Turkey Day +2 or, Happy Fucking New Year
Tonight was everything I feared it would be and worse. The ER and the wards were hopping mad and not with turkey related pathology. It was like everyone was waiting for the Thanksgiving to pass to finally seek attention for problems left to fester. In many ways that was exactly what happened.
I was asked to see an 85 year old lady who had anemia. Upon reviewing her X-rays and her history, I determined that she likely either had a huge lung cancer or metastatic colon cancer. This was causing her to lose her appetite and weight for the last year, feel weak and dizzy for the last seven months, bleed from her bottom, become anemic AND develop blood clots in both of her lungs.* Talk about a conundrum: do I give her blood thinners to treat her clots but risk further bleeding or do I leave the emboli be and risk her developing more?
I spoke with her and her daughter at length about her new diagnoses. It was a lot to take in, especially if you've been healthy all your life, never needed medical care and have been to the hospital exactly once before as she had been. I advised them that at 85, undergoing an extensive workup and possible chemotherapy or surgery would be something not taken lightly and fraught with morbidity. Doing nothing about it was also a viable option as was hospice, if they were so inclined. They were considering the options and in the meantime, I gave her a transfusion and made her comfortable.
Counseling takes time and all the while my pager was blowing up with new consults and cross-cover calls. It was like the ER guys were admitting everyone who came in and well, it seemed like everyone was wandering in off the streets. I hit the ground running and didn't stop until the bitter end.
I had to pass of a bunch of admits to my relief person much as they were passed off to me. I hate doing that. It makes me feel weak and inefficient. Plus, the scowl on his face and the grumbling doesn't make the hand-off any easier to do. Still, he was gracious enough to burn me a CD mix of Christmas tunes while I signed out.
I think I should drink mass quantities of alcohol or masturbate furiously to pictures of baboons in estrous. That's what my brain feels like I've been doing all this time, so I might as well do the crime...Or, I can go to sleep now and prepare to do it all over again tonight. Yes, sleep would be good. I have a full day tomorrow as I try to catch up with any visitors left in town.
Sometimes, I resent my job.
----
* In radiology, they call an ominous X-ray and diagnosis such as that the Happy Fucking New Year (HFNY) Award, especially if it's the first of the year and the patient has had no prior problems. It's a bit early for the new year, but I think she's one it.
I was asked to see an 85 year old lady who had anemia. Upon reviewing her X-rays and her history, I determined that she likely either had a huge lung cancer or metastatic colon cancer. This was causing her to lose her appetite and weight for the last year, feel weak and dizzy for the last seven months, bleed from her bottom, become anemic AND develop blood clots in both of her lungs.* Talk about a conundrum: do I give her blood thinners to treat her clots but risk further bleeding or do I leave the emboli be and risk her developing more?
I spoke with her and her daughter at length about her new diagnoses. It was a lot to take in, especially if you've been healthy all your life, never needed medical care and have been to the hospital exactly once before as she had been. I advised them that at 85, undergoing an extensive workup and possible chemotherapy or surgery would be something not taken lightly and fraught with morbidity. Doing nothing about it was also a viable option as was hospice, if they were so inclined. They were considering the options and in the meantime, I gave her a transfusion and made her comfortable.
Counseling takes time and all the while my pager was blowing up with new consults and cross-cover calls. It was like the ER guys were admitting everyone who came in and well, it seemed like everyone was wandering in off the streets. I hit the ground running and didn't stop until the bitter end.
I had to pass of a bunch of admits to my relief person much as they were passed off to me. I hate doing that. It makes me feel weak and inefficient. Plus, the scowl on his face and the grumbling doesn't make the hand-off any easier to do. Still, he was gracious enough to burn me a CD mix of Christmas tunes while I signed out.
I think I should drink mass quantities of alcohol or masturbate furiously to pictures of baboons in estrous. That's what my brain feels like I've been doing all this time, so I might as well do the crime...Or, I can go to sleep now and prepare to do it all over again tonight. Yes, sleep would be good. I have a full day tomorrow as I try to catch up with any visitors left in town.
Sometimes, I resent my job.
----
* In radiology, they call an ominous X-ray and diagnosis such as that the Happy Fucking New Year (HFNY) Award, especially if it's the first of the year and the patient has had no prior problems. It's a bit early for the new year, but I think she's one it.