Life in the ER

So I am doing my month in the ER. It is an ACGME requirement(I think). I've already been informed by staff that we slow them down, get in the way and generally cause them to make less money. Also, that when he came here he didn't realize that teaching would be required - so "scram." Except the other docs down there were equally annoyed. Gotta make that money and keep from getting sued seems to be the mantra of the ER. They did let me do some procedures for them - a couple central lines when I was supposed to be getting off.

Sadly I had an open mind about this experience. I worked as a scribe in another ER and I had a blast doing that 40 hours a week for a year making, "choke," $7 per hour. It was fun to stabilize patients, and sometimes you would even figure out what was wrong with them.

On my last shift I took care of patients with absolutely no supervision. I am half-way through my intern year, and I can handle the simple stuff by myself but I had some pretty complicated patients. I needed permission to ask to have them admitted. This did not come until 6:55, 5 minutes before I was supposed to be leaving. I had only had 7 hours sleep in 3 days due to my own inability to sleep during the day for various reasons. (Hmm... maybe my plan to become a nocturnist is not such a good one.) It took me another 2 hours to get them admitted. I got admonished by admitting doc - who then yelled at my "attending" ER physician. I literally snuck out of the hospital. All is well with the patients, at least. I have 9 more ER shifts. I have 2 spa visits planned for this week. I am definitely going to need some exercises in deep breathing to get through this month. And, I really thought I would love the ER.

First Day Off...

Just came off a series of night shifts where I never adjusted (aka could not sleep during the day due to various causes - phone ringing, child screaming, hammer paging from attendings from previous months).

I went to a fabulous restaurant for New Year's Eve. Our child had all night daycare available just for the occasion with his favorite caretakers. All my best friends were in attendance. They all ordered the filet. I got the gourmet ravioli and creme brulee (all the desserts were super-heavy). The creme brulee wasn't quite right- couldn't quite explain it... thick, custardy - not smooth and creamy. I thought I had heartburn from the rich foods when I got home, took an H-blocker.

I slept fitfully, woke up, threw up all the contents from previous nights dinner. At first I thought, this is good... I didn't want that all to stick to my hips. You may think I am crazy, but I had eaten way too much. Then I started with the chills, and body aches, including a little back pain. I wondered, is this pyelo, something else , as I am NEVER sick.

When my fever reached 101 I was feeling quite ill, too ill to even get up off the couch, I considered going to the ER. Tylenol would not bring my fever down... but I could keep fluid down in the form of popsicles and decided to wait it out. My head was hurting a bit, probably from the fever - but every possible horrible diagnosis filled my head. I essentially slept for 24 hour straight.

Then I awoke with a temp of merely 99. Could this all be passing? I was actually able to eat a little. No throwing up. And the fever subsided. We were supposed to leave for our ski vacation today, but I can hold off until tomorrow and I plan to. Doubt I have enough strength to fly down the mountain, but hoping I will in the next couple of days. I felt good enough to have tacos for dinner. That BRAT diet didn't really have my interest and I have never been one to follow the rules.

Figures as soon as I get a bit of a break my body, which has been putting up with unbelievable stress, finally gives out. Based on the time course, it may have been salmonella, but we won't ever know. And I will never go back to that restaurant... and I am probably off of tomato sauce and creme brulee for awhile as just don't seem all that appealing.