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Summer vacation - Nobody wears a white coat any more... — LiveJournal
...a tribute to becoming a doctor.
Summer vacation
Okay, let's start with the important things. No, I'm not pregnant, although apparently my last journal entry left several of you wondering. I suppose I will be most likely at least that mysterious when it comes about, but for now the news is only that our old house has finally sold. At a bit of a loss, but not so much that I'm not still glad to get rid of the stupid drain on resources.

Went to the fitness center on Thursday. I was getting on my exercise bike when I heard "Hey! Commie!" and turned around. (Yes, O Best Beloved, I answer to "Commie" when said in a certain tone.) It was my ER staff, a fervent burning Catholic whom I met with greetings from a colleague of his. You're one of those Brethren, aren't you? Commies, all of them. It was a good-natured growl, his first words on meeting me, a growl to which I responded well. "Yep, that would be me."
He was working out, working up a sweat, but that didn't stop him from talking to me. "Everyone just adores working with you," he told me. "Myself included. You have this gift...this unfailing optimism. I've learned a lot from you, more than you've learned from me. I said to myself - if she can come in here amidst the chaos and still manage to look at things like that, why can't I?" He nodded. "You have a gift. You're a great resident. Even if you are a Commie. Now get to working out."

I sat down on my exercise bike and stared at the screen, pedalling just to pedal, brain whirling. That's a lot to live up to, O Best Beloved, and I hope that three years from now he feels the same way, because this is a man who is not afraid to tear one to shreds.

Unfailing optimism.

I am clinging to that, sorting through memories, knowing that next block - starting Saturday - is going to be inpatient medicine and the worst block of the year. That's what they say. Angel is preparing his heart and mind; he has enjoyed having me around for the last five days and he will miss me when I am working so very hard.

I saw a lot of things in the ED that I wish I had told you about then but I was low, too low to write, and now that I am not I have been coding frantically and reading journal articles and pretending that I am not really a doctor, not yet, I'm just getting ready to be one. But I will recap.

One precious infant girl, two months premature, three months past birth, silent and pale and fragile; CT scans hung on the back wall lightbox from the outside hospital, crescents and splotches of brilliant white where there should have been pale grey. Subdural hemorrhages. Retinal hemorrhages. Seizing. Who can shake such a frail creature? The helicopter transport brought her and the story (she started seizing, hit her head on the railing of the bannister) in her tiny carseat from a hospital where they do not have the skills for children who need ICU support. Her father came once he was done talking to the police.
Our shaken baby just went home, the Pediatrics resident told me, and you gave us another. I didn't mention the month-old baby with the broken arm in another bay; greenstick fracture across both radius and ulna, something difficult to do in a child that young on accident. I wanted to take them both home, undo it all, protect them forever.

An elderly Englishwoman with a beautiful accent who patted my hand, waited patiently for me to ask if she needed pain medications, and didn't flinch when we told her that she had a DVT - a blood clot in a leg vein - and that she was not, in fact, going home that night. "You darling girl. You be safe driving home." And I heard the story of her American soldier husband, the former soldier who sat beside her and held her hand and asked for water for her to sip, and they gazed at each other in rapt adoration even now, so many years later.
I want to be like that when I am in my eighties, with my Angel beside me. Although, preferably, at home and not in a hospital with a DVT.

Not so many drunks, not so many traumas recently. I stitched up the hand of a schizophrenic who'd been assaulted with a broom handle, nodded and agreed with everything he said. It's best that way. My stitches were complimented. I asked questions about X-rays, and even the doctors who don't like residents seemed to warm when I listened to what they had to say.
Everything comes in runs, it seems. One day it was abdominal pain - everyone was there for hours, waiting for CT results, so I could say that there didn't appear to be appendicitis. One day it was vaginal bleeding, and just like being on OB once more. Pelvic after pelvic exam, including one on a dark and shy Middle Eastern woman who didn't speak very much English, explaining things to her husband as best I could. I was the only woman doctor, and he wouldn't let a male doctor see her. Fortunately, her problem was only pain - round ligament pain, reflux - treatable without calling in the (male) obstetrician to consult. I called him. He remembered me, listened to my presentation, agreed.
One day, it was nothing, and I lounged around getting in people's way all day, trying to make friends with the nurses. I think I have been succeeding. At least when I called to sign out for vacation, I was greeted with laughter. "You can't do that, we'll miss you."
I am accumulating goodwill. I will try not to spend it all in one place, on one mistake.

Staff ran into clinic one afternoon. "You'll never guess who I saw today!" The crash section baby, the one with vasa previa, with a less than 50% survival rate, went home with his parents. They brought him onto the OB floor to thank everyone.

Next block: Internal Medicine. I will post when I can, when I am not exhausted, hopefully when I am learning new things about my patients and discovering exciting new depths of knowledge within me. I have forgotten so much, already. Now is the time to relearn it - seven repetitions makes a memory. I can't have that many more to go.

now feeling:: hopeful hopeful

7 whispers echo . o O ( ... ) O o . whisper a word
From: dr_bobbie Date: August 24th, 2005 09:55 pm (UTC) (etched in stone)
I'll be thinking of you! If I survived (as did my patients), you will, too. ;)
daimones From: daimones Date: August 25th, 2005 12:39 am (UTC) (etched in stone)
Yay for house. *looses pregnant bet*

Don't know if I think Brethren are commies perse. ;P

*hugs about the darker side of life*
ayradyss From: ayradyss Date: August 25th, 2005 12:43 am (UTC) (etched in stone)
What, you too?
xxasimont From: xxasimont Date: August 25th, 2005 02:39 am (UTC) (etched in stone)
Your writing gives me hope, knowing that there is one doctor on the way who has a heart, an understanding, who cares! Hang in there, I know some days are hard (I'm a retired nurse), but you are going to make one wonderful doctor. And because she probably can't, thank you for being a woman dr there, with the cultural sensitivity and skill to help a woman who is not allowed to have a male dr. Thanks for sharing the news that the Crash Section baby went home. Don't know about your other readers, but I remember the patients (well, I did want to be a doctor myself but didn't have the maths).
Hugs, and keep writing and being the wonderful dr you are.Btw, do you do any work with autistic spectrum people at all? Psychiatry rotation?
ayradyss From: ayradyss Date: August 25th, 2005 03:30 am (UTC) (etched in stone)
I've done a bit - not much. One of my Asperger's acquaintances was trying to educate me on it. From time to time I'll come across a patient who's "on the spectrum" (and actually, several of the residents' kids are) and you'll usually know because I come to my readership asking for advice. :)

And, incidentally, I thank all that's good for nurses every chance I get - I'd die without them. :)
pwwka From: pwwka Date: August 25th, 2005 12:34 pm (UTC) (etched in stone)
Not pregnant? Awww... *biological clock is ticking for everyone now*

What is the procedure at hospitals for shaken babies? Do they report them to the authorities, or just send them home?
ayradyss From: ayradyss Date: August 25th, 2005 12:59 pm (UTC) (etched in stone)
You can't send them home - they need ICU monitoring a lot of the time.

Any healthcare provider who suspects child abuse is required by law to file a report with Child Protective Services; generally at that point baby becomes a ward of the court and CPS determines who they go home with - relative, foster parents, etc.
7 whispers echo . o O ( ... ) O o . whisper a word