Stonehenge

Here's something I wrote a couple of weeks ago:

My first rotation this term is in the medical ICU, but at the hospital there is also a trauma/surgical ICU and a neuro ICU. When we got word where we were going, people kind of looked down on those of us who were placed in the medical ICU (versus the trauma/surgical ICU or the emergency department, which is where the third group went). It's the least specialized area in some way, so it was, like, oh, it's going to be the least demanding. But in fact, it's the exact opposite.

When I was shadowing the respiratory therapist week before last, we went into the other ICUs and I was, like, wait a minute. These patients are talking to us. They're ambulating. They're sitting up in bed and eating breakfast. This is not how it goes in the medical ICU. Our patients are on ventilators or they're comatose. Or both. They're fed through tubes. They're on multiple IV medications. They're on sedatives, on vasopressors, on paralytics, on antibiotics, on opioids. I pointed this out to the RT and he said, yeah, patients are much, much sicker in the MICU than in the TSU. I pointed it out to a nurse on the MICU and she said, yeah, with trauma, it's blood blood blood and all that drama, but once they're over the initial trauma, it's much easier to care for them because the trauma is the main thing--usually the only thing--wrong with them. With neuro, those patients can't be on all the sedatives, so that's easier, and they may be out of it, but they generally don't have the same number of problems or comorbidities that MICU patients have, so in some ways they're also easier patients.

I've been smashed to bits by what I've seen in the MICU, by the strangeness of it.

Many of the patients in the MICU are never going home. One of the women in my group said to me, "Every time I walked into the patient's room alone, I prayed, please don't let them code on me. Please don't let them code on me."

Today

My clinical group met for the last time this morning in a small conference room off one of the dining rooms near the hospital cafeteria. It was nice to meet at 8:30 instead of 6:00 a.m. The morning felt very leisurely. I even slept in until 4:30 a.m.!  There was time for coffee and for me to braid up my hair instead of just twisting it back into a bun. The only snag was that we didn't have to wear scrubs, so I had to hunt down some presentable non-scrub clothing, which is rare in my closet these days. The benefit was that, because I wasn't wearing scrubs, I could sneaky-sneaky park in the parking structure close to the hospital instead of parking in the desert and riding the shuttle in.

From 8:30 to 10:30, we presented individual and group projects. I did a presentation on septic shock, then, with another two of my classmates, presented a project on troubleshooting ventilators (that I wrote single-handedly). Someone brought breakfast tacos. My instructor brought her charmingly bratty toddler and so in between our presentations, we were treated to a dance recital and a monologue about dragons and castles. When our little party broke up, we gave our instructor a Sephora gift certificate and a thank you card and she gave us all a hug. I really liked her.

I came home and started cleaning up a bit.

Dave has been in NYC for the last couple of weeks and the house, already in a state of neglect related to my school schedule, has sunk down into near-chaos, also related to my suddenly more intense school schedule.

I started by clearing off my desk and taking out the trash and recycling. (Now I'm taking a break.) We're kind of jammed into the casita at the moment, what with my schoolbooks and all the detritus that goes along with clinicals and such. It was fine for a long time but then I took up sewing and suddenly we had to find room for my sewing machine and a few bins worth of fabric and notions, so that made it feel a bit hoarder-y. Then Dave switched jobs a couple of weeks ago and brought home boxes of stuff from his old office, and now we're approaching full-on Collyer Brothers territory.

(You remember the Collyer Brothers, don't you? They were the famous New Yorkers who filled their Harlem mansion with junk. After they died (one brother was crushed under a pile of their stuff which he had set to topple onto potential burglers and then the other brother--blind, bed-bound--starved to death), the police went in to clear out the place and found...everything. There were five grand pianos and a pipe organ, a human skeleton, the chassis from a car, a cigar box full of pistols, box after box of newspapers....it went on and on. One hundred and forty tons of junk was eventually removed from the place.  E.L. Doctorow wrote a novel about them called Homer & Langly and though I love Doctorow, I could not finish the novel because it had such a depressing, oppressive feeling to it.)

I got a fragment of the casita cleaned and organized. Then I got waylaid by lunch and Netflix and the idea (but not the reality) of a nap.

David is coming home tonight--he texted a bit ago from the airport in Dallas. It's been okay being on my own this time. I've been crushed with school work and exams, which keeps The Brain from tipping too far over into the abyss. There have been a couple of moments of high anxiety, but nothing that I couldn't handle. 


Between bouts of chores, I've been trying to think of some reward to have for completing my clinical rotation and passing my exit exam. I don't have anything I particularly want right now, but I do need to get some new clothes. Maybe I'll treat myself to a couple of new pairs of jeans or something. (How boring.)