The Final Countdown - Day 3 of 5

A quote by Emerson states: "To finish the moment, to find the journey's end in every step of the road, to live the greatest number of good hours, is Wisdom."

As many of you know, I'm probably at my happiest when I'm traveling. Just the thought of that next voyage or road trip keeps my mind wandering to what next adventure am I going to have? Will I be going someplace familiar, or will I be going someplace new to explore?  Who will I meet along the way? What new places will I find to eat, and how many photos am I going to take? 

Alas, with the new travel restrictions, I really don't have a travel plan until I start working my new job somewhere in the Mid West. To be honest, I'm not quite sure where actually since licensing is up in the air. And, travel for work really isn't a journey. It's more like commuting. Don't get me wrong, I love to fly. I love to check out new places. But it loses some of its luster when it's for work, because, well, you're going to work. Still, I love to sit and people watch at the airport. I create scenarios for some of the people I see. Mostly I can't wait to get to the end of the trip just to be done with the getting there. Certainly not as exciting as heading out for vacation, but for the time being it will have to do.

Anyway, today was a crazy day. It's not like I saw a lot of patients because, even though there were a lot of patients, we can't bring people back to a room when there aren't any because the rooms are full of other people... 

 - people like my meth addict who came back again but this time stayed long enough for me to actually evaluate their wound, give them antibiotics and actually ask them to come back again so that we can try to get social work to help get them the resources they need to keep their foot from getting so infected it would have to be amputated.

 - people like my really bad pneumonia that had to be intubated. Once, again, please have the discussion with your family members about your final wishes. And, while I appreciated that they had a Living Will, it wasn't very clear about CPR versus no CPR, or being on a ventilator. Sure I can say I think it's possible they might come off the vent once the pneumonia is clear, but I can't guarantee it. I wasn't not hopeful for this patient, but I can't promise that they won't need to be on it long term. We'll see how they do.

 - people like my 60-something, meth'd up patient who dislocated their hip... again... somehow "in their sleep..." my back and hip are feeling the effects of yorking on that leg "Captain Morgan style" and getting it back into place. That actually was a "yeah for me" kind of moment because initially a colleague attempted to reduce it and didn't... and I did... yeah, that's right, I did it, 5ft 1in me who had to practically climb on the bed... pat on the back for me.

- people like the transfer from the smaller hospital that needed hemodialysis which they don't do in the smaller hospital, the three psych patients who are in the midst of their varied psychoses and either suicidal, severely depressed, or floridly psychotic... at least I was entertained by their Cardi B impression... they received a clap for that...

And, speaking of entertainment, we had two police take downs this morning. One was drunk and decided that they weren't going to cooperate with a legal blood draw. The second was another of our repeat customers who decided they were bored of sitting in the waiting room and did some kind of substance then proceeded to act crazily which then required three police officers to take them down and away to jail. Funny thing: this patient has a pretty serious heart infection from their IV drug use but keeps leaving the hospital to... shoot up drugs... then returns because somewhere in their brain they know they need IV antibiotics... but the last time they were successfully treated was while they were in jail because they actually got their full course of antibiotics. Fancy that.

- I had the usual chest pains, the falling down, the miscarriage, and, I'm sure a couple I'm forgetting... probably because my head is thinking I should be thinking about the Pacific Ocean and sipping a piña colada on the deck of a ship... 

But, for a while I'm not sure what I'll be imagining other than I've got two more shifts then six weeks to contemplate... and plan... because I never stop planning for that next big adventure... 

NaBloPoMo - Day 28 - First Thanksgiving TYOFWM

I'm sitting here trying to think of the things that I'm grateful for this year,

and it's really hard.

Not that I haven't been blessed with a good job, a beautiful home,

great husband and surrounded by good friends 

but because there is a part of me

missing this year, and I just can't seem to get past that...

I'm trying to not be sad.

I'm trying to just enjoy the beautiful day not having to work,

but there's a cloud over today as I'm sure there's going

to continue to be for a while.

For the first time I'm not thinking about turkeys and stuffing

and all of the traditional foods.

I had no appetite this morning,

and the most I can think to rustle up for lunch is

leftover pizza from yesterday.

Not even in the mood to change out of pajamas

and go out to one of the local restaurants offering

a traditional Thanksgiving dinner...

I should be volunteering today

I should be out with friends

I should be doing a lot of things,

but all I want to be doing is hanging out in the kitchen

with my mom while I prep for a small Thanksgiving dinner.

