That's the quote I overheard during a lapse in rounds today. It was...well, disturbing at best. Arrived at 0700 for once, instead of 0710 or 0715, despite taking a shower and snoozing my alarm too long. Pre-rounded on one baby boy, sepsis, doing well. Woke him up to look in his mouth (I can look at ears without waking a baby, but mouths...well, no such luck) and he sneezed on me. It was sort of cute in an "I'm now showered in droplets of respiratory secretions" kind of way. Called JK to get my otoscope handle back before attempting to pre-round on one little boy, stridor secondary to probable croup, and was for once not given another new patient. But he did tell me to copy my chart note so he could write on it.
I went to newborn rounds and took my chart note writing to do during them (I don't have any newborns). JK scribbled over my chart note copy, and gave it back to me with a mention that overall it was satisfactory. Change the order of my past history: PMHx, Hosp, PSHx, Meds, Allergies, FMHx, SHx, instead of the essentially random way I was doing it. Get all the information in the HPI. Next to my Review of Systems, he put **good** with little asterisks and everything. That made me proud. JL, in casual conversation as I was discussing my congenital disorganisation and need to compulsively organise everything, told me not to worry so much, that I was ahead of where she'd expect. The interns can't seem to remember whether I'm in my third year or my fourth. I survived the morning pimping session by Dr. M.
Rounded with peds around 10:30 or 11. JK prepped me by making me run through my presentation on B with stridor before rounds. He works hard, but he's super laid-back. Reminds me - right down to the initials - of Josh, the pastor's son. We talked over the plan, and I was reassured that I didn't need to know treatments necessarily, just know the differential. It went, overall, quite well, although one of the interns asked a lot of questions. JL says it's rude for interns to pimp the medical students in front of the attending. I didn't know that.
Ran out from our rounds to make it to Riley for noon lectures. Today it was on anaemia. Quite interesting, even if I was falling asleep on the spot. Grabbed McDonalds due to driving need for salty french fries and caffeinated pop to keep me going. I'm so bad. Used the old trick of filling my cup with ice completely to cut down on how much actual pop I had. It worked, for a while. Long enough to get me going through the afternoon.
I was with the interns on the newborn side. I learned how to do a newborn exam, both from JL and from the interns. I learned how to do a mom talk - funny how everyone does them so very differently - and even got to do some. Checked in on newborn babies, got to pass a nasal catheter to check for patency on a snuffly baby, wrote cards and ran errands - I don't mind the scut work, it gives me time to think - and then it was time for them to go home.
I was on evening call tonight, 4-10 PM, usually gets out earlier. And JL was going to let me out earlier. We were capped on our floor because nurses were understaffed, so there were no admits. And there were hardly any babies. And then we decided to go see a C-section. And when we got there, the nurse said Are you Peds? And JL nodded. And she said I hadn't even called you yet. They wanted us there. Failure to progress, possible chorio, generally ickyness.
So I stood by and I helped dry off the baby, and I held her up for her father and mother to see, and I stayed out of the way while they suctioned and gave breaths and finally took her over to Special Care, which is the magic word for NICU. She should be fine, precious thing with her head all stretched out and funny-looking from being in the birth canal so long, just needs her lungs cleared out. I took my gown home, all sentimental-like. And some extra scrubs.
Then I wandered the nursery and looked at Baby D, who has two very black parents but looks quite white. And the snuffly baby came back, still snuffly. He's got a little chin. Pierre-Robin syndrome (or Robin sequence) can't be ruled out; I haven't looked in his mouth. But his ears and eyes look more normal after seeing his mom's. JL thinks he probably has laryngomalacia. I need to learn about that. He won't eat, sounds awful noisy when he breathes, and is generally a worrying baby. We put a pulse ox on him while he slept, and he seems to be getting enough oxygen.
And then Mom came in, and somehow it had gone from getting a taco salad in the cafeteria around 6 or 7, to walking over to Special Care carrying the new baby girl's anti-kidnapping tag and a box of medications around 9, to wondering what Baby A's problem with breathing was. And JL turned to me and said "You want to go home?" I did. I was exhausted and feeling a little useless. "Go home."
Called my baby sister on the way to the car, talked for a bit. She's started school at IPFW for the nursing program (good for her!) and is now 4 1/2 months pregnant. Reminded her to take her prenatal vits, congratulated her on it all, and just thought about how things change. In my mind she'll always be my little Ernie, who climbed out onto the roof of the back porch and got stuck, the time I locked her in her room when I was babysitting. Just a little girl.
But she's nineteen, and she's going to be a mother soon, and she's going to school, and she's working at getting her own place, and she's not my little Ernie any more. It's strange how things change. It was good to talk to her. We didn't so much grow apart when I went to school as we were never really truly close, not like Michelly and she were. I feel strange trying to make lunch dates with my sisters, feel old.
Daddy found a 1980 Mustang for Paul with like 37,000 miles on it. The owner's a mechanic, it's been in proper storage. He's thrilled.
It's late now, too late for me to still be up writing, O Best Beloved. I had poetry in my mind when I drove this morning with the radio off. I thought of it again when I stopped to go to the bathroom and just sat in the stall, in the cool and clean and tiled empty space where briefly I was the only person, the only sound. I even pulled my feet up and sat like a little ball, and I loved it. I walked out eating a hamburger (I washed my hands first), and revelled in the startled looks I got. I have some of it written down, but some of it, I think is lost. It will return. I can't even express to you how good it feels to have, even briefly, that flow of tangled words that form poetry, the symbols that collect and gather, that connect me. It reminds me that I am still who I am.
Running through my head all day - the theme from M*A*S*H * (Suicide is painless) and Every Rose has its Thorn. What does that say?
And I am going to sleep, to be up again in less than six hours. Please don't make me work the weekend...