I'm currently sitting in ICU on call, waiting for an XRay to be done and put up on the computer for me to check before I (hopefully...knock on wood) head to my call room for some sleep. We'll see how long it lasts. I'm not going to say anything that might jinx me for tonight. I've found that when it comes to on call issues, we residents tend to be very superstitious. We never say we're hoping for or expecting a quiet night, because then you can be sure it'll be the opposite. And we definitely knock on wood, and do all sorts of little things that make us feel better...and somehow we really believe that they help. Silly, I know, but I do it too!
We also have this concept of "Call Karma." It's a well-known fact that some people have really bad call Karma, and that others have good call Karma. I'm not going to tell you about mine...don't want to jinx it! I don't know - it seems silly - but really and truly, some people just seem to have the ability to have a crazy night no matter what, whereas others just don't. I still maintain there must be a law of averages in there somewhere, and that it all evens out eventually, but the evidence seems to point against me.
Anyways, here I am on call in the ICU. I'm much less terrifed than I was the first few times, though still feeling way over my head in some ways. But I've at least figured out who to call for help and how to get it fast if I need it. And the nurses know what they're doing...they're the experts, really! So when they say, "Jessica, do you want to give this guy some Lasix?" I almost always say, "Yes, what a great idea!"
It's a different world here - lots more tubes and lines and machines and monitors than you see anywhere else. But it's pretty amazing what we can do. It also brings up a lot of difficult issues and dilemmas that people would never have faced 40 years ago, because we have the technology to do a lot more than we did then (I say "we," but obviously I wasn't even around then!). It makes conversations around end-of-life issues more challenging in some ways, because we have all kinds of ways of artificially keeping people alive, and it isn't as pretty and glamorous (or successful in the longterm) as they show it to be on TV. We have patients ranging from 15-82 at the moment, and everywhere in between. There are some very tragic stories, and it is both difficult and a privilege to be in people's lives at these times. And we see the full range of human reactions and emotions, from anger, frustration, grief, sorrow, despair, denial, hope, joy, relief, etc. I've definitely had tears in my eyes a few times, and also experienced frustration in certain situations, and joy in others. As for relief, I experienced that today when I thought for a moment that a patient's lung had collapsed while I was putting in a central line and then it turned out he was just biting on his breathing tube which was why no air was getting through it. Collapsed lungs are a known complication of these sorts of lines, and we are prepared to deal with them when they do happen, but I'm sure glad that didn't need to happen today! Amazing how a small adjustment to his tube brought his oxygen levels back to normal and made his ventilator stop beeping alarmingly at me. It did take several minutes for my own heart rate and blood pressure to return to normal, though!
Anyways, I'm thinking that XRay will be up soon, and then, well, we'll see...you know how it is.
