The Final Countdown - Day 1 of 5

So about 9 years, 5 months and a week ago I started as an attending

at a small hospital in Northern California.

This is how it went.

Today I started the last of 5 shifts that I will be working

at the slightly bigger sister hospital.

This is how today went:

cardiac arrest came in, after about 30 minutes of CPR and putting in a breathing tube

we got back pulses... then I had to stop the ventilator because we found out the patient had a DNR (do not resuscitate) and the family member let us know that they had wished to not have anything done,

so that was a little frustrating

during that time, a patient came in with a really low blood pressure and fast heart beat,

hung some IVF and some pressor medications and got them under control,

admission to the ICU

then I had to clean up the mass of patients that had come in while I was working on the cardiac arrest and patient with low heart beat

they included:

  - a chronic drunk who was drunk again and needed a room to sleep it off

 - poison oak allergic reaction

 - patient with shingles

 - patient with problem with their ostomy

 - a chronic meth user that left the hospital to smoke meth and was now returning

because their infected foot somehow did not magically get better without 

antibiotics and wound care, not to mention running on it barefoot in the woods

while high on meth

 - an elderly couple both with dementia that went on a joy ride and ended up driving down

an embankment

- a patient who passed out and hit their head and who could now not move their leg

AND

I had to manage the patients signed out to me by my colleague in the morning

which included:

- an appy

 - a pregnant appy

- a car crash victim with abnormal vitals

and a couple of people who didn't like their lives any more

so needed psychiatric help 

AND

in the midst of all this a code was called on the hospital floor

and I had to run upstairs and put a breathing tube in that patient

while they were doing CPR...

... the patient later coded again in the ICU and didn't make it...

AND

not to mention a lot of phone calls where we had to triage and decide

which patients actually needed COVID testing... OMG

The one bright spot in my day was a visit from a patient

who'd had a serious brain infection which had to be transferred down to 

the big city children's hospital where they underwent

brain, eye and sinus surgery,

IV antibiotics,

physical therapy to help them be able to walk and move

their right side again

and here they are a month later looking

bright and a lot healthier than the day I saw them...

this is them:

I hope he does amazing things... 

*photo posted with permission*

#588 - D is for Delta

In science, the Greek symbol of delta mean "change."

And, sometimes, we need change in our lives

to take us out of a rut...

I started working extra shifts in Sacramento at the beginning of this year,

 so I have been making many trips 

over the hills to work in the "big city."

I did it as a challenge to myself intellectually.

It's good to get out of your comfort zone every once in a while, 

and working in the fast-paced environment of a metropolitan

hospital definitely does that to you.

Whereas I generally see about 20 patients a day in my small rural ED,

we see about 20 patient an hour in the city.

It really tests what you are made of as an ED doc

as you quickly make decisions about diagnoses and tests.

I think it's made me a better doc at my small main hospital.

Like Shania Twain sings, "A change would do you good..."

NaBloPoMo Day 6

Tonight we went to our hospital's Benefit Ball which was themed "Diamonds are Forever."  It was a nice chance to get dressed up and help raise money for the hospital.

It made me remember back to being a volunteer in Southern California at our local community hospital.  We were invited to assist with their Foundation Ball which featured a performance by Jay Leno and a great performance by Aretha Franklin.  I still have the CD that her people gave us as thanks for helping out at the Ball.

I remember being a starving pre-med student watching all the doctors, benefactors, members of the board walking around in their tuxedos and wondering if I would ever be a part of something like this.  Sixteen years later, here I am.  While I am still not able to bid $3500 for a painting or a set of box seats to a SF Giants game,  it was still fun participating in the silent auction and winning a Weber Grill and Smoker for just slightly more than retail.

Funny thing is, we've been eating vegetarian and very rarely ever eat even fish.... How many glasses of wine did I have with dinner...?  Oh, well, it's all for a good cause....!