Warning: No happy bunnies this April

April hurt this year. Hurt like a month-long flogging. A combination of Chinese Water Torture and a constant spanking with a ventilated paddle. To put it simply, FP-inpatient is rough. Last April, while it was also rough on Pediatrics, I still managed flowers and Honkfest. The April before that, intern year, I made the Daffodil Parade and escaped to Seattle and managed a few adventures. This April was about struggling to stay under the 80-hour work week restrictions (did so-so), trying to eat more than the crap in the doctor's lounge (fail!) and sleeping when I can (also so-so). I would sometimes inadvertently check my countdown calendar twice a day, amazed at how slow it seemed to creep along (me celebrating 80 days, post-call, in picture). The patients were challenging (socially and medically), often manipulative, looking for secondary gain and the schedule was awful (5 weekends in a 30-day month is just plain cruel), all q4 call. Call days go as follows: arrive between 6 and 630 AM (as an intern it was never later than 6 AM so this may be a bit of an improvement), round, admit a patient during rounds, finish rounds, discharge patients, admit more patients, do your floor work, teach the medical students, manage ICU cross-cover, take calls from consulting nurses, etc, etc, so on and so forth until roughly 9 PM. Then back early the next day for more fun. Unless it's a Friday or Saturday, then the call goes on as previously described until 12 or 1 PM the following day (that 30-hour shift I often refer to). This is q4, or in plainspeak, every 4th day. But, these days aren't necessarily the hardest ones, it's all the other days that are starting to suck me dry. The non-call days go as such: Arrive between 6 and 630 AM, round, admit, discharge, admit, teach medical students -- so far similar to call days with the exception it all has to be done before 1:30 PM, a non-stop action-packed stress-filled 7 hours or so. A full day at work, for some people. But that's just the warm-up because after that chaos there's clinic. Twenty-minute visit slots filled with complicated and sick patients, most too poor for the services they need, and many too unmotivated and beaten down by their hard lives to seek out the alternatives that may make them less sick. All looking me to fix it. And, of course, never forget the drug-seekers that so adore residency clinics. After ten of these patients, not surprisingly taking more than the allotted 20 minutes each, I then check on the patients I left in the hospital about 6 hours earlier, my intern sometimes gone home for the day, making sure the discharges went home and the new admits got what they needed. I go home, eat something, call the fiance for a haggard "good-night", manage some sleep, lather, rinse, repeat the next day, and viola! we have burn out.

So, really, call days are quite refreshing in a sense, since my duty is predominately to the patients in the hospital (never mind the labs, studies, results, phone calls and refills from the clinic patients that keep rolling in all the while).

And I forgot to mention that I had the joy of having four OB patients deliver this month plus a surprise set of twins that our clinic assigned to me to round on in the hospital. OB really, truly is joyful. Delivering babies a pleasant part of the job. Even with shoulder dystocias and methamphetamine addiction and teen moms with two possible baby daddies, it's still a real highlight to my practice. But when already being eaten alive by the FP inpatient service it's hard to really revel in the joy of delivering a baby after being awake for 40 hours straight and then adding the moms and babies to the chaos of morning rounds and admissions.

I missed Honkfest thanks to a killer, internless black weekend. I missed the tulips blooming (I did end up driving to the Skagit Valley with Karin to see them but they had all died by the time I had the time off). I missed the Daffodil Parade and (cue sad violins) even had to miss Karin and my anniversary. I did manage a night in a lovely hotel in beautiful Bellingham, WA (a belated anniversary treat) and a post-call, fume-fueled gig at the Jet City Roller Girls (photo of Renegayde above), but despite those small glimmers of the non-work life, I'm burnt. To say I'm in need of a vacation is like saying humans need an atmosphere composed of 21% O2, 78% N2 and a dash of Argon, H2O vapor and CO2. I will suffocate without it.

And that said... my last day on this rotation is also my last call. Friday night. A 30 hour shift. Last call ever of residency! And after it's over (and I take a brief nap) I head to Swing Fever, our RCB Fundraiser/Auction! There, I'll party with my 80 closest friends, blow some money for a good cause, and, if I can stand upright, dance! But Wait! There's more! After Swing Fever, I hop on a plane for rural Minnesota, Middle River to be exact, population 319, to meet the in-laws (eek!), get some much needed R&R, and recover from this mad, mad April. Sixty-five days and counting...