This has been the first week at work where I actually (maybe) feel like I (kinda) know what I'm doing. However, I think that the word is out on the street that I'm something of a wayward resident, what with being BEHIND THE PACK and all, so while everyone has been very nice about giving me a little extra supervision and tolerating my endless stupid questions, it makes me feel a little bit like the village idiot. Maybe I should get a little beanie and a too-small vest, and walk around talking about how me and George are gonna get a farm someday and I'll get to take care of the rabbits.
Now that I'm only partially overwhelmed (instead of totally overwhelmed as I was a week ago), I have to say that this transition, even without taking the baby into account, has been one of the hardest things I've ever done. I've heard that other attendings who switched from Peds into Anesthesia had similar experiences, and this has actually made me feel a lot better. These are smart people, after all. If they had a difficult time switching over, it's OK that I'm having a hard time too. Throw the fact that I have a 10-week-old baby into the mix, and my head-spinniness is suddenly very understandable, though I really don't want to play the baby card and use that a some kind of an excuse. Still, it's not easy for me to feel like I don't have job mastery--it changes the whole way I picture myself, you know? I never realized how much my professional identity played a role in my self-image until these past few weeks.
OK, blah blah blah introspection-cakes BLAH. About a week and a half ago it started to get colder around these parts in earnest, and I realized that Joe and I were terrible parents because we never actually anticipated that summer would end (despite 58 collective years of life experience) and therefore had no warm clothes for Cal to wear. This was a problem. I hurriedly placed an order with Old Navy for some sweaters and whatnot, but ordered them all in the next size up from the size that The Boy is currently wearing, figuring we'd get the most use out of them that way. Which is all fine and good, only it didn't solve the problem of him having nothing warm to wear NOW.
So being terribly bourgeois as we are, we took a little family trip to Baby Gap on Saturday morning and got Cal some warmer outerwear, at least to tide him over until the Invasion of the Grandparents from Ohio, who are sure to be bearing winter wardrobe gifts for the newest object of their abject devotion. Here's a picture of him wearing his new Elmer Fudd hat.
We also got him a very cute little light grey button-down jacket that makes him look like Kim Jong Il. Baby's first communist dictatorship!
Man, this kid has it good. When I was his age (oh no, it begins) I was wearing scary 70's hand-me-downs from my cousin.
* * *
OK, I just have to say this, because it's EATING ME ALIVE. Most of the time in the ORs, when I do something wrong, it's because I'm inexperienced and didn't know any better. But sometimes when I do something "wrong," it's not really "wrong" at all, rather it's the way one attending showed me to do it, and when I work with another attending the next day and do things the way the first attending likes it, the new attending is aghast and all, "Where the hell did you learn to do that?" when really, I learned it from watching you, dad! Take for example the practice of taping the eyes.
(Expository aside for just about everyone: when patients are put under general anesthesia, we tape their eyelids shut to protect them from drying out or getting scratched.)
Now, no one is arguing the practice of taping the eyes. We are all in agreement, yes? Taping the eyes is important. But the issue of how the eyes should be taped is the subject of more disagreement and personal variation than almost anything else I do during my day.
FIRST ATTENDING
Tape the eyes with paper tape, and squirt in some of that eye goo.
MICHELLE
Got it.
(Next day)
MICHELLE
(Taping eyes with paper tape, squirting eye goo)
SECOND ATTENDING
What the--what the hell are you doing? Don't use paper tape, either use Tegaderms or pink tape over the lids so you can see the eyes! What are you an idiot? And never let me see you using that eye goo! The patients wake up and they can't even see anything!
MICHELLE
(Meekly)
Sir, yes, sir.
(Next day)
MICHELLE
(Taping eyes with Tegaderms, no eye goo)
THIRD ATTENDING
What in the dad-blamed--you forgot the eye goo! What are you, retarded?
MICHELLE
(Looking at the floor)
Yes, ma'am.
(Next day)
MICHELLE
(Taping eyes with Tegaderms, squirting in the eye goo to keep the eyes moist)
FOURTH ATTENDING
Oh my god--never, ever use Tegaderms on the eyes! It pulls out their eyelashes! And what the hell is all this eye goo you squirted in there? Never use that!
MICHELLE
(The picture of obedience)
Yes, sir.
(Next day)
MICHELLE
(In the car, on the way to work)
...so then he said to never use Tegaderms on the eyes because it'll pull out their eyelashes, and that I should be using the eye goo all the time.
JOE
Well, from an ophthalmology point of view, no study has actually bourne out that the eye goo serves any sort of protective purpose. And we always use Tegaderms to tape the eyes over at the Eye Institute.
MICHELLE
Oh lord, not you too.
So what I've taken to doing, just so I can stop getting chastised, is remembering how each attending likes their patients set up. Which is good, because it saves me from getting "corrected" at all the time, but then I think about all the energy I'm expending memorizing HOW EACH ATTENDING LIKES THEIR EYES TAPED and not memorizing, I don't know, something vaguely medical.
I'm going to get in trouble for saying this, aren't I?
[Edited to add: My attendings aren't really this mean. These dialogues have been EXAGGERATED for COMIC EFFECT. In the name of COMEDY. Ha ha, comedy!]
Currently reading: "The Anesthesiologist's Manual of Surgical Procedures." This seems like a pretty good book to own, but the hugeness and weight of it kind of prohibits me from toting it around to where I really need it, in the ORs. Maybe I'll just Xerox the pages that I need each day and stick them in my pocket.
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