December 20, 2012

anyone who walks through the door

At the time I'm writing this (but not at the time I'm positing it - gotta keep to my confidentiality rules) I finished my second shift in a row in the Emergency Department.  My schedule just worked out so that I mostly work evenings, weekends, and sometimes two shifts in a row, which is an 18 hour day in one of the busiest places in the hospital.  But even though it's 1am after an 18 hour shift, I find myself feeling pretty okay.  I really like the idea of treating anything that anyone who walks through the door has (or thinks they have).

I sat for 45 minutes with a woman about my age accompanied by her corrections officers, with her legs and arms chained to the hospital bed trying to figure out if she had attempted to overdose on any medications.  She would only answer me in a strange and disorganized flight of ideas - often only with one number, or one color, or one place.  When I would ask, "When did you last feel like yourself?" She would answer, "Blue."  When I asked if she had taken any drugs intentionally or by accident, she answered, "North Carolina".  Occasionally she would to me, "I'm confusing her." And I wasn't sure if she meant that she was confusing me, or that she was confusing herself.

I talked with an older man who had suffered a subarachnoid brain bleed earlier that morning after having been basically healthy his entire life.  He told me that his wife was the greatest person in the whole wide world, and also advised me never to get old.  He was really fun with the neuro exam because A) it was totally normal, B) he wanted to prove to me that he was still strong (he was), and C) he didn't really like sticking his tongue out at me.  I think it felt rude to him.

I met a woman who was just a few months postpartum and had chest pain that was making her nervous.  She and her husband had come from the south and were just visiting in-laws.  When we imaged her heart, it looked like she did have some abnormalities.  So I helped these lovely young parents figure out some logistics about how they were going to care for their two babies if their mom had to be in the hospital.

I chatted with an older lady who had just had surgery a few days ago and was discharged from our hospital that morning feeling totally fine.  But then she had a few episodes of passing out at home, so her daughter convinced her - very much against her will - to come back to the hospital.  She told me over and over again that the best thing someone could do at her age was to stay as far away from doctors as possible.  I couldn't agree more.  Except that she turned out to have a pretty big bleed in her gastrointestinal tract that we helped her with.  She - and her daughter - were super grateful.  But I sat with them for a while just trading stories and cracking jokes.

Before I left, I said goodbye to all my patients and wished them luck.  There's something nice about feeling like I signed off with all of them before I head home.

On my way home, I passed the Dominos delivery car speeding by me in almost the exact same place it had been the night before at about the same time - again, the only other car on the road.  It made me hungry for pizza.

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