Today I left for work at 5:50am and got home at 8:10pm. Damn, that's a long day. And I wasn't even on call. Honestly, after a certain point, you almost wish that you were on call--if you're still in the hospital that late, you might as well make a night of it and at least get the next day off. No such luck, though.
I was holding the delivery room pager today and was called up to attend to various kids in various stages of popping out of the womb. There was the one gigantic kid that they had to remove by force (C-section for fetal macrosomia), one kid who pooped on himself in utero (light meconium in the fluid), and one kid born to a mom with Hepatitis B. After the latter delivery, the OB (who was of the elder statesmen, "Silver Fox" breed) asked me, "So, what are the recommendations on breastfeeding for mother with hepatitis B? Do we encourage or discourage?" And I was all like, "Uh...hmm...excellent question, very relevent. I will give you my answer, my EXPERT PEDIATRIC RECOMMENDATION...in...a few minutes." Then, when he left the room briefly to fill out some paperwork, I quickly Googled "Hep B and breastfeeding" and read up on the latest CDC recommendations. Thanks, Google. You make me seem like an actual doctor than knows things.
(The answer is that we do encourage breastfeeding regardless of Hep B, by the way. I should have known. Breastfeeding is the default answer for everything in Peds. Pediatricians love the boob.)
Speaking of Hep B and pregnancy, I was actually just barely on time for the above delivery, because two of the three hospital elevators were broken, and once I got up there, I had to hunt around to find a mask with a splash guard so that I wouldn't get Hepatitis B goop in my eyeballs (didn't you see "28 Days Later"?) and have to worry about shooting up Cletus full of Hep B immune globulin in a few months. It was not a very messy or explosive delivery, at least by the time I got there, but the daily fetal risk obstacle course was not yet finished. Later this afternoon, I had to accompany a patient down to radiology for a fluoro study, and the techs there were adamant--adamant--that I stand in the room while the study was being done.
MICHELLE
Look, I'm just here in case the kid, like, codes or something. I'm just going to be watching the monitor, I don't need to be standing right next to him.
PATIENT
(Crying, flailing)
TECH
What if something happens to him? We need you here!
MICHELLE
I am here. I'm just five feet away from you, in the control room. If something happens, I'll be in here in less than two seconds, exactly as much time as it takes for me to walk three steps and open the door.
PATIENT
(Crying, flailing)
TECH
What if you can't see the monitor from there?
MICHELLE
I can see it. I'm standing right here. I'm only five feet away behind a sheet of glass, for chrissake. You know, the clear kind of glass.
TECH
(Indicating tableside)
You should stand here, next to the giant radiation machine.
PATIENT
(Crying, flailing, pooping)
MICHELLE
Look, really, the kid doesn't need me standing next to him to have the study done. Seriously, I'm only here to resuscitate in case he arrests, which is not going to happen. I don't stand next to him all day in the NICU either.
RADIOLOGIST
(Warily)
How will I know if he's arresting?
MICHELLE
(Long pause, considering a number of responses, some more tartly phrased than others)
Well doctor, aside from looking at the monitor that's right next to your face...if he arrests, he probably wouldn't be breathing or moving around anymore.
PATIENT
(Crying, flailing, spitting up)
RADIOLOGIST
(Donning lead apron and neck collar)
OK, but make sure you're keeping an eye on him.
Seriously, the way they were looking at the kid, you'd think he was a bomb or something. Don't drop him! Don't cut the blue wire! And whatever you do, don't let him go slower than 55 miles per hour! The weirdest part of this whole thing was minutes later, in the control room. I turned to one of the techs (none of them stayed in the actual fluoro room during the study either), and asked, just to be safe, "We don't need to wear lead while we're in this room, do we?" And she looked at me with a look that said girlfriend, please, and drawled, "No, it's OK in here. Ain't no way I'd be exposing myself to all that radiation."
Currently reading: The New Yorker 80th anniversary edition. There was that article about those people in Georgia whose dog was abducted in a carjacking, and I felt instant sympathy. Maybe we should get Cooper microchipped.
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