August 9th, 2004

White Coat

They keep me running...

On call tomorrow, O Best Beloved. It may be a pleasantly quiet call, given my current patient load.
My maximum patient load at any one time is 5 patients, and I got two more today. I don't know how I managed to fit them in; I still know almost nothing about the one. She's a surgery patient at the root, multiple hip dislocations and now they want to work her in to revise the prostheses. We were called to do a preop eval. As Cardiology later put it so delicately, "she's so schizoaffective, she's a very difficult historian." Patient was something less than cooperative, you see, but the one important thing she was willing to tell us was that she'd had chest pains within the last week.

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Finally at 1700 (bell rings at 1600, finish your work and go home) I am ready to changeover to the on-call resident and go home. He's a transitional year student, going into something lucrative and highly competitive after this. I rattle off my patients as fast as I can, driven by the need to let him go back to taking his own H&P and doing admissions. It's straightforward: surgery patient, UTI and knee inflammation, pain control and noncompliance, oh and this guy you'll get paged with CT results, call cardiothoracic if the aneurysm's gotten bigger or there's dissection, otherwise just relax. They shouldn't be trouble. "Anything else?" No, go on home. I wish him a quiet night. He laughs.

I am exhausted when I get into my car, discover that my heel pain is due to a malfunctioning shoe and not falling arches after all. I am also smiling. It feels so good to be back, O Best Beloved, so very very good.
I have been up since 4 this morning and on my feet from 0715 to 1730, ten hours of work, crossing items off my list of items one patient, one problem at a time. Non-stop. Now I think it is time to make dinner, since I ran out of the hospital without taking advantage of my free meals.

It isn't that bad.
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