's late, I'm tired, and I'm scared as shit to fall asleep.
Thursday, December 04, 2008
Start where it starts...
So it's about time I buy a return ticket back to reality and writing seems to be the only vehicle that knows the way home. After all the fighting to stay true to who I am and not lose myself, I suppose I will admit that it was a forgone conclusion the entire time. I was never going to win. I was never going to be the same person I was before becomming a doctor. There is no way to learn the true nature of the human spirit, the miracles and horrors, and then walk around the supermarket like every one else. You are all walking trauma victims, heart attacks, and ICU players. I don't see you in front of me. I see your veins and gauge how easy it would be to start an IV. How quickly I can crack your chest. I look in your cart in line as we wait and try to guess whether its your diabetes or cholesterol that will initiate our first meeting. Your buying your grandparents 50th wedding anniversary cake and I am wondering which one of them will walk out of my ER alone. Lets face it, the chances of them dying together is fairly slim. One day Nana is going to lay down in her bed, and for the first time in her adult life there will be no one beside her. Although she can stretch out, she will curl up on her side of the bed, unable to break a habit that it took a lifetime of companionship to learn. His silver hair will still rest on the pillowcase, she will smell him in the sheets. And as her heart breaks and an empty house fills with anguished sobs, she will picture my white coat and hear those simple and inadequate words. "I'm sorry, he has died". When people think of the worst moments of their lives, they see my face. So lets stop pretending that you and I are the same.
So this particular free fall starts and ends with a popcorn ceiling and a pale pink room. I am starring up, and the light is streaming through the window in such a way I can see the dust dancing. It s early morning and I can't move. Like a trauma patient strapped to a backboard I can only look up and side to side. I hear my colleagues voice in my head, a very unexpected source of comfort. "Its okay, your going to be alright. Your safe now". For the last year I have heard this particular surgeon whisper these words to every terrified MVA and GSW in the trauma bay. And for the last year I've always wondered how no one, not even him, noticed that the most injured person there was the one at the head of the bed. I takes a second to piece together what has happened, a little anoxic brain injury I imagine. I have been lying unconscious on my daughter's nursery room floor because my husband just finished strangling me.
I was almost seven months pregnant when I got a call from another hospitals emergency room that he had been brought in to after having a psychotic break. In retrospect he has been unraveling for years, I was just too busy reaching for my dreams to realize he was uncoupling from reality. I blamed myself, my unwavering pursuit of the dream I thought being a doctor was. Our daughter was my last attempt to prove to him that I loved him more than medicine, more than myself. I thought it would give his life purpose again but it simply accelerated his demise. I just didn't see it then. I see it now.
I have spent the last year trying to reach him. Being the good wife and refusing to accept the diagnosis and all that it entails. Going to the doctor's appointments, the group therapy, counting out his pills. I've been chasing him down the rabbit hole that true mental illness is. This potion makes you bigger and this one makes you smaller, but I'm looking for the one that makes you my husband again. And it has taken until this moment and this morning to see that the man I fell in love with no longer is. He hasn't died, he didn't leave. He just no longer exists. Perhaps one day I will be able to explain it better then this, but not today. The loss is still too great and the wounds too fresh.
It starts with my daughter crying in her crib and me not getting there fast enough. I had just opened her door when he grabbed me by my hair, threw me down and began to strangle me. I trusted this man with my life and I have now learned the hard way, the hardest way there is, that I made a mistake. He easily overpowered me and the whole time I clawed at his hands, fighting for air, waiting to wake up from this nightmare, I looked at him. I looked deep into the eyes of the man who I have loved since I was seventeen, the man who I chose to walk to on my wedding day. I looked at him and realized that the man I was looking at was a complete stranger. He had no sorrow in his eyes, no regret, no remorse. He was and remains completely untethered from reality. He just gripped tighter and tighter. So tight I never had a chance to scream or get a tear out of my eyes. So brutal and quick I never got a breath in. I never got to reach him, to pull him back from the cliff and bring him back home. Back to a time when the world was ours and we were going to grow old together. To celebrate our 50th wedding aniversary. I looked into is soul and saw a madman there. One who didn't recognize me anymore. The last thing I remember as blackness began to envelope my head was thinking "Oh my God, he just fucking killed me"
Then I came to on the floor, staring at the popcorn ceiling in the pale pink room. The most violent moment of my life juxtaposed with the serenity of my child's room. A shattered life in a Mother Goose nursery rhyme. My life ended in that room that morning. I keep walking and breathing but I will never be the same. I am desperately trying to get out of my marriage right now. I walk through these hallways terrified most days, waiting for that madman to come out again. At work I see him in every 5150 that rolls through those doors, raving against unseen henchmen and pursuers. I am afraid to breathe wrong, to commit some unknown crime and suffer the punishment. I am struggling to be a good doctor and a good mother. I still hold true to my vows and be a good and faithful wife, but it is to a husband that no longer exists. I know I have to start over, to start somewhere. But I don't know how to get this train back on the tracks. I am lost, but I am trying. Everyday I put on my white coat and navigate through the sea of humanity that is the ER and wait for someone to give me comfort, to heal the healer. Someone to walk into the quiet room and tell me "I'm sorry, he has died". To let me be the griving widow and you be the bearer of bad news. I want to cross back over that invisible line that seperates us and be one of you. But we are not the same. And its about time I accept that.
So here's to starting over again, just as messy and painful as you remember. I had hoped to make myself something more, to make you all, my dear readers, proud. To tie everything up in a neat little bow. But if I keep waiting for that moment I will never get my feet under me again, never halt this year long decent into madness. So I will have to make my new begining here, from the floor of a pale pink room, instead. But as I heard someone once say: It starts where it starts...
