Wednesday, September 29, 2004

the winter of our discontent

Why do they keep things so cold in the PICU? What is this, cryotherapy? It's almost October, people. Turn the damn A/C down.

I picked a bad night to be on call. Well, not like I really pick which day to take call, but you know what I mean. Our hospital, hulking behemoth that it is, is in Phase 3 of 5 of TOTAL WORLD DOMINATION, and we just had a big ward-expansion-patient-reshuffling-move-day, in which patients from opposite wings of the PICU basically traded places, and six addition beds were added to the census, which will probably total about 45 by the end of the year. Why the necessity for flip-flopping patients to opposites sides of the ward, I do not know. I'm a resident. Merely a yes-man. They say jump, and I ask how high. They expand our census without expanding the staffing, and I say, "Yes, thank you for the incredible learning experience! I now know what it's like to be that doctor in 'Gone With the Wind,' taking care of a thousand wounded soldiers lying in a dusty field as a tattered Confederate flag waves forlornly over my head! Also, would you like to pay me a little bit less? Food is so overrated when compared to the privilege of FEEDING MY MIND."

Well, yes. Anyway, our PICU is expanding. We built a whole new Children's Hospital a year ago which we've already outgrown, and now we're renovating the old hospital so that we can create one gigantic MEGA-HOSPITAL. Only that's a lot of sick patients and not a lot of sane residents. I think it's amusing, by the way, how safety standards have suddenly changed out of necessity. It used to be that the max cap per resident overnight in the PICU was 9 critical patients each. Now that number has suddenly been expanded to 11. Now forgive me for saying so, because I know the fellows have to handle about four or five times the patient load as we do, but that's a lot of kids who could potentially crap out on you. The thought of even one kid crapping out makes me nervous. Two kids crapping out simultaneously makes me want to curl up in a ball in the corner, rocking back and forth. Hey, but at least there is a cap. On the oncology service, which is it's own mini-ICU (only without the staffing and equipment), there have been nights where a single freshly-minted intern has been covering a service of 25 patients alone, with no fellow in house. These are the things they don't tell you about in med school, because they don't want you to cry.

Oh, yes yes yes, "Back in my day we had to carry 50 patients each and take 72 hour call and do all our own CBCs with a candle and a microscope in the back room. And also, did I mention that we were barefoot? And that the hospital didn't have a roof?" I know, I know. I've heard that one before. But what does a resident have left except the right to rail against the establishment? No time, no money, no life, no food. (I didn't have time to eat dinner last night, and had to make do with a bag of Doritos. Leaves a nice taste in your mouth at 4am, it does.) At least I have my special pen.

All complaining aside, I'm actually really enjoying my time in the PICU. It's exciting, it's new, and I feel like I'm finally practicing medicine, if that makes any sense. Cause, effect. Diagnosis, treatment. Pathophysiology, symptoms. It's like being a second year medical student again, except everything you every learned is being played out in front of you, in real time, on real people. It's very cool. And much better than faxing things to the Medicaid office or calling the Early Intervention office for the five hundred billionth time to set up physical therapy for your ex-preemie. Just pick up the damn phone, people!

My post-call treat today is to be a pedicure at the hands of the little Korean ladies down the block. Not that it's sandal weather anymore, but I like knowing there's a nice-looking foot inside that clog. Then, maybe another daytime movie rental, followed by a nap. I rented "Seabiscuit" the last time I went to Blockbusters, but I don't know if I'm in the mood to watch a movie about a horse and the triumph of the human spirit and all that. Mostly because "Seabiscuit" sounds like a euphemism for poop. "Hey, who left that Seabiscuit floating in the bathroom and forgot to flush?" Maybe I'll get "SNL: The Best of Will Ferrell 2" if the jackass who had it out last time finally returned it.

Currently reading: Honestly, nothing at the moment. I have to figure out my next move. Any other good suggestions? As you can tell from my reading list, I am all about reader recommendations.


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