one day stories honest thinking feeling

February 1, 2006--

5:15am Woke up...actually...no...

4:00am Woke up first at about 4:00 without the alarm. Fought waking for the next hour and a half, losing every 20 minutes or so. Snooze two times. Finally give in, shower, clothe myself, eat Raisin Bran--Kellogg's because it has more raisin. I realize that raisins are a gas producing food, rivaling beans. But I eat them anyway. Drinking Pibb Zero--need caffeine. Listen to the OKC sports radio station on the internet because KC sports radio sucks, and I miss "The Morning Animals."...but I hate the reminders.

~6:45am Get to work. Mild winter KC morning, unseasonably so.

7:00am Check-out from overnight ER docs at 7am until 7:15. Exit room, "MEDICAL CODE...TRAUMA 2" heard from the over head paging system. Walk over to trauma 2, patient wheeled in, already been "down," or without breathing or pulse for a long time. The team ran resuscitation, told me to try to put in a central IV, which was unsuccessful. Patient shows poor signs of survival. Death called, 0721. Some walk in to work today to meet deadlines. I walk in to work today to meet death.

7:35am But it didn't affect me much, since I had never seen the man alive. It's different when you care for the person for a month or a week and they die. Unfortunately it's by far much different for the family and friends. Must remember. Always.

8:15am Working in the ED. See a girl come through, with the a large team of doctors and medical students, who I've noticed for the last couple of months and who I think is pretty and has always been very nice to me for the 30 seconds of interaction we have had about 4 times before. Talk to her briefly, in passing, while looking over a chart. Double check her name on her nametag. Off to see patient...

8:20am ...who is a very drunk lady, who cannot even attend to my interview, but is complaining about her pancreas. Suffer through an attempt at an examination, doing my best. Get her some fluids. Make notes.

9:45 See the girl again. Sit at a computer to do minor things. The computer closest to where she's standing. Got her attention. Made small talk. Found out she likes to go to the art museum about once a week. I tell her I want to go sometime. I convince her to give me her phone number right there, handing her a prescription pad. Then I realize I'm at the nurses station, hitting on a woman. This isn't a bar! This is work. So in mid-action, I began to feel the need to be discrete--and I can tell she does too. So she sheepishly writes down her number. I tell her to fold it and just drop it in front of me. She turns her head, slides the paper off the counter. I pick it up without looking and put it in my pocket. Begin to say how I've been wanting to go to the art museum for a long time. Sheesh...smooth. But it's done.

10:00am See a lady in room A, who has one leg amputated from the past, and has come in because the other leg has a sore that looks like the sore that began the whole amputation process on the other one. She breathes heavily. Poor dentition. Drinks SEVEN beers a day. But only smokes 2-3 cigs a day (right). Both bad for circulation. I tell her she needs to just quit, explaining how it contributes to her poor circulation and that it could lead to further amputations in the worst cases. "Oh, okay," she agrees, almost as if I was the first doctor to explain that to her. "Can I get some breakfast?"

10:40am Drunk lady is sleeping it off. Nurse tells me that, when she wakes up, she complains of pain, then drifts back to sleep.

10:55am Thoughts return of the ex-girlfriend, shudder in the midst of work, our ending, my loneliness, her face, being replaced, disappointment, loss. For seconds, warm runs my blood, electric my nerves. When does it end?

12:15pm Sneak off to break room. Steal some of the free graham crackers and peanut butter intended for the patients because I forgot my lunch. Dipping the graham crackers into the peanut butter, so flavorful, tastes amazing when you're hungry and shaking. And I love peanut butter.

1:15pm Visit a patient who has belly pain, with bad swelling in his right groin, trouble urinating. Schizophrenic, too. I go to examine the area just right of his genitals. He is avoidant of this. As I press there, he nearly jumps from the bed in pain. I have to palpate his testicles as well, which elicits the same painful response. Sorry, dude. I leave him be for a while. I think he's got prostatitis or an infected testicle. My upper level resident, Natalie, tells me to go back in and do a rectal exam to feel his prostate. When I do that, he again nearly jumps through the roof, like I had a cattle prod on the end of my finger. Prostatitis.

1:30pm Two rooms down--separated only by curtains--a man is wrestling with security and nurses, exhibiting the herculean empowerment PCP provides. I'm asked to get Natalie so she can order chemical restraints. I admire my upper level. She is handling about three times as many patients as I am and exhibiting cucumber coolness. Meanwhile I'm trudging through exams, diagnosis, documentation. One day...I'll be there.

1:50pm Shudder, suddenly thinking again about the old girlfriend as I'm doing paperwork. How did I get here? Why did I have to move? Why didn't it work? How could she? So quickly? That guy. Her face. Love. It's been five months now. My OKC friends. Hours pass idle. My empty apartment. STOP IT!! God, take it away. Please... how many times must I ask you? Get the thoughts from my head. Fix me.

2:40pm See patient who is a lady with a swollen red ankle, telling me her story, how she's unable to support her large frame with this maligned left ankle, while calmly eating McDonalds french fries that her nephew bought her on the ground floor of the hospital. She can't remember hurting it. Just woke up like that. Okay.

3:00pm Afternoon check out. The end of my shift. We run down the list of patients in the ER. I zone out as I finally sit down for a bit, as the upper levels discuss the cases, think again about the ex, her happiness, my uphill. Glad to be back in the ER. Good to be back. I chose an interesting career. Tough, but fun sometimes. Action, anger, humor, people watching, major frustration, poverty, compassion, healing, relief, confrontation, apologies, manipulation, resignation, learning.

4:00pm Finish up with the day's patients. Thoughts return. Nerves fire again. Heading home...To what? Next event scheduled--work tomorrow. But I have lots of reading to do for resident conference and grand rounds tomorrow. Reading. Alone.

4:15pm Return to apartment building. Walk into my loft, which is really cool. Hardwood floors, cool design. Door shuts behind me. Sigh. Put down bag. Take off white coat. Sigh. Throw junk mail against the wall in exasperation.

4:25pm To computer. Begin to check email, which will be repeated, "Send/Recieve" every 3 minutes or so. Check and recheck websites. Shudder, as above, several times. Read blogs. Empathize with Dr. Gilbert. Realize that pain comes in so many different shapes. Cower in shame over self-pity reading Brooklyn blog. Wonder, at one time, where the Living God lives, so I ask him for directions. Check email throught the next several hours, catch a little TV. Surf. Avoid the reading. Scroll through the cell phone again and again, wondering who I can call. Call one of them...no answer. Text a friend. Call my brother to visit, but decide against the drive. Need to read anyway. Call for Thai takeout at the noodle place around the corner from my downtown apartment. Back to computer. Check email. Waiting for bed time to come around. Call mom, talk about Grandmommy's health, and other small stuff, her upcoming visit.

10:15pm TV watching...to sleep. Wait!...forgot to read for tomorrow. Read for five minutes. Shudder again a time or two. To sleep soon after.