So this particular free fall starts and ends with a popcorn ceiling and a pale pink room. I am starring up, and the light is streaming through the window in such a way I can see the dust dancing. It s early morning and I can't move. Like a trauma patient strapped to a backboard I can only look up and side to side. I hear my colleagues voice in my head, a very unexpected source of comfort. "Its okay, your going to be alright. Your safe now". For the last year I have heard this particular surgeon whisper these words to every terrified MVA and GSW in the trauma bay. And for the last year I've always wondered how no one, not even him, noticed that the most injured person there was the one at the head of the bed. I takes a second to piece together what has happened, a little anoxic brain injury I imagine. I have been lying unconscious on my daughter's nursery room floor because my husband just finished strangling me.
I was almost seven months pregnant when I got a call from another hospitals emergency room that he had been brought in to after having a psychotic break. In retrospect he has been unraveling for years, I was just too busy reaching for my dreams to realize he was uncoupling from reality. I blamed myself, my unwavering pursuit of the dream I thought being a doctor was. Our daughter was my last attempt to prove to him that I loved him more than medicine, more than myself. I thought it would give his life purpose again but it simply accelerated his demise. I just didn't see it then. I see it now.
I have spent the last year trying to reach him. Being the good wife and refusing to accept the diagnosis and all that it entails. Going to the doctor's appointments, the group therapy, counting out his pills. I've been chasing him down the rabbit hole that true mental illness is. This potion makes you bigger and this one makes you smaller, but I'm looking for the one that makes you my husband again. And it has taken until this moment and this morning to see that the man I fell in love with no longer is. He hasn't died, he didn't leave. He just no longer exists. Perhaps one day I will be able to explain it better then this, but not today. The loss is still too great and the wounds too fresh.
It starts with my daughter crying in her crib and me not getting there fast enough. I had just opened her door when he grabbed me by my hair, threw me down and began to strangle me. I trusted this man with my life and I have now learned the hard way, the hardest way there is, that I made a mistake. He easily overpowered me and the whole time I clawed at his hands, fighting for air, waiting to wake up from this nightmare, I looked at him. I looked deep into the eyes of the man who I have loved since I was seventeen, the man who I chose to walk to on my wedding day. I looked at him and realized that the man I was looking at was a complete stranger. He had no sorrow in his eyes, no regret, no remorse. He was and remains completely untethered from reality. He just gripped tighter and tighter. So tight I never had a chance to scream or get a tear out of my eyes. So brutal and quick I never got a breath in. I never got to reach him, to pull him back from the cliff and bring him back home. Back to a time when the world was ours and we were going to grow old together. To celebrate our 50th wedding aniversary. I looked into is soul and saw a madman there. One who didn't recognize me anymore. The last thing I remember as blackness began to envelope my head was thinking "Oh my God, he just fucking killed me"
Then I came to on the floor, staring at the popcorn ceiling in the pale pink room. The most violent moment of my life juxtaposed with the serenity of my child's room. A shattered life in a Mother Goose nursery rhyme. My life ended in that room that morning. I keep walking and breathing but I will never be the same. I am desperately trying to get out of my marriage right now. I walk through these hallways terrified most days, waiting for that madman to come out again. At work I see him in every 5150 that rolls through those doors, raving against unseen henchmen and pursuers. I am afraid to breathe wrong, to commit some unknown crime and suffer the punishment. I am struggling to be a good doctor and a good mother. I still hold true to my vows and be a good and faithful wife, but it is to a husband that no longer exists. I know I have to start over, to start somewhere. But I don't know how to get this train back on the tracks. I am lost, but I am trying. Everyday I put on my white coat and navigate through the sea of humanity that is the ER and wait for someone to give me comfort, to heal the healer. Someone to walk into the quiet room and tell me "I'm sorry, he has died". To let me be the griving widow and you be the bearer of bad news. I want to cross back over that invisible line that seperates us and be one of you. But we are not the same. And its about time I accept that.
So here's to starting over again, just as messy and painful as you remember. I had hoped to make myself something more, to make you all, my dear readers, proud. To tie everything up in a neat little bow. But if I keep waiting for that moment I will never get my feet under me again, never halt this year long decent into madness. So I will have to make my new begining here, from the floor of a pale pink room, instead. But as I heard someone once say: It starts where it starts...
Wednesday, April 04, 2007
The Hours Part 2
I'm on a Q 3 schedule right now and it absolutely killing me. Slowly, painfully. Death by a thousand sleepless nights. Or at least that's how I feel. I'm scheduled to be on call 10 times in the next 28 days. Let's think about that. Thirty hours a shift X 10 shifts and were talking three hundred hours. Now in the real world, the world of forty hour weeks, it would take me 7 and a half weeks to accumulate that many hours. But I'm an intern. My sole purpose is to serve as a cheap source of labor. So that means in 10 shifts, I will work as many hours as it takes a normal person to do in almost 2 months. Does no body else understand the absurdity of this. And during your two months, you will get to go home, get federally mandated lunch breaks, call in sick if you need to. And I will get none of that... not in my ten days.
Old school docs, those who don't support limiting hours will say it's not that bad, you can still get some sleep. I'm working in the trauma ICU. I'm in charge of 16 critically injured patients, by myself, all night long. I don't sleep. I not allowed to actually. This particular ICU was cited recently for not providing interns with a place to sleep at night. So they created one on the 7th floor. Little room that even says SICU intern on the door. Reality check. The ICU is on the third floor and the call room is on the seventh. I'm not allowed to leave the ICU. No matter what. If I leave I'll fail the rotation. So every night at my hospital there is an empty call room with a nice comfy bed and there is a SICU intern who badly needs to lay down. And next time the AMA comes by to evaluate working conditions, my program will point to the SICU call room, and the reps will nod their heads approvingly. But no one will notice the sad, exhausted, depressed intern who will never get to sleep there.
