Turning a sort of corner.
I'm not sure how to start this post or exactly what to say, but the title came to me. I figured the words would follow.
I was on call this past Monday. The day started rough. I had this strong suspicion that we would have a mock code on my call day. I was right. I wish I could say that I had rehearsed everything in my head, reviewed my PALS course material and things went flawlessly. But they didn't. I did rehearse a few things in my head and I did look at my PALS material. What I didn't do was figure out how a mock code really runs. It's like being in a play and not knowing what your lines are.
Oh, I should probably explain a bit. Mock codes are practice codes where everyone (doctors, nurses, RT's, etc) pretends like a patient is coding but it's a plastic doll in the hospital bed. We have one each month on the wards and this was our first one of intern year.
I'd better also say that while it didn't run smoothly, the parts about it that didn't work well had more to do with not knowing how to conduct the "mock" aspect of the event and not the not knowing how to resuscitate a patient.
For instance, I was running the code because I was the on call intern that day. As the "code" was being run, I kept drawing blanks because I was staring at a plastic dummy and trying to decide what to do next. It took several mintues for things to kick in and for me to ask all the right questions. In a mock code you have to ask the person creating the scenario what the patient looks like, what the monitors say, what the history is, etc. You'll only get the info you remember to ask for!
Anyway, the code was a bit of a bungle. My fellow interns were as completely frazzled as I was. That was the start of my day.
Shortly after lunch, all my fellow interns and my upper level left for various clinics and an inservice exam. I was alone on the floor by 1:30pm. Then the admissions started rolling in. Around admission #3 at 1:45pm (literally), my husband called to tell me the vet had called him to say that our elderly cat was terminally ill and we needed to put her down to spare her pain and suffering. We've had this cat 17 years, since we got married.
My husband was catching a flight at 5pm, so I would have to go to the vet the next day when I was post-call (having worked a 30+hour shift) and take care of our kitty. Then I got 2 more calls for admits.
So I'm walking down the hallway sniffling, grieving my cat, coaching my husband on how to tell our daughter (who has been caring for the cat as her own for the past 5 years and sleeps with her every night), all while taking pages and organizing my notes for what is now 5 new patients on the floor in the space of about 45 minutes.
I wish I were exagerrating.
One of my fellow interns had popped back up to the floor from clinic to check on something and saw my distress. There was a collection of consultants outside her patient's room who wanted to speak with the "intern" about what to do with the patient that afternoon. Normally that would have fallen to me, the on call intern. But I just couldn't handle it at that moment. I asked my fellow intern to go late to her clinic and take care of her consultants so that I could see the possibly septic leukemia patient that had just arrived to the floor. She took pity on me after I told her about my cat and my dilemma. Eventually she called the oncall upper level to come help me out.
Thank goodness for that because one of the new admits was a child with a DNR receiving palliative care whose family was trying to get home before she died.
There are no words for this.
The rest of my night did not really improve from there.
My husband, bless him, took off from work that afternoon to see about our kitty.
I was finally able to call my kids (still at grandma's house) and talk to them at 9pm. :guilty: You can imagine how distressing the whole evening was for me.
So what about this was a turning of the corner?
Well, I think this is when I fully realized what it means to be a doctor and to have a commitment to patients that can challenge your own commitment to yourself and your loved ones. Of course if the death had been a friend or a family member instead of a pet I would have asked for back up to be called and would have gone home or whatever was needed. But for a beloved pet, well, the patients needed me more and my husband and my parents were there for the kids. And for me? Well. Nothing staves off crying like having work to do and people waiting on you.
It helped me realize something too. I signed up for this. I chose this. And, I wouldn't change it. As much as I suffer emotionally working with some of these kids and their difficult situations, I wouldn't change for the world the fact that my being there might somehow make it better or easier or somehow less awful. If only by being a listener and a sympathetic ear when parents have to ask the tough questions or tell the bad stories.
And there are good things about it as well. I got to discharge a baby who'd been in the hospital since April yesterday. 99.9% of it had nothing to do with me, I'm sure. But I'll still take some of the credit for advocating hard for my patient and helping him get strong enough to be home today. There's also all the kids who've been sick and gotten better while they've been on my service. If I'm going to suffer for the ones who don't do well, then by golly I'm going to take pride in the ones who do do well.
Call is tough. Life is tough. Sometimes life is tough while you're on a tough call. But I did survive. I did my job and I did it well. I'm finding my way and starting to think ahead and formulate my own thoughts and plans and going to the fellows and attendings for clarification and advice instead of answers. That feels good. Surviving a week like this feels good.
Plus, my kids are coming home on Saturday and my son has promised that he owes me about 100 hugs. I plan to cash in on those!
Life can be chaotic. Things happen all the time that we don't plan for, even that we don't want. Blessings happen in the same way, often unlooked for and unexpected. The blessing I find in all of this is that I am getting stronger and better at what I'm doing. I like what I'm doing and I want to do it well.
And hey, I'm still running 4-5 mornings a week! What does that mean anyway? Does it mean I'm crazy? No. Does it mean I'm rail thin? Nope, I've even put on a couple of pounds thanks to the baking talents of some of my compatriots and my tendency to eat when stressed. But what it does mean is that I can still take care of myself and that I'm still claiming something that is exclusively me and mine. I run for no one else but myself. Precious little else in the life of a wife, mom and doc is about that!