Tuesday, May 24, 2005

in one arm and out the other

I had a nightmare of a PICU call on Sunday. Two kids on oscillators, three on conventional vents, one kid who was clearly succumbing to peer pressure and looking to join the crowd, and some kid who was stroking out. To top it all off, the last six hours of my shift I was doing a manual exchange transfusion--literally going into a kid's room and drawing out 150ccs of blood from his art line every half hour as reconstituted whole blood was running into his other arm. Since it took about ten minutes to set up and draw off the blood each time, what it really meant was that I was in that kid's room every 20 minutes. I'm sorry, but in this day and age, what's the deal with doing a manual exchange transfusion anyway? I mean, I can understand if it's a little baby that we're exchanging, but this was a grown-ass teenager. The blood bank has MACHINES for this kind of thing. Real answer: Good luck getting anything in the hospital done efficiently on the weekend, especially overnight, for anything requiring specialized equipment. Other real answer: The resident is the machine, don't you know that by now? A machine with very tired arms. I, Robot. The PICU fellow told me that he would take over a few blood draw shifts from me so that I could, you know, actually take care of some of my other patients, but the PICU fellow is a damn liar.

Aside from learning how to exchange transfuse someone, I did learn something else new about the PICU that night. There's another set of PICU call rooms over on the older wing of the hospital! Jen showed them to me on our way out the door Monday morning, and wouldn't you know, it's a pretty nice call room--it has two bunks and a carpet and everything. I mean, I'd heard about these call rooms in the past, but no one ever really showed me where they were, and sleep wasn't really an option much of the time anyway so the need to find them was less urgent. The only downside to these call rooms, I'm told, is that the clowns sometimes use that space to change. So sometimes if you go in there during the day, you may catch a clown or two in various stages of undress. Which may be reason enough to avoid that whole area altogether.


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Our cable modem service was down for a day and a half because someone forgot to pay the cable bill uh, of technical difficulties, and we only just got ourselves back online. I didn't think it would really be such a big deal, but not until our connection was taken away did I realize how much we actually use the internet. When I got home post-call, I couldn't check my e-mail. I couldn't read the newspaper. I couldn't check the weather report. I couldn't log in my work hours. And I couldn't update this page, which means that whole thing with Joe going to his conference was the lead story for a little bit longer than I would have liked. (We talked about it some more, and result of that is that, like everything else in life, we'll just cope with it. I'll enlist outside help if needed, and call Joe at the hotel at 2am if I need some actual adult interaction and sympathy sleep-deprivation.) I mean, I just don't think I would be a very good Unabomber, because I depend on technology way to much in my day-to-day life. What did people do before the internet? Am I to believe that they had to go to the store and write letters on paper and have to look things up in the library and actually INTERACT WITH OTHER HUMAN BEINGS? Quelle horreur!

Luckily, we got everything sorted out, and obviously we're back up online. Thank god. Now I can finally return to the important things. Like looking up forgotten song lyrics and browsing through various online shopping venues for products I may consider purchasing in the future. Which, as we all know, is really what the internet is best used for.


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I just looked at my calendar and realized that I only have four Peds calls left before the end of the year--three in the PICU and one 12-hour shift in the ER on Memorial Day. Four more Peds calls. Ever. Despite the fact that I'll be a resident for the REST OF MY LIFE, the idea of being done with something is exciting nonetheless. The third-year resident who was also in the PICU with me on Sunday actually just finished up her last call EVER ever, and was a little upset with me that I couldn't head out with her the morning post-call for a Blood Mary. Just her luck to be in celebration-mode and post-call with the one resident who can't drink.

Currently reading: "The Namesake." I figure I might enjoy it, because one of my med students lent me her copy of "Interpreter of Maladies" to me last year, and I liked that a lot. So she got Honors.

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