Thursday, April 14, 2005

The Definition of Irony

  1. Medical staff watching an episode of ER in the ICU
  2. A mechanically-ventilated patient with endstage alcoholic liver disease, whose first words when regained consciousness were 'Give me alcohol...'

It was a busy call again last night, partially too thanks to the incompetence of the ER. Received at least one bogus ICU admission, who really didn't even needed to be in the hospital. 'Pneumonia' in the context of a normal white cell count, no fever, unchanged chest X-ray and normal O2 saturation. Really. While I don't consider myself smart (conversely, I think my IQ is pretty low) at least I'm not in the habit of taking shortcuts and blocking admssions of every Jane or Joe who comes in. I was pretty miffed with the Pulmonary resident (a junior of mine) who declined to accept the patient and insisted on her coming into the ICU, just so he could get extra sleep and not work her up. Out of sheer laziness, and without even looking at the chest Xray he just said no, too 'unstable' for the floor.

But the others though, were sick. We usually worked as a team, my fellow, intern and I. But last night we had several patients arrive and crash at the same time, so we had to tag-team. Last night itself I had to intubate one patient and place 3 central lines in others.

I was able to finally lie down for a 45 minute quickie nap at 4am, 21 hours after starting call. By then, my brain had stopped working and I really just couldn't care less about anything else except getting sleep. Until I got the call that a patient's BP was 60/30.


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