Old school docs, those who don't support limiting hours will say it's not that bad, you can still get some sleep. I'm working in the trauma ICU. I'm in charge of 16 critically injured patients, by myself, all night long. I don't sleep. I not allowed to actually. This particular ICU was cited recently for not providing interns with a place to sleep at night. So they created one on the 7th floor. Little room that even says SICU intern on the door. Reality check. The ICU is on the third floor and the call room is on the seventh. I'm not allowed to leave the ICU. No matter what. If I leave I'll fail the rotation. So every night at my hospital there is an empty call room with a nice comfy bed and there is a SICU intern who badly needs to lay down. And next time the AMA comes by to evaluate working conditions, my program will point to the SICU call room, and the reps will nod their heads approvingly. But no one will notice the sad, exhausted, depressed intern who will never get to sleep there.
Saturday, March 31, 2007
The Hours
Any intern no matter how smart or stupid can quote the the hours regulation. 80 hours max per week. 24 +6 at a time ( 24 hours straight seeing new and old patients and 6 hours to tidy up loose ends) Any intern up to snuff also knows what a crock of shit it is.
Internship was once termed "the last sweatshop" in America, by the AMA no less, and that it still true today. In no other job do you have no right to quit, have forced uncompensated overtime, are denied lunch breaks, bathroom breaks, or the luxury of sleep. We have no protection from abusive bosses or nurses for that matter as shit runs down hill and at the bottom of every hospital is a pile of interns. Complain and you will be thrown to the wolves. There are no truly anonymous ways to fight back. Whistle blowers have been forced out of their residency programs or denied letters from their program directors to get their liscence. We are forced do to it in the name of patient care, because the patient comes first. Ahead of our families, ahead of our selves.
The hours are by far the most painful aspect of my life. I wake up before the sun comes up, before my daughter wakes up and trudge off to a world that will never be understood by outsiders ( though I appreciate you trying). Once there it is a whirlwind of lab results, progress notes, problem lists and admissions. Everyday you hustle, you sacrifice. Then before you know it, you look up and the sun has set, normal people begin the long trek home but not me. If I'm lucky I remember to call home before my kid falls back asleep, if not then I can't help but grieve for my husband who feels like a married single parent. In the hospital there is no distinction between night and day, like some twisted perversion of Las Vegas ( and by the way, what fuck ups happen at the hospital, stay at the hospital). All night long I admit new patients, follow up labs, answer phone calls about patients I have never seen, and replace electrolytes. The one thing I don't do is sleep. Or just rest. I deny myself a most basic of human needs. Before you now it the sun is rising again. I have to prepare for rounds, track down that x-ray, collect vital signs. It's so exhausting. My knees ache in the way that only someone who has been standing for twenty four plus hours can understand. My sense of balance is off because the most primative part of my brain is screaming to just get horizontal for 10 minutes. Even if I can't get sleep , I just want to be horiziontal, maybe even on a bed. After rounds end I start the difficult task of finding the car. Everyday blends into the next and its not unusual to see several post call interns searching for their cars. Like a Seinfield episode magnified by a hundred. Oh and the light. You're so tired that the sun is blinding, you literally can't see. After 24-30 hours of hospital light your eyes just can't make that adjustment. Some interns bring sunglasses. The drive home can be the scariest and most exhausting 20 minutes of call. I never change lanes because I just don't trust my abilities. It's akin to being a drunk driver (A recent study actually proved that being post call is equivalent to being legally drunk). When I get home my daughter smiles so wide, she does a little dance and claps. I try to stay up late enough to put her down for a nap and we sleep together. A little unconscious mother-daughter bonding. My husband gets her when she wakes up because I'm so tired I don't hear her. Sometimes she screams for me, she holds on to the toddler gate and screams Ma, Ma, Ma. The definition of being exhausted is ignoring your screaming child who just wants to see you after she's been waiting all day and all night.
Now repeat every third day, over and over again. For a year.
So why should you care, just one intern bitching about the hours. Because I fell asleep the other day. I fell asleep while driving. I was less than a two blocks from home, I stopped at a stop light and I had pulled my emergency brake (a learned trick to prevent roll back). I guess I set my head down against the steering wheel, I'm really not quit sure it's all a blur. But I woke up to the sound of a little old lady tapping on my driver's side window. Apparently a line of cars honking hadn't woken me up so this poor woman had to get out of her car to come see if I was okay. I can't believe I fell asleep. I can't believe that I was that tired. But what I really can't get my mind around, is that a half an hour ago, I was treating patients.
Internship was once termed "the last sweatshop" in America, by the AMA no less, and that it still true today. In no other job do you have no right to quit, have forced uncompensated overtime, are denied lunch breaks, bathroom breaks, or the luxury of sleep. We have no protection from abusive bosses or nurses for that matter as shit runs down hill and at the bottom of every hospital is a pile of interns. Complain and you will be thrown to the wolves. There are no truly anonymous ways to fight back. Whistle blowers have been forced out of their residency programs or denied letters from their program directors to get their liscence. We are forced do to it in the name of patient care, because the patient comes first. Ahead of our families, ahead of our selves.
