Estoy empacando mi maleta.

One... More... Day...

Almost... Can't... Make... It...

My legs have given out, but I'm not giving up. Pulling myself towards vacation by my elbows, fatigued legs trailing behind.

Hopefully I won't ever have to do such a long stretch without a break again. Shouldn't have to, but only next year's schedule will tell. And now for any stretch less than 15 months, I can honestly say, "pssht, breeze!"

Here's a few pictures that one of my co-residents took the other day. He was only supposed to take a group picture, but then just started clicking while we were in the middle of running the list. He got some good ones so thought I would share.

 Matt, Monica, Me

 Irony

 Monica, Me

 Michael

Matt

Going to go to sleep now, so I can wake up and go to work tomorrow, so I can go home after that!

Much Love.

Estoy cortando carne.

I overheard the conversation, and something didn't sound right. I caught the eye of my co-resident across the room, and I could tell she had picked up the same unsettling feeling.

Sure enough, it was that type of patient where you take half a glance and you're picking up the phone calling the OR to say, "get us a room, we're on our way!"

The patient, stubborn enough to get herself in such a predicament, likewise stubbornly refused surgery saying, she'd come back the next day. She was desensitized to her own putrid smell, and in the process her brain must have become numb. She just wasn't getting it. My chief finally just went with the blunt route, "you leave, and you will die!" She consented to surgery, announcing that she would leave after.

My chief looked at me with a grin resembling that of the Cheshire Cat. I knew what was coming, and volunteered to go before someone else could volunteer me. Perhaps the only two things an intern will get first dibs on, fecal disimpaction and this.

We dab a little tincture of benzoin on our surgical masks. You wouldn't make it otherwise. With each new pocket of necrotic liquifing tissue we open up comes a new blast of foul acrid odor. Enough to make the nose hairs curl.  And my Attending laughs as it brings to mind a Spock quote about the distast for the smell of humans.  And Spock was even just referring to clean humans.

We went to the ICU after the surgery. She never said a word. We handed her over to the ICU team. She still didn't say anything. I wasn't sure what she was thinking, so I finally just asked. She looked at me without emotion in her eyes and informed me that she was going to go home now.

She still doesn't get it.

I can't shake the smell afterwards. While sitting at the computer to dictate, I can smell it. With any movement I make, I can smell it. Like its stuck to my skin. Double shower kind of night.

Much Love.

Estoy apreciando todos los tipos de seres humanos.

She was so high strung, she wouldn't sit down, choosing instead to pace back and forth. And standing still to show me her arm, she chewed her bottom lip and picked her feet up and down. She'd broken a needle off in her arm. When asked about the last time using, she said "today." Thank goodness she was smart enough to use the other arm.

Her honesty was... refreshing.

I went to talk to a patient and his wife about surgery for the following day. Answered all their questions and at the end they asked me to talk with "their daughter" and explain the surgery to her. They hand me a cell phone. Within two seconds I know this woman is not their daughter. What proceeded was a 20 minute conversation with a fly. She, being the fly, kept trying to fly into a window. I stood at the door and explained it was a door. I demonstrated what a door is for. I waved my arms. I jumped and down. I spun in circles and did the hokey pokey. It didn't matter. She kept flying into the window. Bam. Bam. Bam. Bam. Bam. Bam. I finally gave up and went through the door by myself, an incredibly sour feeling in my stomach.

People are just amazing sometimes.

The individual who's life is a mess yet smart enough to find a door, and on the other hand, the individual who in their head has it all together, yet they keep running into the window.

Much Love.

Estoy la torturador.

Have you ever had stomach pains so bad you were positive that your intestines were squeezing and twisting themselves? What happens when you wait a couple hours and the pain doesn't relent... You're nauseous and the waves of pain hit and you proceed to vomit your guts up. Still the pain doesn't relent. You try a sip of water, and vomit. You try tums or mylanta, and it no sooner hits your stomach that reverse peristalsis causes its swift evacuation again. Another couple of hours takes you into the middle of the night and you feel you are the only one unable to sleep. A bleary eyed and concerned loved one drives you to the closest ED where you are introduced to ME. I greet you with a smile and a reassuring line that you will get better. "80% of the time this resolves with conservative management," I tell you. And then I pull out the tube. I need your help and participation and can't do it without you. You graciously smile when you'd rather wring my neck, and spit back you feel like *%&@^$* and participation is last on your mind. Completely aware of what you're thinking, I take the tube anyways and up the nose it goes. Now you really hate me. But you're too tired to care anymore. The tube has just sucked out your stomach and it took your dignity with it.

About 80% of my patient's have those tubes currently. It's torture for them. It's torture for me. All they want is the tube out, and no matter how many times I say no. The next time they see me... perhaps they think my answer will be different, because they ask again. I am their tormentor.  She who pushed a tube down their nose.  And then she who won't let it come out again.

And thus my life has been for the past 11 days. Babysitting NG tubes. No OR time. I just wanted to run away. So the closest thing to it, that was acceptable. I went to get lunch. I handed the pager to the NP telling her I'd be right back and I left the floor. I grabbed a sandwich in the cafeteria then headed to the back corner, only to find my chief already sitting there. A quiet break ruined, I changed my strategy, and instead sat down across from him stating. "Send me to the OR. I can't do this anymore. Give me some OR time."

Maybe by the time I'm out, it'll finally be okay to take the tubes out. Then I can be the one who ended the torture, rather than the one who started and prolonged it.

Much Love.

Estoy manejando un auto manual.

Emerged from the hospital this morning with a stretch and a smile. Made it through another week of nights. Even more triumphant, my Last week of nights for the year! Small successes.
Had a nice rest then rose again for a day of laundry and odds 'n ends.
One of my co-workers rotating at St. Vinny's with me right now has a manual vehicle. I'd been looking to get some practice in before leaving for vacation, and he was willing to let me drive. Best part... He has a Ford Mustang with a whole lot of horsepower behind it! It's so much fun! Hopefully with a bit more practice my transitions will become more reflective of graceful rather than rough and unrefined. And then, who knows... I'll be down-shifting on the entrance ramps.

He also tried to teach me heel-toe shifting. Maybe next time. ;)

Much Love.