Sleep, Loss, 5 Days Until Vacation

Well, I tried to crank out a quickie blog entry before my last call. Didn't work so well. Here I am post-post-call about to go back to work to round on all the c-sections I did on my last call (yep - every delivery was by c-section, half of them emergent under general anesthetic - just a typical call for this black cloud). I am very drowsy so I apologize in advance for the typos. Pre-call I didn't get much sleep as I kept hallucinating my pager going off all night and had to answer all the non-pages. Last night I think I did sleep most the night, but now the days are shorter and I wake up in the dark again, groggy and disoriented.

I am so excited that my last week of the massive marathon twelve-week Q4 call is upon me. One more day as rover (i.e. secretary, ultrasonographer, referral nurse and slave to the OB clinic), one more crammed packed high-risk OB clinic, two more of my own nutsy clinics and ONE more call. That's it. Then I start vacation. Thank GOD!

Speaking of vacation... On the way back from riding the other day I saw a car drive by with a Yale sticker and felt a longing for Connecticut. I still haven't heard about my May rotation swap. For all I know it's circling around some committee somewhere. I'm anxious to submit it back to my own people so I hope I get approval soon so I can move on to step 11 of 23.

In my initial attempt on this blog entry I was reflecting on last Friday. It was a particularly hard day for me at work. Sure, I had to get up extra early round on the bazillion patients I delivered (plus pre-termers trying to keep their buns in the oven a little longer). But then I find out one of my favorite panel patients is losing her one-day old baby to child protective services for some vague unspecified reason. The patient, me, her nurse, and even the social worker were all shocked. How come they don't take babies away from totally unfit mothers but then take them away from rehabilitated mom's? I don't get it.

Then, I had my "One on One" in clinic. That means that a faculty doc shadows me all clinic, sits in the room while I interview and examine my patients that day and gives me instantaneous feedback. Sounds fun, eh? It's kinda like being a medical student all over again. Then, after she didn't show for her appointment, I find out one of my patients died. She was one of the hardest (I've blogged about her before) and one of the crotchety-est patients on my panel. But she really liked me, trusted me, and we had a great time together. I looked forward to seeing her each clinic even if I knew she would whip out some health-threatening surprise each time. I easily spent more time with her than any other patient. I rounded on her in the hospital, in the ICU, saw her each month in my clinic, talked to her while she was ventilated, even watched the snow fall at 5 am on Christmas morning post-call and she gave me root beer as a gift (and because it didn't jive with her diabetic diet). Funny, I always talked to her about her end of life plans but she was so resilient I think everyone thought she would never die, even though we all knew better. I also imagined myself being able to say goodbye at her funeral instead of finding out days later from a "why did you miss your appointment" phone call from my nurse. SG, I hope your passing was peaceful and you are breathing easier wherever you are...

Thankfully I had a Saturday off to try and process all of this and catch up on a little sleep before hitting up another week of everything and my Sunday call was too busy to think about anything other than work.