This is why I'm a bad evangelist, O Best Beloved. I have far too open of a perception of Biblical interpretation for me to really pressure people. I've been attacked myself by the radically conservative side, and it was those attacks that were the impetus for me to question my faith, whether I could believe in the kind of God they were hammering me with. I can't; I believe in an I AM that is something more than the petty, picky, spiteful and illogical God who seems to manage so many people's lives. I believe in an I AM that is difficult to describe and present, and so I have a hard time doing so other than by hoping that the joy of my faith, to borrow from a song, shines through. And sometimes that worries me, and sometimes I wonder, and most of the time I just hope and pray that God can take the things I can do and use them to Their purpose. Because it frightens me, how alone and hurtful people are.
But on to other things.
Thursday: The news of note was that our large smelly delusional patient had been seen by psych. They wrote a nice little note about how he was just undergoing alcohol withdrawal and that he was no danger to anyone and he should be sent home as soon as he was medically clear to. His mother is terrified of him. They said his mother said he wasn't any danger. He knew, when we sent psych in, that we thought there was something wrong. And he started to play it up, I think. He spent the rest of the day standing behind his bed with his arms folded, grinning creepily in our direction. And if you caught his eye, he'd get weirder.
A and I didn't know what to do with him, we wanted him in ID. O said "fine. If he snaps and kills people, well, the experts said he was safe," and signed the discharge papers. And apparently he got more coherent when he was discharged, the manipulative jerk, but I bet he's still talking, like he did when we went to see him, about how Joe and A had been stealing stuff from his house while he was in the hospital, and how the people who beat him up were lurking around.
Also had an admit: a 70-something lady who'd had some shortness of breath and gone to take a nitro, then fallen in the act of reaching for it. They found her unconscious and brought her in. Neurology, the people who take care of stroke patients, refused to admit her because she had new-onset atrial fibrillation and she'd had chest pains. So we got called. We don't take care of stroke patients normally, and all of the things we do for a fib require anticoagulation, which is a bad idea in someone with a hemorrhagic stroke. So O gets on the phone with the Neuro resident. He's very polite, but very firm that we should be the consulting team rather than the admitting team (the difference being, O Best Beloved, that the admitting team writes all the orders and gets called if something happens) since we don't know the first thing about managing a stroke patient. Neuro refuses. Neuro gets agitated. O stays very level but gets a little sniping. At one point, after holding the phone away from his ear for a few seconds, he puts it back up to his ear and says "So what you're telling me is, you don't feel competent to draw three sets of cardiac markers?" Things like that. She accused him of being passive-aggressive, because she couldn't say he was being rude.
Staff talked to staff and we took the woman overnight to rule out MI - draw three sets of cardiac markers and watch for ST changes on the EKG - to transfer her back on Friday. I asked O, when he got off the phone. "Do you ever yell at anyone?" He's the most professional, calm, unruffled and laid-back person I've ever had the pleasure of working with. I do, he said. But around here it just gets you written up. Better to play the game and talk them in circles. Better, indeed.
Went home and went shopping; Frums's game was in questionable status so I told Angel to call me if he was running and I'd be home 10 minutes after that, but it didn't happen. So I came home and did nothing. I've done a lot of that recently, and I think it's getting on toward time to start doing something again.
Friday: Went in bright and early to see my patients. Turned the stroke lady over to Neuro as soon as set #3 came back. We had no interns, just 4 students, O, and staff. It worked, though.
The girl - the one with the drugs - was sobered up, pleasant and talkative, a totally different person. We have no inpatient detox; we had to send her out. It was a nightmare trying to get her and her father and her discharge all worked up, because her father has visitation with his son this weekend and his son can't be around her because of her drug habit, so he wouldn't come into the hospital but he would meet her outside the doors in exactly 40 minutes. So I wound up begging the nurses to expedite the paperwork and I stayed those extra 40 minutes to walk her out to the front of the hospital, and she promises she's going to call rehab and get set up, go every day. I hope she does. I don't have a lot of faith that she will, but I hope and pray that she does. She has a 5-year-old son, she is, underneath the rot and the devastation that the drugs have wreaked on her, quite pretty. She asked me what she'd done, and I told her. I think she was embarrassed, maybe, and maybe that will help.
I'm afraid we did her a disservice by discharging her on a Friday, but we couldn't keep her. Not when she's not got insurance and we have no medical reason to. Psych saw her and assessed her as ready to go and meet up with outpatient rehab. I hear rumor that her probation officer is pretty miffed. I know her dad is. We'll see, O Best Beloved. Or maybe we won't...maybe I'll never see her again to know what happened.
Left around 1600 and headed out for home. That was when Michel-Ange committed his suicide pact.
I got home around 9 or so, took a short nap to get rid of my headache, and dressed sparkly to go to dinner with Bri and Jefe. We went to Red Lobster. We got carded for drinks. We had a lovely time, and I wish I had been awake enough to watch a movie with them, but it had been a very long day already.
Saturday: Got up and went to Curves. Weighed in. I've lost 6# from last time, and 5.5# since I first came there. 10.25 inches gone from various parts of my body, and 1.20% body fat. For an occasional user, that's not bad. My goal is to get there twice a week the rest of this month, and three times during my ambulatory month, and then we'll see.
Went out and about to get things for Michel-Ange. Installed the new dishwasher, which did a load by the time I was done with making lasagna, instead of the 3 hours previously, yay! Had dinner and watched The Wall, then fell asleep during Mitchell.
Today Angel is sick, so I'm taking care of him instead of going to church. Hopefully we can get a few things done and I can leave not-too-late this afternoon.