It's Monday night on Memorial Day. I've been at the hospital since 6:45 this morning. ICU call today, tonight, and through the morning. It's been a while since I blogged.
Thinks are relatively peaceful in "the unit" for now, but that could change of course. The lives of about 8 people requiring intensive care are in my hands tonight. That's kind of a surreal thought, but not all together disconcerting. As an intern I would have felt different. But now, nearly graduated, I guess its just that I've been here before, and have a certain comfort level with really sick people. That's reassuring in my work, I guess.
One of the people in the ICU but not in my charge is a sad 20 year old kid who was in a highway accident. He was a passenger in the back seat, not wearing his seat belt, and was thrown from the car and fractured his spine. His fracture is high( about C6/C7 for those with a knowledge of anatomy). The incident has left him a quadriplegic. 20 years old. Very, very sad. (He's not in my charge because he's on the neurosurgery team).
Other News
I spent 4 days of last week doing some actual military training. It seems that "they" (they being an unknown set of shady military higher ups, in my best estimation) make most of the graduating residents go through the 4 day course that they give to the military's combat medics. The first 2 days of the course were mostly in the classroom. Lots of powerpoint, but also several videos, mostly military footage of injuries and combat care regarding the ongoing war in Iraq. There was some pretty sketchy stuff. Its kind of funny to me how I probably shouldn't be talking about it here. Let's just say the footage I watched doesn't make it to CNN. I think the military and the government prefer it that way.
The latter 2 days of the course (particularly the last day) were spent "in the field". The third day featured running simulated combat medic training exercises (as a point of reference - a combat medic is not a doctor; they are an enlisted soldier with EMT or LPN training, capable mainly of rudimentary medical care and stabilization measures....under fire. They are those guys that come running in a firefight when other guys with guns start screaming "MEDIC!"). These drills were done in the "sim center" which is kind of a cool set up with everybody practicing medical care on expensive fully automated mannequins which are run by a computer and can bleed, have a pulse, speak, and all sorts of other cool stuff. After putting us in teams of 4, several "real army people" started putting us through scenarios which comprised of the squad encountering a casualty (mannequin), often under fire (provided by speakers and other theatrics). Some times we had to work in the dark - other times there were strobe lights. (Either to simulate tracer fire and explosions during a night raid OR to simulate the specific niche of treating casualties in a techno dance club - I'm not sure which).
On the afternoon of the 3rd day we practiced real procedures on anesthesized animals - and the less I mention about that the better lest I get in trouble. I will say that the army handled the lab with respect and care for the animals - so while the acts were sometimes difficult, the training was invaluable and I wasn't too against it. (Plus I think I would have to be a full fledged vegetarian before I could get on any sort of serious animal rights soap box, so there).
On the fourth day, we spent the entire day in the field running a simulated live exercise from battle to battalion aid station (or the echelons of military battlefield care) regarding the treatment and evacuation of war casualties. It was kind of nutty, but then again so is all the real "military training" I've undergone to this point. Suffice to say it involved a lot of me running around the brush in full camouflage with lots of theatrics and mannequined casualties along side of real animal casualties, all of which had to be treated and evacuated according to proper military procedure. At one point I was made "medic squad leader" (we all sort of rotated) which involved me sort of running the evacuation. This became entertaining because the course instructor made it his job to try and exasperate the various squad leaders by berating them constantly, as if channeling the drill sergeant from "Full Metal Jacket". So for several minutes I had this whole evacuation to coordinate while some ex-medic guy screamed in my face trying to distract me and add to the overall "feeling of real combat". He was firing off countless acronyms and military jargon which I found amusing more than anything else. After the exercise, he said I did well in keeping my cool and that I "deal with my stress" by laughing. I just shook my head. Honestly, I think I "deal with things that I find funny" by laughing. If and when I ever go into a real battle (now THAT thought is fucking surreal, and all too possible, sadly), I dare say I would not be as amused...
Since the course, which ended last Wednesday, I've been back at this ICU thing, which is getting old. I'm tired of being a resident, tired of being on call like this. Its time to move on. And that presents a whole other set of issues, because moving to Europe via the army is not a simple nor administratively streamlined process. The amount of forms, admin, and overall bullshit required borders on the ridiculous. You see, the REAL army is run by government service workers, which are nothing more than packs of lazy, underqualified, unmotivated, and unfirable civilians who make an already boggy process into an excrutiating, hair pulling ordeal. Imagine people from a 1985 DMV running your life. And that's what I go through on a weekly basis to ensure a smooth transition from this continent to the next.
And though I'm excited to be moving onward and upward, I'm definitely starting to get pangs of anxiety and nostalgia as the Pacific Northwest clock ticks persistently down. Its tough to pick up and start somewhere else, even though it can ultimately be rewarding. I've decided that I'm going to miss Seattle. I like my city apartment and I like the scene up here. Its been a crazy 3 years of my life. I shall have more to say on that in upcoming posts, I should think.
Moustache May
I can't believe I haven't mentioned this earlier, but I've spent the entire last month with a moustache. Not a goatee. A moustache. The Army won't allow much facial hair, but it will allow a simple moustache, as long as the ends don't go beyond the corners of your mouth. And as a sort of a goofy misguided pact, all of the senior Internal Medicine residents (to include myself) decided to grow a dirty moustache and wear it (reluctantly vs. proudly) for the month of May. Of course we proudly deemed this "Moustache May." The results have been interesting, and of course I'll post pics up in a future post.
All I can say is that moustaches are nasty. Especially the narrow military-legal ones that we are suffering through. What becomes sort of a comical bonding experience at work inevitably mutates into a badge of shame out in the real world. At work, it's fun to watch everyone's filthy growth come in (and to a man they all look terrible - though there is a range within even that terribleness, I must say). Out in Seattle, at a restaurant or the like, its no fun to watch a waiter's eyes go from my eyes to my lips, as he contemplates the flagrant atrocity that I sport. My eye contact with strangers has been at an all time low. Parents keep their children on the other side as we cross, not wanting to let little Suzie come anywhere near "that clearly perverted man". Its no fun feeling that you look like a rapist or child molester, and its been very tough at times to keep going with the 'stache. But its fun to come to work and see everyone else looking as ridiculous as I do. And thank heavens June 1st is just around the corner, signaling the heralded end of Moustache May. And believe you me, my razor is ready.
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