Trauma alert to the trauma room ...

I am currently on my third shift of "trauma nights" as I sit typing this in the hospital library at 130am.  Stuart is being a wonderfully helpful and patient husband during this experience!  The next few days will be a bummer because as I leave the house at 6pm, Stuart will be arriving, and as I arrive home at 6am, Stuart will be leaving for work.  But we will make it through and I'm sure appreciate each other a lot more because of it!

So what is trauma like (for a medical student at least)?  Basically I sit around with my residents (or hide from them in the library) and wait for the calm-voiced lady on the overhead speaker to say "Trauma alert to the trauma room".  Then I drop everything I'm doing and run downstairs to the trauma bay in the emergency department.  What you might find is always a surprise.  It could be something 'minor' like a goofy teenager who got shot in the head with a BB gun, or something disturbing like a man with a near amputation of his leg due to a car accident (if you want more yucky details than that, you can ask me!  Of course the only details I provide are those that are HIPPA approved!)  My job during these sessions is that of an 'information gatherer'.  I take a trauma history and physical form ("the pink sheet") and write down all the patient's vitals and exam findings.  Sounds easy enough, right?  Well ... it would be, except for the fact that there are approximately 8 other people in the room all examining the patient at once.  Each person is focused on a different part of the patient, and they all yell out their findings at the same time.  Basically, I wind up running circles around the patient with my pink sheet in hand, and sticking my head into places I would rather it not be, saying "Wait, were those weak upper extremity pulses or normal?  Did you say he had decreased breath sounds?  Which bone is that sticking out of his leg?!?"

When it's not busy around here, I sometimes get to do really neat stuff that I otherwise would not get to do if it were day time and there were more qualified people around (associated pearl of knowledge for you: try not to get sick at night time).  For instance, tonight I was able to help put in a subclavian central line.  The resident got it started for me and I did over half the procedure by myself!  And of course, if someone needs stitches then I am the one to put them in.

As an aside, last night I got to suture 5 or 6 lacerations on a drunk man who wrecked his car.  He was not a happy camper and kept trying to take a swing at me while I was stitching his arm.  We tried to sedate him and he did not tolerate that well, so my resident just held his arm down while I sewed.  I am usually a fairly patient person, especially with my patients.   Nevertheless, I thought I was gonna have to smack that man in the face. 

So, personal lessons learned thus far on the trauma service:

1a. I never knew what tired really was.  I thought I had been tired before now.  But yesterday around 330am I fell asleep sitting up at the nurses station while writing a patient progress note.

1b. Coffee is a good thing.

2. Always keep your toenails in check.  70% of the patients I have seen the past few weeks have outrageously disgusting toenails.  Yellow, cracking, thick, peeling off toenails.  Perhaps fungus is more prevalent than I thought, or maybe people just don't take the effort to bend down that far.  Regardless, I think I'm going to paint mine when I go home today.

3. Nothing good happens at 2am.

4. Always wear clean/cute underwear.  In the unfortunate event that you are in a traumatic situation and come to the ER, you will have all your clothes stripped/cut from you and everyone will see you in your skivvys.  At least until those get cut off too.

5. If your patient has a gun shot wound, you ask why, and they say, "I don't know, I wasn't doing anything", they are lying to you.  If a person gets shot "while reading their Bible downtown", they also are lying to you.

I'm narrowing down my life's calling

I may not know much about which specialty I will choose, but I can tell you this much: it's NOT surgery.  I surprised myself and found that I actually like the OR.  I can stomach blood, guts, and sticking my hands wrist deep into body cavities.  I cant stomach the profession as a whole.  The reasons are multiple; I will state only a few here.

1. I am not as cute as I can be.  Waking up at 4:00am does not lend itself to makeup application or hair-fixing.  I have learned that the best option is taking a night-time shower and usually falling asleep while my hair is still wet.  The next morning I throw up a pony tail and bobby-pin my bangs that I paid so much money for at Aveda and now have to hide.  Add to the mix a thunderstorm-gray scrub suit and a pair of Dansko clogs, and you might not even recognize me.

As an aside, Dansko clogs are the most comfortable shoe my feet have ever met.  They let me be on my feet on concrete floors for 12+ hours a day and not want to cry from pain when I get home.  Unfortunately, they are ugly as sin.  Mine are a nice brown leather rather than the patent leather you see above.  On the plus side Stuart always knows when I get home because he can hear me clumping up the stairs outside.  And he, being the more fashionable one in our marriage, makes me remove them and hide them in the closet as soon as I get home  =)

2. I cannot do normal person/wife activities such as cooking and cleaning.  But I am pretty excited that we came up with the genius idea to cook all our meals for the week on Sunday afternoon.  Weekends are good because we can sleep in, so with some extra energy last Sunday we went to Publix after church and then came on home and cooked away!  We made a delish Chili Verde with honey cornbread muffins, and then a sundried tomato pesto for pasta and some rosemary grilled chicken!  It was weird to cook all that and not eat it, but it has definitely paid off this week so that we can just warm stuff up!

3. I am officially lame.  Bedtime is about 8:30. 

4. Surgeons are ... how can I put this gently ... weird.  I think there are basically two types:  

• The mean type - this is the type who expects you to know things like "who was the father of heart surgery" or "who was the first surgeon to use cocaine intraoperatively".  Sometimes they may also make patients, or medical students, cry.  When patients are about to undergo life-changing and hopefully life-saving operations, they say things like, "You got a bad heart.  You need an operation.  You could die, but probably not.  Got any questions?"

• The crazy genius type.  One of my surgeons, if you met on the street, you would definitely think he was homeless.  He looks disheveled at all times and wears a red beret.  He prays to God in Latin, and curses his medical students in English.  He can conversate on any topic you bring up, yet did not understand, after multiple explanations, that Gene Chizik was the coach at Auburn.

I suppose those are enough reasons.  And while I (nor Stuart) am not particularly enjoying this rotation, it is nice to be able to narrow down my future list of specialties!   Next week I start trauma surgery, so perhaps I will have some interesting stories to share!

Halloween updates!

This post will not be too wordy, as I am post-13 hour cardiovascular surgery shift!!  You can probably expect posts in the near future to be short too, being that I am in the come home, eat, go to bed mode.  Bless Stuart's heart for having to deal with me!  =)

Halloween is one of my favorite holidays.  I know some folks aren't too keen on the spooky day, but any day you can dress up as something silly and give out candy to kiddos is good in my book!  

Stuart and I had a super fun pumpkin carving party a week before Halloween.  We decided to make a pirate pumpkin in honor of our aforementioned new friend, Mary.  The pirate was a success and almost made it to Halloween before it caved in.  Darn you, Mobile humidity!  We ended the holiday week with a costume party/small group!  Not many couples were able to come, but we still had a great time, and Stuart and I got to show off our Family Double Dare costumes!

Also, unrelated to Halloween, October 30th was our 1-year engagement anniversary!!!!  It was also conveniently our 3 month wedding anniversary!  Stuart surprised me by picking me up from the hospital (after I performed the incision and drainage of an abscess on my own!!!) and driving us to Meridian, MS to stay in a bed and breakfast!  It was so much fun, and so very nice to sleep in and have someone wait on us!  

I didn't get any pictures of Meridian, but here are the Halloween pics ...

concentrating on that pumpkin!

the part of pumpkin carving that is most like my surgery rotation

Gray's technique made me a bit nervous ...

and now on to some sort of saw thing

our masterpieces!  our pirate is the second from the left

Family Double Dare!  We'll take the physical challenge!!