The Biscuit and I got a puppy. I have wanted one for a long time, but the demmands of college, med school, and residency made it almost impossible--particularly for a single guy. It just wouldn't have been fair to get a dog and then subject it to living in a cramped apartment and being ignored for 140 hours a week. But with a new job, new time, a new fiancee and two pairs of dog sitting parents nearby...the timing seemed auspicious.
She's a 7 week old Lab-German Shepard mix. Pitch black. Very loving. And BIG. This is a monstrous 7 weeker. The Biscuit picked her up from work yesterday at 7 (one of the nurses had had puppies (you know what I mean) and was giving them away). In short order our plan of actions--granted a loosely formed plan of action--was in shambles. The dog napped during the early evening and when I got home at 1:20 in the morning the dog was on the couch! next to an exhausted, grumpy and very much awake Biscuit. The crate training had not gone well--we live cheek by jowel with our fellow apartment complex denizens and can't just put the little girl in the crate and let her cry/whine herself to sleep. So I spent a large portion of the night shuttling from my room to the dog's little enclosure to lay by the crate and keep her company. Poor little girl.
It's going to be quite an experience! I'll post pictures of her when I can.
We've named her Shelby, after the Mustang.
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On the 14th the Biscuit and I went to Hawaii. I was going for the wedding of a good friend. Sadly, the wedding activity and associated hustle and bustle made a six day vacation feel like a lot less; we never hit our relaxation stride and really got to the business of slovenly relaxation. Ah, so be it.
Work last night was grueling. I was at St.D's for a 12 hour night shift. Not a whole lot of Aloha! at Our Lady of Desperation. I started counting the hours after seeing my first two patients and that is a really good way to make a 12 hour shift feel like every painful minute of a twelve hour shift. Oh, agony. Nobody too sick, nobody too complicated, but just a constant flow of human misery with which to contend.
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Today I went home to work on a jewelry box I'm making the Biscuit for Christmas. I've put probably 100-150 hours into it and the parts that are left are a little less technically challenging than what I've done so far. And, today, I broke the lid. I could have almost cried. It was devastating, like being punched in the stomach. It was hard to rally myself and try to recover and I'm still demoralized. I know it sounds crazy, but I was so happy with how the lid in particular had turned out. I was really looking forward to having a nice finished product. It was clamp and glue hell for me.
Alas
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Last night was magical in the ED. I went to a dinner party with the Biscuit and then to work at 10pm. I managed to feel pretty good through the whole night. Not bad on 4-5 hours sleep the night before. The key is pacing: enough work to keep time moving, but not so much that it's oppresive. I was ready to go home only 15 minutes late. 22 patients in 10 hours on the high acuity side. Oh, and I harpooned a peritonsilar abscess!
The highlight of the night was a drunken college student. Some poor young guy who was found naked in a shower in one of the local colleges and brought in by paramedics stone drunk and smelly. I have a special fondness for this demographic: I went to those same colleges and can't help but feel a certain avuncular warmth towards these wayward youth. This guy reported having had 17 tequila shots. I believe it--and the fact he had lost bowel continence and was covered in his own vomit and feces attested to some heavy imbibing. His alcohol level was only 242--a lightweight, new to this exciting world of binge drinking, stupefaction and laying shivering and crying in one's soiled clothing. Every now and again over the course of two or three hours he would vomit and gag on his puke---I'd rush over and roll him over and scoop his mouth out and he'd start breathing again after probably aspirating only a little stomach contents. Finally I decided to just tape him up so he was permanently leaned over to one side, a thin trail of pinkish liquid dribbling from his mouth. This "taping" of patients is ILLEGAL, but damn handy and a cheap alternative to the JACHO approved method of...well, just watching him choke on his own vomitus.
By 5 am he was awake and said "Exxcuse me, sir, I think I'm feeling okay, now." Polite son of a gun. His friend came to pick him up. As the guy got out of bed to get dressed our entire department had the chance to witness this patient and his friend simultaneously realizing that he was wearing diapers. That's a life highlight!--having your good friend come to the hospital and see you in diapers. Because you shit yourself. Repeatedly. Really, between the ages of 3 and 93 that's not a good memory to have. His friend, of course, thouht this was screamingly funny and immediately got on the cell phone. Our staff--we're only human--we couldn't help laughing. But it was fond "Those were the days" laughter, not "Ha,ha--Mister Poopy Pants is going to die of liver failure" laughter.
As the guy left he thanked all the staff and thanked me for not calling his parents. Of course not--illegal and, while funny, not really appropriate.
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I went in yesterday for a day shift. What a difference a day makes. Day shift-Wednesday is only a third the intensity of night shift-Monday-post holiday. I saw 11 patients. In 10 hours. That's just silly. Got out of work early--first time in 5 months!
I had a terrible medical student. Just a mouth breathing idiot. She tried to make up for an absence of medical knowledge by being chatty. I tolerated her, and gave her my friendly act because I know how much it sucks to be a medical student, but she was just a zero. Mercifully she is going into a field where her potential to destroy lives will be minimal. I asked her to do one thing--one F'ing thing in a 10 hour shift--"Get your lunch and come back here to eat it in the radio room. That way you can keep an eye on your patients and if somethign interesting comes in you won't miss it."
I promise my med students two things: a)they'll be worked hard, but b) they won't be abused. They will have time to get food and eat, I'll get them out on time, and I'll send them out early if their work is done. That's a square deal.
All she had to do was get some food and come back, and she couldn't even manage that. Fifty minutes later she came back--she had met a friend she hadn't seen for six months. WTF? Where did she learn this crap? You're going to be a DOCTOR, you little twit! Have a little pride and work ethic. I wouldn't have failed her for that, but if it was me filling out her evaluation I'd be damn sure she didn't get any better than a C for the rotation. It's not complicated: show up on time, work as hard as you can, and leave when you're done.
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