Saturday, November 04, 2006

Short Circuit

Sometimes it is the little things that surprise you. Of course I knew that the leaves would fall as it got colder. What I didn't know is that they would fall in order. The leaves on the maple out front are like mini-paratroupers... all crammed in together, each one waiting for its turn to jump. It was surprising to me how orderly they seemed to fall, starting from the very top of the tree and working their way down the branches.

I am sure there is some sort of scientific explanation for it-- such as the nutrient-providing xylem and phloem not being able to reach the distal tips as efficiently. Perhaps if I had paid more attention in botany I would know, but then that kind of destroys the romance of it, doesn't it? Not exactly the sort of thing Walt Whitman would write about, I suppose.


I worked a 24-hour shift yesterday. We had 9 admissions overnight. That's a whole lot of paperwork. One of the worst things about being an intern is that you aren't independent. Most of the time I end up being micro-managed by a senior resident, whose own responsibilities take precedence over mine. Sometimes they aren't the greatest at time management.

The hardest thing about being on call is that in addition to managing your own stuff you take calls on patients that you've never met. Half the time is spent trying to catch up, while being constantly interrupted by other junk. And then, because a lot more mistakes are made overnight, it's always necessary to check and re-check orders against plans to make sure that the morning team has everything set up. I slept 20 minutes total, and had about a 15-minute lunch and scarfed down a bagel at midnight for dinner while checking labs. Because we were so far behind all night, I didn't get to start my morning notes until we had signed out to the new team. I ended up staying 27 hours, at which point I got sent home.

Last night my PDA died again. This time my pharmaceutical program keeled over due to some inborn error, which just slowed me down more. Medicine is all about being able to access information quickly. And then, after I woke up this afternoon, I realized that I had left my cell phone at work! The electronics, they are out to get me!

Between all the quality of life issues we deal with, sometimes I think it would be better to go back to having only a handful of medications. So many people are on so many medications that it's all too easy to dose things incorrectly or have interactions. There was a pharmacist (not the cute one) that paged me about a dozen times last night. He kept cancelling my orders and switching medications without even speaking to me. In one case he stopped something because he thought that the patient was allergic, but she just develops some nausea and she'd already been given the medication by the ER without any problems. In another case, he switched someone to a cheaper antibiotic, but he wasn't aware of the culture results and didn't know that the bug was resistant to the cheaper med. Micromanagement, I hate it.

And then there was the nurse that paged me at 2 am to ask for the correct spelling of my name. My name is misspelled in charts all over the place, it's not really a big deal. Apparently, she thought I would get ticked off if I saw it misspelled in the chart. Fortunately, I wasn't sleeping, but I think that perhaps that one takes the cake for the most inappropriate page ever.


Theme song for last night:

You need to know your friends,
You need to know that

I'll be waving my hand,
Watching you drown

Watching you scream--
Quiet or loud.

And maybe you should sleep,
And maybe you just need...

A friend.
As clumsy as you've been,
There's no one laughing.
You will be safe in here...

"Clumsy" -Our Lady Peace

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