The MICU

I don’t even want to write today, but I will for the sake of record-keeping. After close to a one-month hiatus from the hospital, I now completed my first call and my first four days in the medical ICU. As far as calls go, it was hardly something to complain about – only 3 admissions, a full 4 hours of uninterrupted sleep, and no crashing patients. I was lucky. But my pager is still going off, for one reason or another, and I already dread tomorrow morning when I will have missed a full 18 hours of patient care and will still have to present these patients to a brand new “weekend” attending. The discontinuity of care from a medical team standpoint is disruptive for patient care.

Being in the MICU reminds me of all the reasons I do not want to do medicine. Fixing people here is satisfying, but unbelievably draining. Will continue with further updates after more sleep.

Blogging from afar…

So it is a Sunday morning and I will be on shift for the next 20 minutes – my last shift as an intern. It was quite a day, which began when I took care of a healthy woman in her 40s who turned out to have a saddle embolus and pulmonary nodules indicative of malignancy. She was on her way upstairs before I was able to tell her the results of the CT scan, and I was thankful. It isn’t easy to relay that kind of news. This is my first experience with a saddle embolus - and it frightens me to think how close I was to missing it. We hear stories over and over again of chest pain, difficulty breathing, syncope, and near-syncope and so easily brush them off…and then for all of those that are benign, there is one that shakes us to the bone.

Another lady who lives alone came in for chest pain, but was asking to leave before I even saw her because she had locked her dog in the house when the ambulance came. Loneliness can provide amazing incentive for people to visit the emergency department in the middle of the night.

I am looking forward to my escape from the hospital for the next month – it is greatly needed. One of the highlights today was getting blood work from an obese gentleman in his 50s – a difficult stick. Always an accomplishment.

And that’s all, folks. Farewell to the emergency department as an intern…on to bigger and better things as this year comes to a close. Time moves on whether we realize it or not…

A hurried reflection…

There is a quote from Matthew Arnold, “Journalism is literature in a hurry.” This is journalism. Tonight was one of those nights when people flowed through the emergency department doors like water. There’s no catching up on nights like these – you ride the wave, breathe deeply, take care of the important things. I was caring for between 10 and 11 patients, keeping good pace with the attending. There was a young woman who presented in tears after getting drunk and driving into her ex-boyfriend’s house, absolutely unable to contain herself. The idea was revenge – the result was devastation, and a loud, whining, weeping presence in the emergency department all night long. It is a curse that psychiatry consults only happen in the morning here. This all happened in light of a funeral for someone who was well-known in these parts – a fatal motorcycle accident on the highway. And so the tone of the night was set – a grim, reflective, and chaotic gray cloud settled over the emergency room and hung there through the night, a hushed reminder of the world around us.

Aside from this, I have one final shift left in the emergency department as an intern. Yes, my time has come… This also marks the beginning of a three-week vacation. I can’t quite believe I survived the year without taking vacation, but somehow I managed it. Now I will have the next 24 days of my life free from the hospital, clinical obligations, medicine. Most importantly, free from being a doctor. Starting tomorrow at 7AM, I can be whoever I want to be and I can forget medicine all together. What a lovely thing.

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