The hours are by far the most painful aspect of my life. I wake up before the sun comes up, before my daughter wakes up and trudge off to a world that will never be understood by outsiders ( though I appreciate you trying). Once there it is a whirlwind of lab results, progress notes, problem lists and admissions. Everyday you hustle, you sacrifice. Then before you know it, you look up and the sun has set, normal people begin the long trek home but not me. If I'm lucky I remember to call home before my kid falls back asleep, if not then I can't help but grieve for my husband who feels like a married single parent. In the hospital there is no distinction between night and day, like some twisted perversion of Las Vegas ( and by the way, what fuck ups happen at the hospital, stay at the hospital). All night long I admit new patients, follow up labs, answer phone calls about patients I have never seen, and replace electrolytes. The one thing I don't do is sleep. Or just rest. I deny myself a most basic of human needs. Before you now it the sun is rising again. I have to prepare for rounds, track down that x-ray, collect vital signs. It's so exhausting. My knees ache in the way that only someone who has been standing for twenty four plus hours can understand. My sense of balance is off because the most primative part of my brain is screaming to just get horizontal for 10 minutes. Even if I can't get sleep , I just want to be horiziontal, maybe even on a bed. After rounds end I start the difficult task of finding the car. Everyday blends into the next and its not unusual to see several post call interns searching for their cars. Like a Seinfield episode magnified by a hundred. Oh and the light. You're so tired that the sun is blinding, you literally can't see. After 24-30 hours of hospital light your eyes just can't make that adjustment. Some interns bring sunglasses. The drive home can be the scariest and most exhausting 20 minutes of call. I never change lanes because I just don't trust my abilities. It's akin to being a drunk driver (A recent study actually proved that being post call is equivalent to being legally drunk). When I get home my daughter smiles so wide, she does a little dance and claps. I try to stay up late enough to put her down for a nap and we sleep together. A little unconscious mother-daughter bonding. My husband gets her when she wakes up because I'm so tired I don't hear her. Sometimes she screams for me, she holds on to the toddler gate and screams Ma, Ma, Ma. The definition of being exhausted is ignoring your screaming child who just wants to see you after she's been waiting all day and all night.
Now repeat every third day, over and over again. For a year.
So why should you care, just one intern bitching about the hours. Because I fell asleep the other day. I fell asleep while driving. I was less than a two blocks from home, I stopped at a stop light and I had pulled my emergency brake (a learned trick to prevent roll back). I guess I set my head down against the steering wheel, I'm really not quit sure it's all a blur. But I woke up to the sound of a little old lady tapping on my driver's side window. Apparently a line of cars honking hadn't woken me up so this poor woman had to get out of her car to come see if I was okay. I can't believe I fell asleep. I can't believe that I was that tired. But what I really can't get my mind around, is that a half an hour ago, I was treating patients.
Thursday, January 04, 2007
Happy at Last
I promised myself that I would blog next time I'm happy so that I can stop being called the "most depressing blog out there" Thanks for sharing everyone. So why I am happy today. Well I found out that I get to stay at my current program. I was originally set to leave after this year and go to another place but I really didn't want to . My family is established here, I have friends and I love the ER here. My new program was fine with me staying and my current program wanted me to stay so everything seemed fine. But then the NRMP stepped in and said that we didn't have the right to change our minds. So, long story short there has been a fight for the last three months to be allowed to stay. And now I finally can
Then I found out I got nominated for best new medical blog fo r2006. I feel very honored. So thank you so much to everyone who cares. You make me happy.
http://www.medgadget.com/archives/2006/12/the_2006_medical_blog_nominees.html
Then I found out I got nominated for best new medical blog fo r2006. I feel very honored. So thank you so much to everyone who cares. You make me happy.
http://www.medgadget.com/archives/2006/12/the_2006_medical_blog_nominees.html
Saturday, December 30, 2006
Where'd you go... I miss you so...; seems like it's been forever....since you've been gone...
Well, I guess I've been avoiding blogging recently because I've had a lot of personal things going on with me. Things I had originally decided I wasn't going to talk about with anyone. Maybe I've changed my mind on that thought though. It's more difficult now because I know that some people I know personally now read my blog and now I have to wonder about what they think. There's an anonimity I miss.
So where have I gone. That seems to be the question. I found out I was pregnant. Don't get too excited though, this does not have a happy ending.
I suppose I could lie and say that I miscarried the baby, that would be the chicken-shit easy way out. But that's not what happened. I terminated the pregnancy at 8 weeks.
I just couldn't have this baby right now. My family is barely making it right now, not on my pay. Neither car is registered, or insured for that matter. I'm two months behind on my car payment and the only reason they haven't taken the car is that they don't know where it is. My rent costs more than one paycheck so even though I get paid twice a month it only feels like once.
But there's so much more than that. I can't survive this year while being pregnant. I know that deep down in the core of who I am. I would either fall into a deep depression that I may not recover from or I would just become some one I never want to be. I don't want to regret my children, or regret my marriage. As bitter and sad as some believe that I am, I still know that underneath it all is the girl who likes to sing into her hairbrush and dance naked after a shower. I don't want to lose her. I see people I used to know who have lost themselves in this profession. It's so sad, I wish I didn't know them anymore. I miss them. And I wonder if they miss themselves. I don't know if they'll ever be the same.
And then there's the difficulty of being pregnant. Before I had my baby I didn't think it was that hard to be pregnant. So your a little fat... man up. Then I got pregnant. I threw up ever day for almost the first six months. It didn't matter what I ate. I lost weight . I picked partially digested salad out of my teeth so many times that I still can't eat lettuce. Have you ever tried to preform chest compressions at eight and I half months. They had to but two step stools underneath my feet so I could get my belly over the patient. I was sweating buckets. My pregnancy didn't go smoothly either. At 22 weeks I had an ultrasound that showed a problem. The baby had bilateral kidney defects and a heart defect. I was advised to have a late term, 2nd trimester abortion because they thought she had a genetic anomally. I couldn't do it though. She already had a name, I could feel her moving inside of me. She would have been a D&E, the so called partial birth abortion. So for once in my life I had a little faith and things turned out okay. Not perfect, but okay. After she came out and she wasn't deformed my husband and I just cried and cried. We didn't realize we had essentially been holding our breath for 4 months. I can't do that again. I'm just not ready to go back there yet.
