It’s probably dangerous to write this before the weekend of call is over, but it hasn’t been too horrible. Which is kind of funny, since I managed to spend most of the night either in the hospital, or driving back and forth to it. (At one point I got to thinking, since the charge nurse prefers to do all the talking when admitting new patients, and prefers to do all of the explaining of how bad their injury is, and what we’re going to do about it, and since she clearly knows far more about all this than I do – why do I have to come in at 4am for the fifth admission of the night? But for the sake of peace and quiet I let her take the history, nursing style (where tetanus shots and family relationships are just as important as open heart surgery and current medications – and to be fair, we do rely on the nurses to tell us the social history), and stood in the back and made notes about the treatment plan while she talked.)

The big case went well, completely beyond my expectations. This patient keeps hanging in. The nurses are waiting for the other shoe to fall, but I’m hoping he keeps on this way. One advantage of getting him in the OR was that it became clear that his injuries are, just marginally, not as bad as we had thought; which improves his prognosis, and makes the current fight more worthwhile. So it was me and the attending on the case, so I was doing, for the first time this year, more than half of the work. (Only because it was actually very simple work, and there was so much of it – but still.) And, the attending for some reason decided to use cautery instead of blades, so there was only a fraction as much blood as I expected, and it was much more fun. Using blades as extensively as we have been is not easy for me; it requires a very firm commitment to do something pretty brutal, and somehow my hands can’t make it bite in as much as it should. So the cautery was a fun change; I like the bovie, it’s not hard to use, and I wasn’t stumbling for the whole case.

Afterwards I stayed around for a couple hours, just to ward off evil spirits, because by Murphy’s law, when I leave will be when things start to happen. This rotation is an interesting taste of what it will be like to be a chief: more control over your hours and what you do, but also a bigger responsibility, as the only or sole team member available for the patients. Just because you can choose to leave the hospital earlier, or arrive later, doesn’t mean you really can. It means now you have to choose to come in early and stay late enough to do everything that ought to be done, and to make sure the patients are tucked in. And you get called all night at home. I could do without that. But of course that’s what life is like after residency.

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