Sunday, March 12, 2006


So my housemate was postcall today. Cardiology. He told of how he couldn't sleep despite not having a busy night.
I remember that well. Bad memories. But so very very vivid. I'm not even kidding when I say I still have nightmares about codes on bad days.
Cardiology senior resident. In this institution that means you're the code team leader.
It's indescribable what one feels, unless you've been through it before. That f
eeling of dread, that feeling of impending doom. As I had said once, almost like having a grenade with its pin pulled off, stuck to your pants.
You know the code pager's gonna go off. When, what, where are the questions. And unlike a regular pager, you can't take your time to answer it. You respond, stat. You run, like you've never run before. Once when I was responding to a code, I hollered that we were coming through, and to make room for us. A lady instead turned around to see what the commotion was about, and I ran square into her. The force was so great that we both went flying. Thankfully she was chunky, and had plenty of padding. But yes, when we run, we run. One reason why I wear my running shoes when I'm oncall.
You can't even take a dump, for fear of the pager going off.
You lie in bed trying to sleep, but the palpitations and thoughts one gets can be incredible. I had crazy palpitations; I could see the pen in my breast pocket move in rhythm to my apical beat.
The simple ones are pseudocodes. Syncopal episodes. The easy ones are respiratory codes. The arrhythmias are a different story; will it be vfib, or vtac, or pulseless electrical activity, or asystole? And then there was one patient with a pulmonary tumour who coded from massive hemoptysis.

And just you try to remember those ACLS algorithms after you've been rudely awakened by that shrill pager from hell at 3:54am; it's like your brain-fuse has just blown and you're still in a fog.
But yea, I remember those memories vividly. I admire people who love adrenaline, who thrive under those conditions. But I'd sooner cut off my right foot before I do that for a living. Nope, I enjoy what I do now. Endocrinology and internal medicine are my niche.
Looking back, I bet many of use would fulfill DSM-IV criteria for Post-traumatic Stress Disorder.