Thursday, August 25, 2005

He's aliiiiiveee!!!!

Hey there! Long time no type...again...I know. I really suck at this blogging thing. I think it has something to do with the fact that Ii type with so few fingers. I just finished up my first official month of medicine as a full-fledged MD. Scary stuff. I was on the regular medicine wards, which for me is a kind of personal hell. Thank God there are people who enjoy internal medicine, but it is definitely not for me. Everything moves at such a slow pace, and it is amazing how much freaking time is spent with paperwork and documentation, and how little is spent with the patient.

I did have one moment that made my butt pucker though. It was my first night on call by myself on cross-cover, which means that for all practical purposes, I was the doc uin charge of all the patients on the floors. I got called at 3:30 in the morning when I had just laid down after working nonstop for 22 hours. The voice on the other end of the phone said, "Dr. Sample, come quick, on the run." I jumped into my shoes thinking, "oh my God, somebody's gonna die." I got to the room, and it was a man who I had just hung blood for a transfusion on about 45 minutes before. His blood pressures had jumped from the 110s over 70s to 245 over 135 whrn I walked in. He was also having difficulty breathing, and there was nasty neon green stuff coming out of his trach hole. "What should we do?" the nurse asked. "Call a real doctor!" was the first thought that came to mind, thought I didn't say it. I had been a doctor for 5 days at this point, and hadn't taken care of a patient at all in several months. I trated every possible thing I could think of. First, I had them suction his trach. In case he was having a transfusion reaction, I gave steroids and benadryl. I also pushed Lopressor, a blood pressure medicine, to get his pressure down, and gave him a nebulized breathing treatment. He got better, but a few minutes later I found that he had a feeding tube in his intestines, and that the stuff they were feeding him was the same neon green that was coming out of his breathing hole. This is not supposed to happen, and likely means that he vomited, and then aspirated the vomit into his airway. He probably was silently choking, and my big life-saving maneuver was to have the nurses suck the stuff out of his airway. The drugs were all probably useless. Oh well, he's still alive and he went home a couple of days later.

I start in the ER on Saturday, which is a relief and scary at the same time. This is where it counts, and my program is notoriously hardcore. I think that this whole year is going to be one new stress after another. I am thankful that I have my family here with me. I think being alone during this time would be pretty stressful.

I will do my best to start updating this site more regularly...I promise! Until next time...don't get sick and come to my ER!!

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