This week has been a beatdown of an epic proportion.
I worked Saturday and had Sunday and Monday off. And yet Tuesday through Friday was just incredible. Incredible.
Tuesday had the 7 AM bronch so hauled my grudging ass outta bed at oh-dark thirty (actually 4:45) to get the 5:34 train from El Cerrito to Embarcadero. Transfer to the N-line and arrive by 6:30. 12 on service, so the whole day was bronch-round-radiology-bronch-round-repeat then notes. I was done by 8:30 PM and N-line to BART. Between tunnels on the BART, got some frantic pages. After tunnels returned them, and due to some poor communication between teams and attendings, apparently a "routine" Outside Hospital transfer arrived on the CT surgery service without anybody knowing anything. They didn't even give us the courtesy of a big stack of nursing notes. Just the pt (and anybody who's been through Hopkins would know that's pronounced "pit"), reportedly stable and for a simple lung transplant evaluation.
Except she was hypoxic to beat the band and syncoping with florid right heart failure in cardiogenic shock. That's the one-liner that's bound to send a shiver up any medicine doctor's spine. The CT surg fellow was just called in because they were doing a heart and a lung transplant (cases start at 0030!) and only the intern was available to admit the patient. OK, no big deal, transfer to the ICU and let the ICU deal with it.
Oh yeah, the ICUs at the hospital are open. Funny how that kicks you in the goodies. CT Surgery would still have to deal with the patient, they'd just get an extra set of hands to put in lines and do chest compressions if need be. So transfer to the ICU is not an absolution like it is most everywhere else.
The very nice fellow said that they would try to deal. I tried to contact everyone I knew in the hospital (none of whom were there) and my attending and see if there was anything we could do.
So I changed into scrubs and into the car and back to work by 11:30 PM. And true to form, the pt was sicker than snot and other secretions starting with "s" and proceeded to try her hardest to check out for more celestial climes.
Anyway, I slept in 10ICU bed 16 (it was closed for a water leak) for around 30 minutes between peri-codes and pressor titrations and urine output checks.
Wednesday morning crawled out of the ICU, had the 7 AM bronch and now 14 on service (with the new and the overnight transplant). So it was bronch-round-bronch-round-etc oh yeah and two hours of meeting. Crawled to my car (parked conveniently in the only non-J permit street parking in the Sunset around 9 blocks from the hospital up one of those hills that end up being the scene of slo-mo sequences during movie car chases). Got stuck in traffic for about an hour and managed to make it home by 5:30 where I worked on my notes for 2 hrs before crashing at 7:30.
Thursday had the 7 AM bronch, 4 other bronchs, clinic, oh yeah and 4 new admits. So bronch-round-bronch-round-clinic-round-round-notes until I dunno around 10 PM and then home by 11:30. Must admit some notes didn't get done.
And today yet again with the 7 AM bronch as well as 2 others, 2 hrs of lecture. And all the notes from today as well as the ones that didn't get done yesterday. 17 on service (as one was discharged). Worked on notes until 11 and then sat down to try to blog. So excuse the marginal coherence.
At least I'm learning a ton. And riding the bronchy donkey all day every day.
So here's a new music acquisition that I think of every morning while starting my one and a quarter hour commute. Because the name is so true. In this short life of mine, I've come to realize that you can judge books by their cover and likewise you can judge bands by their names. So you just know that ...And You Will Know Us By The Trail of Dead and Clap Your Hands Say Yeah are going to be awesome. Ladies and gentlemen: We Were Promised Jetpacks. It is so true. We were. Every day, I imagine myself standing in front of the house in an asbestos jumpsuit, pulling down my goggles, lighting the burners, and arcing off into the darkened Western sky on top of 20 feet of white flame only to arrive in the Sunset fifteen minutes later, face windburned but with a permanently tattooed smile.
WWPJ is from the Scottish group of bands on Fat Cat Records that all sound the same (but good! see Frightened Rabbit, The Twilight Sad). Here's "Moving Clocks Run Slow." They have a video for "Quiet Little Voices" but there's no way I'm passing up a reference to special relativity. There's also a killer live acoustic version of this up on the youtubes.
To bed for me. As an aside, as I retire at 12:11 AM, this September 12 2009 Anno Domini, it has started to rain lightly. This is the first rain that I've seen since moving to California.