This week is shaping up to be one of the worst I’ve worked in a while. When I go to sleep at night, my face is so tense that I have to mentally and physically relax it so I can go to sleep. My ankles have swollen to twice their size and new spider veins have appeared on my already spidery thighs. In three days, I’ve worked 43 hours – and that’s not even taking call. I still have at least 10 hours a day for the next two…followed by a 24-hour call Saturday. If you’re the ACGME and reading this, my sincerest of apologies. In my world, patient care and taking care of my junior residents and nurses supercedes you and your work hour restrictions. In other words, kiss my white Irish ass.
But I digress.
After Monday’s opening ceremonies for the August Goat Rodeo, things have not improved. All my kids are at various places on the “trying to die” continuum. When I came in this morning, six of my grand total eight patients were on ventilators. We withdrew support on one patient in the late morning, one was made a DNR in the late afternoon, and another is trying less hard to die (but could blow raspberries at us at any moment and say, “Fooled you!” as she’s beating feet for the Pearly Gates). We extubated three of them successfully, and threatened one with reintubation (stupid teenagers).
Yesterday sucked hard too. I yelled at more residents than I saw patients in my afternoon clinic. One got chewed out because he failed to arrange follow up for a newborn that missed an appointment and is already immunization delayed. Another got chewed out for failing to pay attention to the big picture (where I come from, we don’t treat x-rays or numbers – we treat patients). I can’t remember the other snarky things I said but I’m sure it was colorful and involved the use of the f-word. A lot.
I want to yell and scream and shout and cry and be angry.
But I’m not going to do any of that. It’s only going to make me feel better in the moment. I’ve pacified myself with knowledge instead.
I learned that by taking the extra five damn minutes that you really don’t have to look a family in the eye and give them the answers to their questions straight up sans bullshit can make all the difference to them in the world.
I learned that by holding someone’s hand and saying to them, “I know you’re scared. I’m here. Squeeze my hand when you’re afraid.” works better than telling them to stop crying and thrashing about.
I learned that dying is never easy and that it’s doubly hard on the caregivers, nurses and doctors included.
I learned that I’m trusted and that I’m really not so bad at what I do.
I learned that other people respect me because of who I am and because I try to be a good doctor and a good person.
I learned it’s ok to not know all the answers. Sometimes the attendings don’t even know them, either.
I learned I really need to brush up on my 90’s movie trivia if I’m going to be working with this one attending.
I didn’t have time today to open any books, or hop on PubMed and look up articles. It didn’t matter. I still did plenty of learning today.
Moment of Burrito: “That’s because you’re the resident that no one should fuck with.” – Terri, one of my favoritest PICU nurses