Culture, body fluids and the health care system
My last night was an eventful one, lots of various fluids and excretions causing me to shower twice and ultimately go home in my fourth pair of scrubs in 30 hours. One delivery was fast enough that we didn't break down the bed. I sat at the end of the bed and delivered the baby, along with a gush of amniotic fluid, which soaked the bed and the parts of me sitting on it, namely my right thigh and butt. Another woman, screaming in labor (no epidural) spit and got phlegm all in my hair. A third baby was delivered with a huge gush of blood, soaking me enough to the point where the mom, looking at me perched between her legs, said, "Now I see why you wear the face guard."
I saw another patient who inquired about my age. She and her husband reminded me of my college friends and I felt we had pretty good rapport - sometimes you bond with some patients in the wee hours of morning. I told them I was 30, then, followed with my new epiphany, "I'm old enough to be a grandma in Tacoma". Both my patient and her husband found my statement hilariously true and were inspired to give each other high-fives.
One exciting thing about this call was that there was a cultural festival in Wright's Park (the park between my apartment and the hospital). Some of the OB nurses went there on their breaks. There was a brief lull after the butt-soaking delivery and Molly (the fellow I had worked with all month) and I were able to check it out and watch the stage shows until we were paged back in. I managed to bring my camera to work and snapped a picture of Molly, the part of the festival we got to see, and Molly snapped a pic of me - post shower #1, second pair of scrubs, pager as close to my ear as possible (it was loud there), and hiding my badge (that has the huge MD all over it) in my front pocket. Note the scruffy hair and glasses - a classic "on-call" fashion statement. I'm terribly disappointed I wasn't able to really attend this event - it looked to have great shows and vendors. Perhaps next year I won't be on call that weekend.
It was a good call overall - busy - and I was exhausted enough to sleep through most the day after I got home, waking enough to eat crap, watch TV and talk to someone on the phone before crashing again for the night. The following morning I was introduced to my new rotation: Community Medicine.
It's two weeks long. Each day is spent shuttling around different community resources, learning where they are, what they do, who works there and how I can use these resources for my patients. Yesterday was a couple hours at a domestic violence comprehensive help center (not a shelter, though) and the afternoon and evening were spent with a really cool naturopathic doc, basically shadowing him with is patients - one of them a seriously powerful executive who I will certainly not tell you about since it's a HIPPA violation, but she may be one of the more powerful business women in the Sea-Tac area :)
I think I may have helped that executive quit smoking which made me feel like I was doing something. That was refreshing, especially in light of a patient of mine who has been making me feel a little helpless. On scales from 1-10 - ten being the most and 1 being the least - she is 9/10 sick, 10/10 unhappy with the health care system and 8/10 sure I will do whatever she wants when she wants it. Likely she is also sad, angry and scared since she probably does not have all that long to live and admitted to me that she doesn't really want to die. I don't think there is a lot I can do for her aside from listen to her and manage her the best I can. I can't fix her illnesses, I can't get her everything she wants when she wants it, and I'm pretty sure, given the resources I have, I can't restore her faith in the health care system. I'm not saying I don't have great resources at TFM, I'm saying she may be partially right. Our system is inherently flawed. We all know it. It's like the environment: we all know it's messed up, but who is actually doing anything about it?
And on that happy note, I'm off to shadow some hospice care workers for the day...
…And to infuse some optimism at the end of the post – my gerbera daisies have not only come back from the dead – but they started blooming!