So where have I gone, I've gone where most people who terminate a pregnancy go. Into hiding. Sure, I'm allowed to make the choice I made but that doesn't mean I don't feel ashamed or judged. Part of me says fuck everyone, they don't know me. But its hard watching my daughter playing and knowing that there would be another one of her if not for my choice. I regret it. Make no mistake about it, I'd do it again if I got pregnant again. But I still regret having to make the choice. I think the pro life and the pro choice side get so caught up trying to make the issue black and white that they forget that life is grey. I'm just trying to do the best for me and my family and it in this case the best choice was to not have this baby.
So now you know. Say what you will, think what you must. Turn me into a sinner or a saint. At least I didn't lie about it. At least you know where I've been
So where have I gone. That seems to be the question. I found out I was pregnant. Don't get too excited though, this does not have a happy ending.
I suppose I could lie and say that I miscarried the baby, that would be the chicken-shit easy way out. But that's not what happened. I terminated the pregnancy at 8 weeks.
I just couldn't have this baby right now. My family is barely making it right now, not on my pay. Neither car is registered, or insured for that matter. I'm two months behind on my car payment and the only reason they haven't taken the car is that they don't know where it is. My rent costs more than one paycheck so even though I get paid twice a month it only feels like once.
But there's so much more than that. I can't survive this year while being pregnant. I know that deep down in the core of who I am. I would either fall into a deep depression that I may not recover from or I would just become some one I never want to be. I don't want to regret my children, or regret my marriage. As bitter and sad as some believe that I am, I still know that underneath it all is the girl who likes to sing into her hairbrush and dance naked after a shower. I don't want to lose her. I see people I used to know who have lost themselves in this profession. It's so sad, I wish I didn't know them anymore. I miss them. And I wonder if they miss themselves. I don't know if they'll ever be the same.
And then there's the difficulty of being pregnant. Before I had my baby I didn't think it was that hard to be pregnant. So your a little fat... man up. Then I got pregnant. I threw up ever day for almost the first six months. It didn't matter what I ate. I lost weight . I picked partially digested salad out of my teeth so many times that I still can't eat lettuce. Have you ever tried to preform chest compressions at eight and I half months. They had to but two step stools underneath my feet so I could get my belly over the patient. I was sweating buckets. My pregnancy didn't go smoothly either. At 22 weeks I had an ultrasound that showed a problem. The baby had bilateral kidney defects and a heart defect. I was advised to have a late term, 2nd trimester abortion because they thought she had a genetic anomally. I couldn't do it though. She already had a name, I could feel her moving inside of me. She would have been a D&E, the so called partial birth abortion. So for once in my life I had a little faith and things turned out okay. Not perfect, but okay. After she came out and she wasn't deformed my husband and I just cried and cried. We didn't realize we had essentially been holding our breath for 4 months. I can't do that again. I'm just not ready to go back there yet.
So where have I gone, I've gone where most people who terminate a pregnancy go. Into hiding. Sure, I'm allowed to make the choice I made but that doesn't mean I don't feel ashamed or judged. Part of me says fuck everyone, they don't know me. But its hard watching my daughter playing and knowing that there would be another one of her if not for my choice. I regret it. Make no mistake about it, I'd do it again if I got pregnant again. But I still regret having to make the choice. I think the pro life and the pro choice side get so caught up trying to make the issue black and white that they forget that life is grey. I'm just trying to do the best for me and my family and it in this case the best choice was to not have this baby.
So now you know. Say what you will, think what you must. Turn me into a sinner or a saint. At least I didn't lie about it. At least you know where I've been
Friday, November 17, 2006
Moving On
Wow, I got a lot of responses for my previous blog and it was well appreciated. I 've just started Neurology and I'm feeling a bit ambivalent about it. I don't enjoy the brain. I don't really care what it does, or how facinating most people think it is. It's just a pile of pink jello as far as I'm concerned, or at least that's they way it looks splattered on a gurney.
I suppose I dislike the brain because it's like a very fragile toy, once you break it you generally can't fix it. How boring is that. Some people get a kick out of seeing the neuro problem and trying to figure out where the problem is. I'm not one of those people. I'm not even distantly related to one of those people.
Most of my patients can generally be seperated into two groups. Old people with strokes and young people with brain tumors. It sucks for the young people. There's just no getting around the fact that it's over for them before it even started. Down in the ED you watch their scans come up and we all say" Dammmnn" as you watch this huge mass appear where normal brain should be. There's just not a whole lot you can do about it. Take the trip you always wanted, forget studying for college exams, you will not grow old with someone. You will never grow old. And the old people don't get much of a break either. This is it for them. Today you find out what will kill you. Now it may not be the stroke that kills you but you have now begun the decline that will only end in your death.
I suppose it must be weird knowing what your going to die from. I have no idea what's going to get me. Most people don't until the last minute. I wonder if that's one of the last things that goes through your brain after you get shot or in a car crash. This is how I die. Weird. Anyway....moving on.
I suppose I dislike the brain because it's like a very fragile toy, once you break it you generally can't fix it. How boring is that. Some people get a kick out of seeing the neuro problem and trying to figure out where the problem is. I'm not one of those people. I'm not even distantly related to one of those people.
Most of my patients can generally be seperated into two groups. Old people with strokes and young people with brain tumors. It sucks for the young people. There's just no getting around the fact that it's over for them before it even started. Down in the ED you watch their scans come up and we all say" Dammmnn" as you watch this huge mass appear where normal brain should be. There's just not a whole lot you can do about it. Take the trip you always wanted, forget studying for college exams, you will not grow old with someone. You will never grow old. And the old people don't get much of a break either. This is it for them. Today you find out what will kill you. Now it may not be the stroke that kills you but you have now begun the decline that will only end in your death.
