Let me say this, which I can because it's my blog and I can say anything I want, so there. This young physician exudes a lot more confidence on her first day than I did. Wow. As I watched the story and worried about health care in rural areas and the inner city, and then worried about health care for everybody, then worried about health care for my old patients, then worried about my old patients, then flashed back to my first night of call, coincidentally also OB, in which I did 65,943 deliveries before 2am and had at least 954 ER hits and gave more terbutaline to more women than ever before in history, and painted lactated ringers all over town, it all comes down to the baby. Right at the end of the video, awash in worry and fretful memory, there was the baby.
I delivered, in fact, five babies that first night of call. There are five little people in the world--not so little anymore, in fact--who saw me first. My panicky hands held their slippery, wriggly little bodies first. As residency went on, I was occasionally the last person somebody (maybe) saw or heard as they died (poor them). I'm sure my fat head is indelibly imprinted on some patients' and families' brains as the person who gave good or terrible news. They don't remember my name, but they remember my unplucked eyebrows, or shoes, or nasal voice, or crooked fingers, or the way I stooped while I stood or hunched while I sat.
I don't sit beside or partake in much of that drama anymore, but I still love ushering people into and out of my office, with or without prescriptions, physical therapy orders, pats on the back, a good joke, advice, instructions, anticipatory guidance or anything else which might help. No matter the swirling chaos and barbarians at the gate of healthcare reform, for me it always comes back to the patient and the magic special space between the first breath and the last quiet heart beat. Despite the worry, the heartache, the upheaval, and the relentless needs of the sick, it's more precious to me now than it was, ever.
Good luck to you my new colleagues. Enjoy the ride. There's nothing like it and nobody but your fellow physicians will completely understand that. And not all of them will remember it. Take it away from me, US Government, and I'm walking.
But happy 4th of July from me, IcedLatte.
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2 comments:
Ugh. My repressed memories are surfacing.
After FD's comment about panicking about Tylenol, I remembered cross-covering my first night of residency on medicine and getting my first call. Patient had a low potassium. I had no freakin' idea how much potassium to give for a K of whatever it was. Had to call my resident. Thank goodness she was a sweetheart.
That next morning we got the dreaded 6am ICU admit--GI bleeder, drinker, varices. We walked in the room as he got in his room, and he started vomiting blood all over the room. Ya can probably guess where this is going--died despite everything. I learned VERY, VERY quickly to respect UGI bleeds. They still scare the shit out of me.
My friend Q and I were on call one night. She had an elderly guy bleeding from below quite briskly; enough to require a tube in the nether regions to collect the blood. This lovely gentleman never stopped talking. For hours he talked, and once he got to the ICU he had a captive audience in his nurse. Despite the chat (and many other interventions) he kept bleeding. At 3am the buttoned-down gastroenterologist showed up to scope him. We all go into the ICU room and this stubborn old bleeding patient has an endoscope down his throat and still, he keeps talking. Q, the GI nurse, the GI guy, and I are staring intently at the monitor, listening to the guy talk. Suddenly, the scope hits the stomach and we see the arterial bleeder shooting blood at us. As one we jump back and say "SHIT" at the same time. After that, silence and sweat as the poor GI tried to stop the bleeding.
There was no more talking from the poor guy, in fact, who died a few days later. His poor diseased heart and brain couldn't take the horrible stress. But God knows, he tried.
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