The first lecturer this morning was caught in something else – meeting, procedure, whatever – so we’re at loose ends for an hour. I’m so frustrated I could cry, so to forestall that I’m dividing my time between looking up the Mauriceau-Smellie-Veits maneuver for delivery of breech presentations, and typing on here.

We showed up at 5am per orders this morning. I spent fifteen minutes looking for a locker room that would let me in. The residents aren’t talking to us. I mean, they’ll answer questions if you ask. But no one has told us what we’re supposed to be doing; we’re just guessing that we’re supposed to be writing certain notes. And talk about the patients? Good luck at figuring out which resident is responsible for which mother. I wrote two idiotic notes (having forgotten my stethoscope in the locker room on the other side of three separate flights of stairs and five locked doors, and being way too upset to go back for it, I for the first time wrote “heart regular, lungs clear” without having listened at all; very wicked), and finally went into the nursery and rocked a baby for fifteen minutes rather than stand in the hallway and look lost. I missed my calling in life. I should have been a NICU nurse. Can I switch now?

The Csection patient yesterday is diabetic; the resident wrote regular and NPH insulin for her, ignoring me when I asked whether lantus and aspart (new, hightech, beloved of diabetologists and internal medicine people) might not be better. This morning I checked her blood sugars, and they looked good. When I got to the chart, the intern had written to decrease her doses of insulin. I’m too scared to catch the intern and ask why on earth decrease the dose when her lowest sugar was 95, and do they have some objection to lantus and aspart around here. And on rounds we’re sitting in the back of the room, and the residents are having a rapid, low-toned, coded conversation with the attendings, and when management decisions are made we have no clue what was decided, let alone why.

My stock of enthusiasm is not quite up to this being continually ignored, lost, and behind schedule. I’ll have one more go at it tomorrow, come in way early at 4:30am, see all the patients myself (why are we waking postpartum mothers up at 5am to ask how they’re doing? why can’t it wait till some extravagantly luxurious hour like 6am?), and walk on the interns’ heels to find out what’s happening. If that doesn’t work, I think I’ll frankly start crying, and withdraw into the nursery.

Did I mention that my glasses are falling apart? The lenses keep popping out at odd moments, and I don’t have a screwdriver, and they won’t fit back in, and I won’t be near a place to fix it till the weekend, and I get dizzy looking through only one lens, so I stuck them in my pocket and then I couldn’t see the other wall, and I was trying to find my patients and looking really stupid, which made the interns even friendlier of course. . . .  !!

Ahem. On the plus side, Alito was confirmed and sworn in. And the weather is cold, maybe it’ll be cold enough to go skiing this weekend.

Speaking of politics, the grand rounds presentation this morning by the chief resident was about emergency contraception, and consisted of a paean to plan B as the perfect method of preventing pregnancy (abstinence, anyone? planning ahead, anyone? sheer providence, anyone?), and a drawn-out bewailing of the inadequacy of information and resources available to American women, so that they can’t access this Godsend easily enough. One study cited in horror showed that a quarter of all hospital ERs, whether Catholic or not, place some restrictions on giving prescriptions for emergency contraception to women, including a pregnancy test. Since pregnancy is an absolute contraindication to taking these pills, I fail to perceive the horrific nature of this requirement. Words fail me. Fortunately I was sitting next to a male medical student whom I don’t know, so there was no temptation to mutter during the lecture. The only comfort was one of the interns, an African guy who approves of abortion, but was willing to stand up to the chiefs and attendings and argue that Plan B does technically constitute an abortifacient.

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