I suppose it must be weird knowing what your going to die from. I have no idea what's going to get me. Most people don't until the last minute. I wonder if that's one of the last things that goes through your brain after you get shot or in a car crash. This is how I die. Weird. Anyway....moving on.
Thursday, October 26, 2006
"It"
I'm half asleep in the Peds ED, the only thing that has stood between me and blissful sleep is a 12 y/o with abdominal pain. I was set to send her home until her WBC count clocked in over 15,000 and she bought herself a CT scan. One more rule out appy for my last shift before vacation.
"Do you guys have an attending in here yet" asks one of the residents from the adult ED. We do not in fact have an attending on, not until 8:00am. It is just me the intern and a second year pediatrics resident running a level 1 trauma center. "Call the NICU then, you have a premie comming in".
I start to wake the resident when the firemen walk through the safety doors carrying a towel. They are sweating profusely as they walk quietly to the rescusitation room. The women has her fingers delicatly positioned over the middle of the towel as her index finger softly pumps, one two, three, four.... Her partner is holding an oxygen mask over the towel completly obstructing my view. The nurses with vastly more knowledge and experience than me have already rolled over the warmer and turned it on. The fireman sets the towel down.
It's bright red, about the size of my hand. It eyelids are fused, and it's skin is so transparent I can see it's lung moving beneath impossibly small ribs. The frantic movement I see beneath the sternum I can only surmise is its heart. It is not even clearly human, it insteads looks like some shrunken alien crash landed on this planet. It's head is smaller than a lime, its mouth opens less than the width of a pea. It can't possibly be alive. And then it breathes. So hard that I can watch all the muscles between its ribs retract with every tiny breath. We all stop, the seasoned nurses, the naive intern. The ER is usually one big traffic accident and most of us have long since stopped rubbernecking but everyone comes to see this. And from each one you can here the same audible gasp.
Peter, the NICU resident arrives on the scene and states what I know we all understand in our hearts. "It's not viable, we don't have a tube that runs that small. We just have to get the weight and we can be done" The rule in neonatal recussitation is firmly drawn at 500 grams. Anything bigger we go all out, do everything, even though most will die or be permanently neurologically disabled. Anything less and we do nothing. Like it never even existed. Whether you live or dies depends on whether you can outweigh a Coke can.
It weighs in at 177 grams. According to the report from mom, she thinks she was 18 weeks pregnant. That's less than 5 months.
We rewrap it in the towel, turn off the warmer. Peter goes over to ask the mom if she wants to hold it, say goodbye. She does. I go back to my desk to see what the hold up is on my appy kid. The ED is eerily silent and I can here the nurses in the lounge talking about what has happened, decompressing, trying to forget. A half an hour passes and Peter returns to the Peds ED with the towel.
"OB is going to take Mom upstairs to check her out. I already talked to my fellow and she says that protocol is to put it in a specimen jar and send it to pathology." "Alright, " I say half paying attention, " thanks for all yor help". I hear him sigh and then slowly start to speak again. "the thing is, it's still breathing. " The world grinds to a halt as I turn to face him, to take in what he is trying to tell me. "I have all the paperwork for path, I even have the jar. But it's still breathing. I can't put it in the jar like this. We can't take it to the NICU if were not going to do anything. I didn't think it would still be alive." None of us did.
We agree to keep it downstairs with us. It doesn't have any where else to go. Technically it not alive, but it's still breathing so I can't really say it's dead either. We find an empty room, Peter and I are now co-conspirators of some horrific crime that up until tonight I had no idea existed. We lay it back down on the warmer but we don't turn the warmer on. " Don't wrap it up," he says as I begin to swaddle it. Looking at it breathing, I can't help but think of my daughter when she was a newborn. I want to hold it, to tell it that its okay, to comfort it. Does it feel pain? I don't know. But I do. It must feel something. To go from the comfort of being warm and snug suurounded by amniotic fluid with it's life finely tuned to the rhythmic beating of it's mother's heart. The world now cold and chaotic. We are as foriegn to it as it is foreign to us. " If you expose it then it will go faster."
And so we wait, while it continues to breathe and defy us. We wait as another intern on a different rotation stops by to see how my night went. I bring her in to see it. It is colder now, breathing more slowly. A bloom of bright red covers it's chest. Trauma from the fireman's CPR has ruptured its fragile blood vessels. And so we wait. My appy kid does not have an appy, just some kid with run of the mill abdominal pain. So we wait. Time has slowed to an unbelievable crawl as we wait for death to claim a life that never was. I come in to check on it. It is cold to the touch, it has stopped moving. I pick it up, ready to finally put it in the jar.
Then it breathes.
And so we wait. The nurses change shift and the waiting room fills with patients that have no idea what is happening in room 6. I wait for it to die, to be done. The attending comes in and I tell her about the cordened off room, the squiggly line on the board with no name and no chief complaint. We wait, in truth it is just me who is waiting. Everyone else seems content to forget about it but I keep returning to the room every half hour. To let it know that it has not been forgotten even though I will do nothing for it. I wait.
Four hours after it first appeared in the ED, one of the senior nurses comes in the doctor's area with a towel. There is no doubt what is inside. She gets the jar. I don't even know if it was actually dead when she put it in the jar. I didn't ask to see it, to see for myself that it was over. Who knows maybe she just has more nerve than me. All I know is that it is over. Or it least it should be.
But I am still waiting. Waiting for forgiveness though I my head knows I did nothing wrong. Waiting to stop seeing it breathe in my dreams. Waiting for it to give up on life even though it never knew what life was. Waiting to stop seeing it in my dreams. To stop seeing it in my daughter's eyes when she laughs. Waiting to stop being mad at myself for not holding it and giving it comfort while it died. To give it the gift of humanity that is all our birthrights, when it had, in fact, been born. It had lived though it will have no funeral, no name, no birthday. Just "it". I am waiting. I am still waiting. I wil always be waiting.
