For how much I complained about this rotation for the last month, I’m surprised by how sad I feel about leaving. Almost every single night I was angry at the residents for making me stay so late. I guess it paid off somehow, because this last week they’ve trusted me with a lot of things, to wit, their call pager. Which is their way of getting to do surgery and not worry about minor details like the urine output, intracranial pressure, blood pressure, or temperature of the ICU patients. (They do care, really, and much more efficiently than I do; but in the OR it’s a distraction.) The junior residents especially, I think, have enjoyed dumping all their calls from the ER on me. I know that most of their interns haven’t done this much work.

But it goes two ways. Even though they were dumping on me, they trusted me; and I like that. I was starting to feel like part of the team this last week (albeit the team’s division of labor consisted of: Alice, write the notes, write the orders, see the consults, and do the admissions, while we are in the OR and clinic).

This morning they discovered one of my management plans from yesterday afternoon, which at the time had seemed so simple that I hadn’t thought to check with one of them. So of course today on rounds everyone was exclaiming about what a bad idea it had been, how completely and obviously wrong, and how detrimental to the patient’s physiology. I spent about an hour feeling guilty for 1) hurting the patient, 2) not checking with them (which was my one real mistake), and 3) still not realizing why my method had been wrong. Then the repeat labs came back, and the patient’s vital signs continued to do their thing, and it became clear that I’d had the correct diagnosis and a fairly correct treatment. I didn’t feel too good about it, though, because if I’d been thinking clearly yesterday there were some even more correct things I could have done. Anway, the patient wasn’t hurt, thank God. I hate this medicine stuff: always more than one right answer. Electrolytes especially are my downfall; and that seems to be the majority of what happens in the ICU.

I also feel bad about leaving because we have some interesting patients: the above-mentioned, who turns out to have a relatively rare disorder, which I wish I could see play itself all the way out; a new subarachnoid hemorrhage in tenuous condition; some trauma patients whose final outcome I want to know; and the pleasantest guy who came in today with a sad story and a completely abnormal neurological exam, with findings I’d thought I’d never see in real life.

The chief even invited me to come around to their surgeries again, and I hope he meant it seriously, because if I get any spare time next month when he’s in the OR, I will. I feel almost drunk with what he lets me do in the OR; it’s addictive; I can’t stay away.

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