Tuesday, June 30, 2009

Senseless

IUFDs after the age of viability.

Preemies who are going to be gorked thanks to their mothers' drug habits.

Teens shot at the bus stop.

Son/brother/nephew/cousin of my coworkers/friends/patients dead.

God, I hate open-casket viewings.

Monday, June 29, 2009

You know you are a PITA

When the ER doc, upon getting through to me says "She's driving us all nuts."

Yes, we will see her tomorrow. But all of her issues are supratentorial, so we won't be able to help much. :(

Wednesday, June 24, 2009

How to make the answering service drone laugh.

Cell phone goes off. It's around 8 pm (thank goodness). Caller ID reveals the ever dreaded answering service.

"Hello?"

"Hello doctor. This is Dawn at the call center. I have a call for you."

"OK."

"Patient Ida Dunce calls stating her period started today..."

"Why the hell do I care?!" interrupting her spiel on the reason for the call. She started laughing.

"I don't know. Do you want me to connect her?"

"Not really, but go ahead."

I only wish some of these stories were made up, but I'm not that good of a storyteller.

Saturday, June 20, 2009

My family has superpowers

My mom and sister have the superpower to call exactly 10 minutes after I have laid down for the first time in 40+ hours. It's inevitable. It happened yesterday. Again. And then they get irritated with me for not being spritely and willing to talk.

My kids have the superpower to whine exactly when I am on my last ounce of reserve from dealing with needy people and the generalized craziness of my life right now.

My husband has the superpower to always make me feel better, even when my world is crashing.

I like the last superpower the best. ;)

Friday, June 19, 2009

New quote of the day

So I'm getting ready to pap a lady, who isn't too keen on me being down there. Actually, she's terrified. So she asks me to talk while I'm examining her to distract her.

Me : "I'm really good at talking to butts."

We both burst out laughing.

Wednesday, June 17, 2009

Happy Time-Out Day!

So said the signs posted about the doc's lounge in the OR.

Bleah.

I had a pre-op nurse ask me today if I wanted to mark the patient. "No" was my answer...I was doing a D&C and didn't think marking the cervix would be a good idea in the pre-op area. Hell, I probably couldn't SEE it in the pre-op area!

One of these days, I'm going to mark an abdomen (pre-laparoscopy) with the words : Camera here, dipshit. I told this to our hospital's risk manager and after her laughter died down, she told me to stop being difficult.

Now, I think timeouts are a good idea to remind us what we are doing. However, the new craze of MARKING every single incision is insane. Every surgery is unique. I should be able to reserve the right to THINK and ACT on the basis of my skills, knowledge, and unique factors any patient may bring to the table. The majority of my cases are laparoscopies. Sometimes I need 2 incisions. Sometimes 3. Bad cases get 4. I've done tubal ligations where I couldn't place the usual suprapubic port...it ended up being a left-sided port due to her uterus being scarred to the anterior abdominal wall. I changed my surgery intraoperatively from my usual way to something unusual.

Now, I'm not against marking incisions in cases where laterality/location is important. When I choose to get my knee fixed, I damn well want the RIGHT knee (literally and figuratively) operated upon. Neuro better operate on the correct level. But in cases like laparoscopies, c-sections, or where you're doing the same thing to both sides (ie, bilateral tubal ligation, tubes in ears, tonsilectomies...) does it truly help to mark? Or is it yet another blip on the computer to mark off?

I'm threatening a true temper tantrum if they start requiring marking the incision site for c-sections...

Saturday, June 13, 2009

Enough!

My 3rd ectopic in less than 2 months.

Stop it!!!!!!!!!!!!

Implant in the correct place, dammit!

Friday, June 12, 2009

PSA

A yeast infection is NOT a medical emergency.

You do NOT need to go to L&D at 1 am for it.

There ARE over-the-counter medicines for it. Trying them first is NOT a bad idea.

Doctors are really bitchy at 1:23 am when paged by the L&D nurse about this.

I'm starting to think I need to screen patients on common sense.

Saturday, June 6, 2009

Fun times

At least Mecca is closer to me than home is, which means I can run up every day I'm not on call.

So Mom's over anti-coagulated (again), this time with a retroperitoneal bleed. She's gotten 4 units of PRBCs and some platelets (since they're down to 30). She's also acting like she's infected, although the source is nebulous. So Vanco and Zosyn are on board.

The whole team rounded when I was there...med students, intern, resident, God. Made me smile internally. Thank god it's June! I said that outloud and Mom and her cousin asked "Why?" July 1st is the start of the new academic year...and interns are worse than clueless! They are clueless AND have the ability to write orders!

Coincidentally, her cousin was there because her niece (my second cousin) is getting her bone marrow transplant next week. Usually we do a family reunion every August at a park on Lake Michigan. I suggested the reunion site near the Mecca, where we could play spin the bottle to see who gets admitted to the onc floor at Mecca next. Gallows humor at its finest. I followed my cousin to see Emily and her mom.

Emily's mom (also my mom's cousin) is about 10 years older than me and was one of my favorite babysitters as a kid. She is just one of those people who exudes generosity and caring. I was shocked to see how she has aged in the last year. I can't imagine the hell she has been through. And yet, she still makes you feel like everything you are saying is the most important thing in the world to her. Truly a beautiful person.

I made sure to hug my kids extra hard when I got home last night.

Going back today.

Friday, June 5, 2009

Huh?

You know that saying that states there is no such thing as a dumb question? That person was an idiot for saying that. Here's proof:

Patients husband, in the post-operative conference room. I'm there telling him that the vag hyst went well. His question:

So, um, where will my cum go if she doesn't have a uterus?

Wednesday, June 3, 2009

Readmitted

Pelvic abscess. Being shipped to the mecca as I type. I'm on call tomorrow. I have instructed DH to go up there tomorrow and scout out what's going on. My sister is somewhat clueless when she calls.

I think I'm going to enjoy a lot of wine tonight to numb myself.

Whatever happened to "2009 is going to be fine."?

Tuesday, June 2, 2009

Moods

It's been a rough few months...between working my ass off, my mom getting sick, various appliances all deciding to die at once in my house (I think they're unionized and striking). I'm finding myself listening to a lot of punk/hard rock lately with some later Beatles thrown in.

It makes for a strange mix in the OR. The punk and rock seem to cover the anger that I'm feeling at the world. The dandelions in my garden beds can attest to that anger. But the Beatles...not angry. Their songs that I'm drawn to are more wistful, more longing for connection. Let It Be is even more on the road to acceptance. (yes, I've been reading Kubler-Ross)

My usual assist is getting sick of American Idiot. ;)

Monday, June 1, 2009

Validation

Sometimes, it seems like all we hear is the whining and complaining of people whom we can NEVER make happy. (Usually because we are withholding narcs, but that's another story). And although I don't do this for praise, an attagirl every now and then is appreciated. But they are few and far between. Just knowing that some people recognize the effort that you put forth to care for and about them...it makes a lot of the daily crap a little more bearable.

Well, I got two today! A box of dark chocolates from a patient at her postpartum visit with a very nice note. And then a call from the patient advocate at the hospital. Usually those calls mean someone is pissed off and let Press-Gainey know it. But not this time! A patient took the time to write this long, handwritten letter about her birth experience and how wonderful it was, how caring we all were to her and her stillborn child, and how she will never go anywhere else for her care.

So even though I'm delirious from lack of sleep, I'm feeling good. Stupid, I know, but it doesn't take much.