Estoy contemplando homicidio.

One more week of trauma, almost there. I didn't think I would be so ready to be done with my block of trauma this time. The work has not been heavy. We've even had two days so far with no traumas at all, and the team is able to keep up with the work flow that we do have.

But if you were to see me in the hallway, in the store or even at church and asked me how it was going. You'd probably receive some sort of complaint surrounding M&M. (Morbidity & Mortality). (An M&M is a confidential meeting at which complications and deaths are presented for review in effort to provide feedback and opportunities for improvement). My life as trauma chief is nothing but M&M. It did not used to be like this. We presented at the monthly multidisciplinary M&M and then when our turn came up at the departmental M&M. Now they want us to present once a week, and they want Ev-Ry-Thing presented. A catheter-associated urinary tract infection is a complication. We have checks in place to prevent them already. There is no educational benefit having me prepare an entire presentation to state that patient xyz had a CAUTI. But they want it now, they want them all. So I oblige and present and then watch as they talk in circles and peacock.

Today was multidisciplinary M&M. My attending had set up a meeting with me and another co-resident last week during which he went patient by patient, pointing at each one telling us which M&Ms he wanted presented. And then again after our weekly M&M I spoke with him verifying new patients that I would include. To which he responded, "definitely, they're mortalities. They have to be presented."

So today, when I stood up and started going through the statistical analysis portion, and that same attending interrupted me to tell me I was doing it wrong.... I was soooooo. Not. amused.  I stared back at him, in my mind, trying to determine if I could successfully verbally rip his head off without anyone else noticing. I know, excessive perhaps, but it lasted a hot second. And I went on with my presentation according to my now brand new rules. My intern had snuck a picture.  Had she ment to take it at that moment of murderous contemplation, I don't think so. 

Zoom in if you dare, but I warn you. It's not a pretty picture at all. Like I said, so Not amused.
As horrified I was to see how I looked in that picture, good reminder that I need to smile more often.

(Disclaimer: I do not now, nor ever want to rip my attending's head off. I do love my attendings, can just get frustrated at their poor management and unrealistic nonbeneficial expectations from time to time.)
Much Love.