Talking to her about work, and life, and what trip we should be planning...

Asking her advice about upcoming changes

upcoming career moves

upcoming anything...

I hope when you sit down at the table tonight

all differences can be laid aside

and you hold your loved ones close

or call anyone you haven't spoken to in a while

because life is short and you never know

when someone will suddenly be gone

Have no regrets....

For that I am thankful,

Momma and I lived life together as if it could end tomorrow.

Sure, we left a few things undone,

but no regrets on the rest...

My Thanksgiving wish to you all...

Have no regrets...

Birthday Month Shuffle - 7th Edition Day 1

When I look back at my posts, I am amazed I haven't done this since 2016...!  OMG!  This was such an annual tradition.  Of course, life got kinda busy, and July especially so with Momma in the house, then DH's grand daughter coming to stay for the summer the last 2 years.  I never had time to write.  Now I do, so now I am...

For those of you that are new readers, traditionally I start off with a song of my choosing then spin the iPod shuffle and see what's in my music mix.  Given that this is the YOFWM, I will pick a song in her honor to start the shuffle off... and, who knows, I may just continue picking songs from my music list that remind me of her to continue... so let's begin:

I don't know why this song always reminded me of my mom, but it's a song about support and love and lifting someone up when they are feeling so down.  So many times in my life, my mother did this for me.  Through the struggles of getting into medical school, going through medical school, internship, residency, my many moves and trials; she was always there, supportive.

I can't remember a time when she would say, "Well, maybe you can't do this and should think about doing something else."  It was always, "You can do this.  Pray to God for support.  I'll pray for you, and you will get through this."  And, I did.  I achieved all the goals I set out for myself because I knew, no matter what, that she was there.  The song is "You Needed Me," but in reality, I needed her moreso than I ever could have imagined.  And, I still do.

Here's my original post from 2014... and the sentiments are still the same.  Hug your mom today.  Or send a prayer for our Mommas in Heaven.

All the Lonely People

This is cross-posted from the professional blog I write for....

I know that the holidays can get really depressing for a lot of people, but I had three patients over the weekend that really got me depressed because of their situations. I always said that I would never make a good psychiatrist because I would tend to internalize and identify with my patients, and so that’s why I enjoyed surgery so much. There’s quite a bit of distancing that happens when you’re behind a mask looking at a square of skin.

As an E.D. doc, though, we’re up close and personal with a lot of our patients, so it’s back to internalizing and not having the luxury of a sterile sheet between you and your patient.

Patient One crashed their car. They are homeless, so their car is like their home. Everything they own is in there. They had just gotten kicked out of one “fleabag” motel and were on their way to find something better along the coast when they lost control on a curve. Now, all they have is the clothes on their backs. Well, actually in a hospital bag because they were stripped down to a hospital gown when they arrived. They’re bruised and battered and slightly torn. And, they have no one and no where to go. I can discharge them because, luckily, they didn’t suffer any major injuries. But, they have nothing. So they get admitted. Social Work and Discharge Planning can figure out what to do with them in the morning.

They used to have a life, and friends, and a home. But then they were forced to take early retirement from their work. They lost their home and their social network. They can’t afford housing on a fixed income. So they roam… in their car… from place to place.

Patient Two had a nice home, and a wife. Then their wife died and a part of them died too. So they turned to alcohol to help deal with the pain. Soon their nice home deteriorated as did their health. They have a neighbor who checks on them from time to time. Their neighbor brings them in whenever things get too bad. Patient Two can’t see their PCP because they have an outstanding bill, so the E.D. becomes their PCP. Diabetes out of control again? Yep. Bad cellulitis on your legs again? Yep. Anything new? Yep, pressure ulcers on my bottom from not getting up out of my chair for the last three days because my legs felt too bad. Am I going to be admitted? Yep.

Patient Three has a psych history. They’ve been in and out of the system their entire life which is only 50+ years long so far. They have the look of a 90 year old man. A neighbor stopped by because they hadn’t seen them for a few days and found them looking slightly worse than usual. Not eating or drinking. Somehow, though, they continue to smoke despite the rattling cough in their lungs. How the cigarette paper doesn’t just rip their Sahara Desert dry and cracked lips to shreds is beyond me. Must be the warm stale beer that somehow is within reach. Another admission for “Failure to Thrive.” It’s the least I can do.

Three hots and cot… at least for tonight… at least for today…

All the Lonely People