Temperance

Last weekend sometime:

It's fall and the cranes are back and on one of our jaunts through the valley, Dave and I saw a half dozen of them.

I finished my paper--one on ethics--sometime in the middle of the night. I let it sit and age until the morning, then after reading it one last time, I sent it in.

I had an exam in the morning that I'd only kind of half-ass studied for. I'm having trouble corralling my motivation. Still.

Tuesday:

An exam, then a singing lesson with Dave.

Wednesday:

Class. I wanted so badly to skip it, but didn't.

Thursday morning:

I was in bed by 8:00 or so and got up around 11:00 p.m. Then I just couldn't go back to sleep. I tried, and finally got maybe another half-hour or so around 3:30, but I was wide awake when my alarm went off at 4:30.

Daylight savings time meant that I didn't have to drive to the hospital in pitch black night. Rather, there was some dawn light breaking through as I left the casita. 

I had two patients, one a charming old man about to be discharged. Another, a woman with some serious but non-resolvable problem and a sunny disposition. Nothing too troublesome. I was not responsible for but looked in on another patient who was in serious straits, a young man with alcohol withdrawal syndrome so serious that he had to be restrained and his bed padded to prevent himself from getting hurt as he flailed around. He was having seizures, DTs, hallucinating, sweating, his eyes rolling up in his head. The alarm on the heart monitor kept going off as his heart rate climbed up into dangerous levels. (I wish every kid, before their first drink, would have to spend an hour at the bedside of someone going through alcohol withdrawals.) He was later moved to the ICU.

It was a short day, for which I am grateful. I came home but wasn't able to nap...

Friday:

I took Benadryl to sleep and did, waking up at 3:30, an hour before my alarm. The only thing that got me going this morning was the fact that it was my second to last day of in-hospital clinicals for this term. Next week, we are only there for one day. (Then there's two more weeks of classes and that's it for this term.)

I started out at 7 a.m. on the usual floor, doing the usual things, but it was kind of an unusual day in some ways.

There was a patient whose family didn't want students in the room, so we were warned away without explanation. That's fine with me, but it was curious. We're trained to look in rooms as we pass and, as I passed this patient's room later in the morning, I saw a man sitting on the bed who looked like the Elephant Man, surrounded by family. Later, his doctor came out and was upset about something, saying that everyone was going to have to be careful because of the family, but wouldn't say why.

Mid-morning, I ended up in the cath lab (following a patient down for a procedure). The cath lab was presided over by the biggest doctor in the hospital, an enormous Pakistani man, seriously, like, 6'6" or more, built along the lines of a small barn, with the face of a middle-aged Kewpie doll and gray hair cut into a style that would have suited a Campbell's soup kid. I observed the procedure and then stayed with the patient in recovery for about 45 minutes.

It's easy to get caught up in the work, so at noon, I hadn't had a drink of water or anything to eat since around 4:30 in the morning (breakfast had been half a sunflower seed butter and cherry jelly sandwich and two cups of coffee). I ran upstairs and took five minutes to drink a liter of water and eat the other half of the sandwich and a banana before going down to the emergency department for a tour of the facility. (I'm not fond of emergency rooms. I don't think I could work in one, but that's not because I wouldn't be suited to it, Brain-wise, it's just that at my age, I likely wouldn't have the stamina to work 12 hour ED shifts.)

The man giving us the tour told us about having to decide between two patients with similar traumatic injuries, one an infant, one a grown man. The infant came first. The grown man's response? "I understand. I've had a good life." (He survived.)

The tour took about an hour and a half and then I was free for the day.

I came home via Sonic (giant fizzy drink and tater tots). I got out of my scrubs and took a shower and got into my pajamas. I was napping when Dave came home. We had egg sannies for dinner and then I went to bed.

Of note:

A couple of weeks ago, I was working with a Native American woman at the hospital. Someone told her a patient kept saying, "I feel like I'm going to die," which is something that we're taught to pay attention to, since patients often inadvertently predict their own outcomes. This Native woman's beautiful response (not to the patient, obviously) was, "Well, it's a good day to die."