"Do you guys have an attending in here yet" asks one of the residents from the adult ED. We do not in fact have an attending on, not until 8:00am. It is just me the intern and a second year pediatrics resident running a level 1 trauma center. "Call the NICU then, you have a premie comming in".
I start to wake the resident when the firemen walk through the safety doors carrying a towel. They are sweating profusely as they walk quietly to the rescusitation room. The women has her fingers delicatly positioned over the middle of the towel as her index finger softly pumps, one two, three, four.... Her partner is holding an oxygen mask over the towel completly obstructing my view. The nurses with vastly more knowledge and experience than me have already rolled over the warmer and turned it on. The fireman sets the towel down.
It's bright red, about the size of my hand. It eyelids are fused, and it's skin is so transparent I can see it's lung moving beneath impossibly small ribs. The frantic movement I see beneath the sternum I can only surmise is its heart. It is not even clearly human, it insteads looks like some shrunken alien crash landed on this planet. It's head is smaller than a lime, its mouth opens less than the width of a pea. It can't possibly be alive. And then it breathes. So hard that I can watch all the muscles between its ribs retract with every tiny breath. We all stop, the seasoned nurses, the naive intern. The ER is usually one big traffic accident and most of us have long since stopped rubbernecking but everyone comes to see this. And from each one you can here the same audible gasp.
Peter, the NICU resident arrives on the scene and states what I know we all understand in our hearts. "It's not viable, we don't have a tube that runs that small. We just have to get the weight and we can be done" The rule in neonatal recussitation is firmly drawn at 500 grams. Anything bigger we go all out, do everything, even though most will die or be permanently neurologically disabled. Anything less and we do nothing. Like it never even existed. Whether you live or dies depends on whether you can outweigh a Coke can.
It weighs in at 177 grams. According to the report from mom, she thinks she was 18 weeks pregnant. That's less than 5 months.
We rewrap it in the towel, turn off the warmer. Peter goes over to ask the mom if she wants to hold it, say goodbye. She does. I go back to my desk to see what the hold up is on my appy kid. The ED is eerily silent and I can here the nurses in the lounge talking about what has happened, decompressing, trying to forget. A half an hour passes and Peter returns to the Peds ED with the towel.
"OB is going to take Mom upstairs to check her out. I already talked to my fellow and she says that protocol is to put it in a specimen jar and send it to pathology." "Alright, " I say half paying attention, " thanks for all yor help". I hear him sigh and then slowly start to speak again. "the thing is, it's still breathing. " The world grinds to a halt as I turn to face him, to take in what he is trying to tell me. "I have all the paperwork for path, I even have the jar. But it's still breathing. I can't put it in the jar like this. We can't take it to the NICU if were not going to do anything. I didn't think it would still be alive." None of us did.
We agree to keep it downstairs with us. It doesn't have any where else to go. Technically it not alive, but it's still breathing so I can't really say it's dead either. We find an empty room, Peter and I are now co-conspirators of some horrific crime that up until tonight I had no idea existed. We lay it back down on the warmer but we don't turn the warmer on. " Don't wrap it up," he says as I begin to swaddle it. Looking at it breathing, I can't help but think of my daughter when she was a newborn. I want to hold it, to tell it that its okay, to comfort it. Does it feel pain? I don't know. But I do. It must feel something. To go from the comfort of being warm and snug suurounded by amniotic fluid with it's life finely tuned to the rhythmic beating of it's mother's heart. The world now cold and chaotic. We are as foriegn to it as it is foreign to us. " If you expose it then it will go faster."
And so we wait, while it continues to breathe and defy us. We wait as another intern on a different rotation stops by to see how my night went. I bring her in to see it. It is colder now, breathing more slowly. A bloom of bright red covers it's chest. Trauma from the fireman's CPR has ruptured its fragile blood vessels. And so we wait. My appy kid does not have an appy, just some kid with run of the mill abdominal pain. So we wait. Time has slowed to an unbelievable crawl as we wait for death to claim a life that never was. I come in to check on it. It is cold to the touch, it has stopped moving. I pick it up, ready to finally put it in the jar.
Then it breathes.
And so we wait. The nurses change shift and the waiting room fills with patients that have no idea what is happening in room 6. I wait for it to die, to be done. The attending comes in and I tell her about the cordened off room, the squiggly line on the board with no name and no chief complaint. We wait, in truth it is just me who is waiting. Everyone else seems content to forget about it but I keep returning to the room every half hour. To let it know that it has not been forgotten even though I will do nothing for it. I wait.
Four hours after it first appeared in the ED, one of the senior nurses comes in the doctor's area with a towel. There is no doubt what is inside. She gets the jar. I don't even know if it was actually dead when she put it in the jar. I didn't ask to see it, to see for myself that it was over. Who knows maybe she just has more nerve than me. All I know is that it is over. Or it least it should be.
But I am still waiting. Waiting for forgiveness though I my head knows I did nothing wrong. Waiting to stop seeing it breathe in my dreams. Waiting for it to give up on life even though it never knew what life was. Waiting to stop seeing it in my dreams. To stop seeing it in my daughter's eyes when she laughs. Waiting to stop being mad at myself for not holding it and giving it comfort while it died. To give it the gift of humanity that is all our birthrights, when it had, in fact, been born. It had lived though it will have no funeral, no name, no birthday. Just "it". I am waiting. I am still waiting. I wil always be waiting.
Wednesday, October 11, 2006
It's been awhile
Well, I am finally begining to recover from the Hell that was my month on Orthopedic surgery and I'm pretty sure I didn't learn a damned thing. Oh well, at least it's over. Intern year on the whole has not been that bad. It's certainly a lot of work, there's no getting around that. I'm back in the ED again so I'm pretty happy about that.
