January 21st, 2004

White Coat

So what do you want for dinner?

Today I listened well, and I begged my interns for something to do, and they let me type up the discharge summary for a patient to be discharged tomorrow. And then SB came into the room and said that he might go tonight, and he'd gotten the discharge orders ready. The patient was #5 waiting for a psych bed after a week or more of trying to get him transferred to psych. Go tonight, SB said, because we can't afford to lose that bed.

I took call tonight. AE was talking on the phone and I heard him say something about transferring, and could it wait until morning, and was this a Trauma patient? And I said "Wait, is that Mr. X?" It was. "It's all in the computer, just activate the discharge." He did. My chief is going to be thrilled, I hope.

Then I went in on a transverse loop colostomy, in which we make a tiny hole in the abdomen, fish out a bit of colon, stick a bar through it to hold it outside the body, and cut a hole in it. So it comes out to the air (where stool is then dumped into a colostomy bag)and then goes back in. Quick and easy, a simple way to do a colostomy that you're going to take down (read: put back in the body) later. I got to cut sutures and joke around a little with the residents and staff, who has a beautiful accent. He's from South Africa.

It's now 2040 and I'm still wide awake, more so than I was for my lecture on ventilator management earlier today. But part of that was that he was unmiked and in the front of a long room, and I could only hear half of what he said. But I'm starving, despite having been fed Pizza Express earlier.
And AE is done dictating, so it's time to go.
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