Tired

ICU is over. I finished my last call of the month last night. Now it's on to CCU (Cardiology) again. Unfortunately, CCU is also a busy month, though the call is not as brutal as the ICU. The CCU service, for residents, is essentially a bunch of 12 hour shifts, 7 am to 7 pm, or vice versa. 3 residents cover those shifts, 24 hours a day, for the 4 weeks of the rotation. So I will literally be working 1/3 of the time over the next 4 weeks. I work this Tuesday day shift, then I'm actually off until Friday night shift. Then Saturday night shift, Sunday night shift, and Monday night shift. Then a ton of day shifts. I have clinic on Thursday afternoon.

And that's that. I'm tired right now. Got about 3 hours of sleep last night on call, which is a vast improvement from the 3 prior calls going back the past 2 weeks. I went 3 straight call nights without touching the pillow, a record for me in residency, actually. (There's almost always at least a half hour of sleep you can grab). But those were busy nights in the ICU.

I saw some good stuff this past month. Good from a medical standpoint, anyway. Unfortunately, "good" in medical terms means "sad" in humanistic terms. For example, I saw a 36 year old woman with end stage HIV bleed into her brain and die. We turned off her life support after a few hours. I watched my friend and fellow resident Jeff stick a long needle under a man's sternum in an attempt to drain fluid out from the sac that covers the heart (the pericardial sac) while the man lay there with no pulse on a ventilator, moments away from death. (When fluid accumulates in the sac around the heart, preventing the heart from contracting properly, its not a good thing). Unfortunately, the man died. But it's a little nutty watching a guy put a needle about 8 inches long under the sternum aimed right at the heart. We were up all night "coding" that guy. At 2 pm the next day, after being awake for 32 straight hours, I had to sit down with his family and tell them what happened. Not fun.

I've been a lot more tired this month, which of course is a function of the busy ICU schedule. It makes me glad that I didn't apply for and get a cardiology fellowship. Cardiology is pretty damn cool, but those guys work and work hard. And they get called in the middle of the night, a lot, to come in and work their magic. It's a pretty cool thing, but to be honest, I'm tired of being up all the time at night when I don't want to be. Give me normal hours. Let me turn my pager off when I get home from work. That's what I look forward to someday. A 40 hour work week with plenty of "Mick time" on the side. Someday. A general internist's schedule tends to be a lot more forgiving than a cardiologist's. Yes, I'll sacrifice a good bit of money, but to hell with that. Give me my free time, and some normal sleep wake cycles. And I'm good.

Enough for now. It's late and time for bed. I'm up at 5 am again tomorrow. After work tomorrow, my old ward team (my chief resident, my two (male) interns, and myself) will be having our "team dinner" at the Tacoma Hooter's. I'm looking forward to some good unintentional comedy there.

I'm also working on a review of this movie "Hostage" that Gwen and I saw on a lark last Saturday. More to come.

Busy Week

So my big plans on Tuesday to post multiple times while on call were foiled by the fact that call was simply too busy. I was on my feet for at least 28 of the 32 hours I worked from Tuesday at 6:30 am until Wednesday at 2:30 pm. Lots of standing and lots of running around. Lots of sick people. And no sleep.

I watched a 37 year old lady with end-stage HIV die because she was bleeding into her brain. The pressure of the blood in her skull (intracranial pressure) caused her brain to herniate out the bottom of the skull where the spinal cord comes out. Prognosis - bad. The massive bleed killed her, and there was nothing to be done about it. It was obviously quite sad.

I drove home yesterday at about 2:30 pm, sleepy as all hell from another 32 hours of straight wakefulness. I didn't crash. I got home and went to bed. Woke up for some dinner, and then went back to bed. And went back to work today. And now I'm home again. And I'm on call again tomorrow. And there it is.

Gwen and I re-watched Napolean Dynamite again the other night. That movie cracks me up. The movie is genius at delivering a modern-day subculture without being self aware. (Contrast this film with a similar hypothetical film starring Adam Sandler called "the hick days of Idaho" or something). Plus, I think the film has a genuine good heart. And it ends with that song "The Promise" by When in Rome, which is possibly the coolest 80's song ever. (Or at least tied with "Land of Confusion.")

"Back in 1982, I could throw a football a quarter mile..."

Tonight, I'm looking forward to a little Counter-Strike (hopefully with Eryn and Adam). Then it's off to bed early in preparation for more call! Yes!

Gwen and I hit the bookstore on Sunday when I found out I was going to Germany. I bougtht the Lonely Planet "Germany" guide and some other "Crossing Cultures" book which teaches readers all about intermingling with German peeps. The selling point of the book is the tagline on the back. It reads "Enjoy Germany and it's culture without feeling like a Dummkopf". Best ever.

It's odd to think that in a year I might spend a weekend off taking a train to Paris. Or Prague. I could be into that...

Lates.