It's so weird when your on a tough rotation how much you lose touch with the outside world. It gets to the point where your never quite sure what day of the week it is because the standard reminders like TV shows and weekend are lost to you. The only thing that holds any reference is whether your on call, post call, or pre-call. That's pretty much the only thing that has any effect on you. Then when the rotation is over it's almost like the sun comming out after a long winter and you remember what it's like to go outside again. I have a fairly rough stretch comming up over the holidays. Three straight months of call to screw up my Thanksgiving, Christmas, and New Year. Oh well, I just have to remember that once this year is over I'm done with call.
Today is my daughter's first birthday. Technically I have the day off but I get off today at 8:30 in the morning so it's going to be a struggle to stay awake all day. It's hard not to be selfish about these things. She won't remember that I missed any of these events, she has no idea what it means to have a birthday or Christmas. But I know-and I know that I'm missing them. I missed my daughter's first steps and I cried when my husband told me on the phone at work. I know its better for her that she won't remember any of this but I wish that it was easier on me. I guess I'm just selfish.
It's so weird when your on a tough rotation how much you lose touch with the outside world. It gets to the point where your never quite sure what day of the week it is because the standard reminders like TV shows and weekend are lost to you. The only thing that holds any reference is whether your on call, post call, or pre-call. That's pretty much the only thing that has any effect on you. Then when the rotation is over it's almost like the sun comming out after a long winter and you remember what it's like to go outside again. I have a fairly rough stretch comming up over the holidays. Three straight months of call to screw up my Thanksgiving, Christmas, and New Year. Oh well, I just have to remember that once this year is over I'm done with call.
Today is my daughter's first birthday. Technically I have the day off but I get off today at 8:30 in the morning so it's going to be a struggle to stay awake all day. It's hard not to be selfish about these things. She won't remember that I missed any of these events, she has no idea what it means to have a birthday or Christmas. But I know-and I know that I'm missing them. I missed my daughter's first steps and I cried when my husband told me on the phone at work. I know its better for her that she won't remember any of this but I wish that it was easier on me. I guess I'm just selfish.
Wednesday, September 13, 2006
Grumble, grumble, grumble
Have I told you yet that I hate ORTHO. Ugghh. First off I'm Q2 this week. For those not in the know that means that I am on call from 6 am Monday until noon on Tuesday then 5:30 am on Wednesday until noon on Thursday. I have no life outside of the hospital. Just a mind numbing blur between sleep and the hospital. And if I'm real lucky, sleep in the hospital. Except I find that trauma has a distinct prediliction for happening late at night when normal people are sleeping. This is not to say that some idiot can't get drunk and run you over at eight in the morning, it's just that if I was a betting woman I would definitly bet on midnight.
Add to that I have sent my family away this week so they can spend time with people who will actually be awake and interactive. My eleven month old daughter and my husband went to visit the grandparents and though I thought it would be no problem I find that I miss them terribly. They remind me that there is a world out there aside from the hospital. One where I am loved and needed. So aside from the cats, it's all me this week. Sighhhhh.
I hate medicine somedays, mostly because I don't feel like I'm actually doing medicine right now. My day goes something like this. " Yes sir, it's broken. Your going to need surgery", or "Yes it's broken, you need a cast.", or "No its not broken, you'll be fine". Exciting isn't it.
Grumble, grumble, grumble.
Add to that I have sent my family away this week so they can spend time with people who will actually be awake and interactive. My eleven month old daughter and my husband went to visit the grandparents and though I thought it would be no problem I find that I miss them terribly. They remind me that there is a world out there aside from the hospital. One where I am loved and needed. So aside from the cats, it's all me this week. Sighhhhh.
I hate medicine somedays, mostly because I don't feel like I'm actually doing medicine right now. My day goes something like this. " Yes sir, it's broken. Your going to need surgery", or "Yes it's broken, you need a cast.", or "No its not broken, you'll be fine". Exciting isn't it.
Grumble, grumble, grumble.
Sunday, September 03, 2006
Ortho Hell
Well, I'm on Ortho now and am in the seventh circle of intern hell. Nothing I ever do is right and for the most part my goal at the end of the day is to try and psych myself up for yet another shitty day.This rotation is just re-enforcing what I've always known. I hate surgery. It's not just the actually surgery itself ( oh let's see how long we can stand on our feet without eating and peeing), it the whole lifestyle of surgery. The hours are such that I haven't seen daylight in at least a week. That and I have two weeks worth of laundry piled to the sky in my room. Thank god for the Costco sized pack of underwear I picked up recently. Plus, Surgeons are among the most arrogant people on the face of the earth. It's like living in a medical version of Hell's Kitchen with Simon Cowell playing my chief resident. Seriously, I am just not as facinated as they are with their own greatness. And I have yet to learn anything remotely related to orthopedics.
There are only a few ways to actually survive this rotation.
1. Hide out on the pediatrics floor. Although I am accessible by pager for the most part the seniors find it too much work to call me.
2. Be completley incompetent. "Oh, you were serious when you said no food before surgery"
3. Pretend that I have been wisked away to a prison work camp. Spend any free time planning my escape.
For the most part am I trying option number one and I am now considered the fourth Peds intern. At least it beats being on Ortho
There are only a few ways to actually survive this rotation.
1. Hide out on the pediatrics floor. Although I am accessible by pager for the most part the seniors find it too much work to call me.
2. Be completley incompetent. "Oh, you were serious when you said no food before surgery"
3. Pretend that I have been wisked away to a prison work camp. Spend any free time planning my escape.
For the most part am I trying option number one and I am now considered the fourth Peds intern. At least it beats being on Ortho
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