Last night at work I was in the zone. It was like the patients were moving in slow motion. Weren't too busy so everyone got the special sauce: updates, pillows, little conversations with family members. All the non-billables that patients love and Medicare doesn't pay for. Also had some sickies. One woman was brought in after "arresting" in her nursing home and being brought back with CPR. At first I thought the story was bogus, because she looked pretty good for having been dead twenty minutes ago, but as she started looking shitier and after I called up the Casa Decrepitude to get the facts of the case I decided maybe the story wasn't so preposterous. Tubed her and watched her anxiously until we got the intensivist on the phone. The beauty of tubing someone is that you've got an automatic dispo--there's no argument about where a lady hooked to a two hundred pound ventilator is going to spend the night.
Tubed another lady. A lady I had first met 8 days ago when I decided to treat her pneumonia with outpatient PO's. Now that decision seems unwise. I had arranged for her to get next day follow up with her PMD, but that......fell through. So now, a week later, she's being managed with 23 cm of polypropylene tubing and Zosyn. Shit.
Went home feeling tired but decent. The Biscuit had cancelled her plans so she could come over to the new aprtment and cook me enchiladas and watch a movie. What a girl! She's a phenom and a damn good cook. We watched "Over There", put down a bottle of Trader Joe's $7 Sauvigbon Blanc and I was in bed and asleep by 10. What a good night!
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