21 Days Later

(With apologies to Danny Boyle.)

Just finished a bit of a marathon in terms of continuous days on duty. But now I have a day off! Of course, I was in the hospital so late tonight that I actually worked over an hour into my day off. But if you're going to be that fastidious about your "days off" you'll never make it as an intern. I'll take what I can get.

Anyway, I thought I'd open a bottle and have a glass of wine to celebrate, but surveying the kitchen drawers it turns out that Lady M got custody of both of the corkscrews. May have to improvise here....

Thriving?

So you work eight days straight, finishing with 30 hours on call (and no sleep, natch). Then today you have your one day off, which you get to spend taking not one, but two standardized tests. Then tomorrow morning brings a third, half-day-long standardized test, after which you're on call again for another 30 hours, kicking off twelve more days of work with no days off.

If this sounds like a good work schedule to you, you would thrive as an intern. Me, I'm getting kinda tired of this.

Too close to home

Has anyone out there read Intern by Sandeep Jauhar? Last week, eight months into my own intern year, I picked it up and started reading and had to stop -- it just cuts too close to the bone right now. Please, somebody tell me that it has a happy ending....

On-call Liveblogging: Final Exam

In my line of work we perform physical exams all day long. Many of them can be quite specialized; for example, the exam of the patient with eye pain differs somewhat from that of the patient with rectal bleeding.

One of these specialized exams is performed when we are called to the bedside to pronounce a patient's death. There are certain exam criteria that must be met before we can officially declare a time of death, and sometimes it can be a slightly eerie experience. There's often no one else in the room. If this was your patient you may have been examining him or her several times a day for weeks. Often you knew the patient's body intimately, and now you're seeing it in an entirely different condition. There can be unsettling impressions: did I just see an eyelid flicker? am I certain that I don't hear the slightest murmur of cardiac activity? Just wishful thinking, unfortunately. (Although death can be a more dynamic process than one might think.)

Here's hoping that I don't need to perform this exam on tonight's call....

On-call Liveblogging: ICU Solfeggio

Things I think about in the ICU at midnight: the alarms on the ventilators sound out the melody "sol do fi sol sol."

Legends of the Call

Why the blogging radio silence you may ask, faithful reader? Well, lemme tell ya....

I've been rotating on Cardiology, certainly a vital area for an emergency medicine doc to know a thing or two about. However, the census of patients more than doubled just before I came on-service, so it's been busy, busy, busy. I'm on q4 call, which means that every fourth day I'm on for 30 hours straight. It's a truism among doctors that call gets a lot harder once you pass 40, and I'm here to testify to the truth of that. Everybody wilts by the end of call, but I'm having a tough time keeping up with my much younger colleagues. Today is my only day off in a 12-day stretch, so I wanted to seize the opportunity for a quick post.

However, I'm off to the library now. Every month we take a standardized test that's compared with scores in other programs around the country and reported to our program director, and today's my only chance to study and take it before the end of the month. Not exactly what I'd prefer to be doing on my day off, but whaddya gonna do? Nobody said that being intern would be easy. Or humane.