I'm in a ghastly stretch of five overnight shifts followed by a DOMA (I get out of the hospital for my day off at 8am following an overnight shift and am due back at 6am the following morning for day shift; doma = "Day Off, My Ass") and 5 day shifts. I'm going to be fairly crispy by the end. I've told my boss twice in the last week that I have had it, that this is it, that there is no way I'm coming back. Both times he said that he was terribly sorry to hear that and could I pick up an extra shift. Both times I said yes, of course.
Last night we had an acute MI that went to cath lab, an acute stroke in a 34 year old mother of 3, a horrible trauma (car fell on a guy and burst into flames), two gun shots, a stabbing, an unstable GI bleeder, a rape victim who had been set on fire, and all the usual other stuff we see. Oh, wait. Maybe that was the night before. I think last night was the leaking aortic aneurysm, the crazy woman who stabbed herself repeatedly in the abdomen with a arm-long sliver of window glass and managed to hit every organ in her body, the young woman who appeared to have been beaten and raped but wouldn't talk and was in the middle of multisystem organ failure, and the 5 year old who inhaled a plastic something and required a surgical airway. It's all sort of running together now. The City X cops who were supposed to be guarding a murderer who had run in front of a car left to get us food because we were so overwhelmed. The murderer was intubated, he wasn't going anywhere.
There was another riot by another family. The victim was drunk, high, and going 100mph the wrong way on the freeway without his seatbelt. The semitruck did everything possible to get out of his way but it wasn't enough. The guy went through the windshield and was stuck, a la "Signs," between his car and the semi; the highway needed to be shut down to get in an ECHO truck to extricate the guy . Unbelievably, he was still alive when he got to the ED. In addition to me, 2 residents, the trauma surgeon, the surgical PA, and half the nurses in the department did everything we could for over hour before we pronounced him. The deceased family did not take this well. We were accused of not doing anything to try and save his life, of being happy he was dead, of wanting him dead for spare parts. I had to walk away before I lost my temper. Multiple family members ended up handcuffed after threatening the police officers who were attempting to de-escalate the situation. I heard about that later, I was already taking care of other people.
This morning, when I left the ED 3 hours past the end of my shift, it was grey and raining. Perfect sleeping weather. The non verbal woman still bothered me, I hope I didn't miss anything on her. I slept -sort of- until hot sun on my pillow woke me up and I realize that the jackhammer in my head does not mean I had a great time last night but that there is construction outside my window. I look out. The neighbors both sides of me have suddenly decided to have work done; I hate them with the passion of ten thousand fiery suns. I'm too tired to sustain that so if quickly fades into grumpy annoyance. I try to go back to sleep but it doesn't work. I get up, do some laundry, unload and reload the dishwasher, make some food for dinner (or breakfast or whatever the one meal a day I end up eating when I work overnights is called). Normal stuff, but I feel like I am moving through mud. I'm so tired that thinking hurts.
I open the door to get mail and see that part of the construction crew belonging to the house on the right is lounging against the hood of my car. I know I should say something, but I'm just too tired. I stand there on the porch in my bathrobe in the afternoon sun and stare at him. He stares back.
"Nice time to wake up, Lady!" he calls derisively, "Maybe you should get a job!"
I close to the door, realize I have still not gotten the mail, and trudge up the stairs. Maybe I can get another hour of nap in before I have to be back in Hospital X. As I drift off - despite of the sun, the heat, the jackhammers- I realize that today is June 30th; we'll have brand spanking new, fresh out of medical school interns tomorrow.
When I finally sleep, I have nightmares.
Tags: emergency medicine