Chief complaint

Had a patient come in the other night a little the worse for wear. A European in town on vacation, he had had waaaay too much to drink, fell down (several times) on the pavement, and had the head injuries to prove it. I went up to his bed where he was strapped to the backboard, lying in the c-spine collar, and decorated with his own dried blood, and asked him what happened. He looked up with me with a sparkle in his eyes and replied in a lovely Hibernian brogue, "I was being Irish."

Big pants

The Emergency Department in one of the hospitals where I'm working has special cranberry-colored scrubs for ED staff. They're sharper looking than the traditional greens, so they tend to disappear from the lockers quickly. I managed to get hold of tops that fit, but for the past several weeks I've been making do with the only size of pants that I could find, which are enormous. They hang low, and I have to roll up the legs so they don't drag on the floor. Plus, I'm constantly running the risk of them being pulled down by the various gadgets and reference materials that I carry -- something that would probably tend to undermine my medical authority.

The other day our program coordinator located two pairs of the correct color in my size. Now I can finally approach my next shift with the confidence that comes from knowing that my pants aren't about to fall down.

Doppelgänger-Bob

Like many ERs, we have an electronic board where residents put their initials next to the names of patients they're seeing, but the other night I noticed my initials next to a patient I'd never seen or heard of. I clicked for more details, finding that the initials belonged to another resident who, coincidentally, shared my initials. And who happened to be sitting next to me. And who turned out to have come to medicine later in life, after another career. In music. Classical music. In Boston.

How's that for a coincidence?

Ups and downs

I wish I could think of something original to say about starting as an intern, but I'm finding that the cliches are more or less true. One of the things that I'm finding most difficult is how up and down it is. Sometimes I leave a shift feeling like a complete idiot, and sometimes I leave feeling like I might even have done a tiny bit of good. But no matter what, it's all-consuming.

Newbie's blues

It can be hard to settle into a new job. The other night I wrote some orders for a patient and got his hospital ID card, since all patient documents need to be embossed with the patient's information for safety reasons.

I found the swing-arm device that imprints the paper from the card, put in the paper and the card, and pushed down. Except that it wasn't the embosser -- it was a stapler. So now I've stapled the order sheet to the ID card that everyone else needs. And there I am, struggling to pull the staple out of the plastic without ripping the paper, and people are starting to wonder what I'm doing.

Finally managed to sort it all out while projecting, I'm sure, the sort of calm competence that we expect of our healthcare professionals.

First shift.

Very humbling.

Must sleep.

More later....