Night float. I got called on a patient, one of my cross-covers that I know well after spending an hour trying to establish code status and avoid intubation the other night. Nice guy, has AIDS, has a nasty probably-pneumocystis pneumonia. Nurse calls me to tell me he's hallucinating. Seeing angels or beasts or some such, and he's overcome by the ( Read more... )

It always amazes me that I can walk into someone's room, calmly discuss the death sentence they've just been handed, and then go back to sleep. It's an adaptive thing. It took me ten minutes to work up the nerve to go in there in the first place, but once the deed is done, I can drift off easily.
It is never good when your arm wakes you up by ( Read more... )

Two patients this morning - one who's finally gotten her EP studies and is now going home, the other in rehab. Done rounding by 08:20. Got called by the cardiologist and told to come discharge his patient; then paged from the birthing unit. You have a card. One of my patients - one of those many wonderful deliveries that I don't tell you about ( Read more... )

Ran through Triage. "Not us," nursing comments, stopping me in my tracks. "We're all CBU." Code was cancelled by the time I'd made up my mind to go down to the ICU. All in all, this has been a slow OB day ( Read more... )

Slept almost 14 hours last night. It is a day off. I finished charts and did H&P dictations 72 hours overdue.I have recovered something of my old strength, but not enough yet, O Best Beloved. The memories, I think, were never clear. I fall asleep on the dictaphone at 0300 when it has been a steady stream of admissions - seven in a night, one to ( Read more... )

Still here. Medicine is devouring my very soul.
Grandpa is having bypass - triple or quad - on Friday when I'm post call. I don't know what I think about that; I haven't had time to think for two weeks or more now.
Patients to talk about and no time right now. I can't think.

Fourmoredays.

Angel is cleaning the carpet to make it stop smelling like cat.I got home around 1900, after a full day of rounding on three patients (new attending, Dr. R, is super-smart and interrupted presentations to look at chest X-rays and discuss the intricacies of pulmonary emboli versus perioperative myocardial infarctions), including a very sweet and ( Read more... )

Came in today to an empty board. M's family withdrew support yesterday; he died quickly after that. R nodded at me; I saw his eyes. My patient was not the only one to die on his watch. I am glad he was there.Today have been observed by our Friendly Behavioral Science faculty; she watches our patient interactions. She tells me I am good with ( Read more... )

There is not much snow on the ground right now, but what there is seems to be dividing itself between ground and air. We decided not to go to family thanksgiving; we made a turkey breast and mashed potatoes and green bean casserole and dressing right here instead. Too much driving, once you factor in the additional travel time due to snow ( Read more... )

Now on pediatrics. Perhaps I will be able to tell you stories again. I've had one call thus far, in which I stayed up late filling out child protective services forms for a Child At Risk who is going home to foster care. He is worth hearing about. But today, I will follow up the last entry and tell you this one.My second-to-last medicine call I ( Read more... )