Sunday, January 29, 2006

Cat Tails: My heart is a Flutter

This week has found me increasingly busy, with less time to recount the mundane details of daily life. Some highlights - I intubated about 10 people (4 of them successfully, 6 narrowly escaping death), ran into my ex-boyfriend in surgery (was able to hold his hand in the recovery room), saw some friends I haven’t seen in ages, and worked out like a ho. My appetite is also back, and that’s never a bad thing. Overall, it’s been a good time, and slowly but surely this kitten is finding all four paws planted firmly on the ground.

Today, I would like to share a tale from a call shift that I worked last week: There is this doctor in the ER at my hospital, and I swear to God I cannot manage to have an intelligent interaction with him. Every time we cross paths, I wind up feeling like an absolute tool. There are (unfortunately) a number of anecdotes I could relay, but I think the following one should sum things up nicely:

It’s about 8pm. I am working away on an admission. The paper work is abundant when someone needs to come into hospital. I am not working with Dr. X, but he is present and doing his job in the ER. His demeanor is difficult to qualify - kind of rough around the edges, a bit moody, and teeming with sarcasm, but he may have a soft side as well. We’ve already had a few run ins and he appears to think that my IQ is less than adequate for someone pursuing a career in medicine. Nevertheless, he seems to enjoy teaching, possibly because he derives pleasure from seeing medical students in emotional distress.

Right, so it’s around 8ish and he comes over to me out of the blue and says, “I want you to go over to curtain 15. There is a patient with an interesting arrhythmia. I want you to look at the heart monitor and tell me what it is”.

At this point, I am already feeling incontinent of urine. I abhor being put on the spot. Worse still, I am extremely poor at interpreting cardiac tracings. When I arrive at curtain 15, I find the woman within resting quietly. Not wanting to disturb her, I tip toe over to her heart monitor and begin deliberating over what I am seeing. Suffice it to say, I have no clue what I am looking at. Common things being common, I would like to see something I immediately recognize – nothin' doin’. So I start to ruminate over the rarest arrhythmias, and look for evidence thereof. I am at a complete loss.

As I quietly pee in my pants, the woman opens her eyes. She is a little startled, and I tell her that I am medical student and that Dr. X thought I should have a look at her heart monitor for teaching purposes. She’s a kind woman and we strike up a bit of a conversation. I ask her how she’s feeling, and she says “I’m just tired, and want to go home. Every time this happens, I end up spending hours in hospital”.

“Really?” I inquire. "This has happened to you before?” You already know where this is going…

“Yes” she says. “Just a couple of times”

Now bear in mind that at this point, I’m getting a little desperate. Dr. X can’t be far away and I know he’s gonna want answers any second. Ironically, the heart monitor is giving me no love.

So I get a little closer to this kind woman and say quietly “has anyone ever told you what it’s called?”

“Yes, but I can’t exactly remember”.

Think Goddamit! My whole future is on the line here. I throw out a couple of suggestions, but she’s not able to help. By now I’m totally frantic. At this moment, the curtain flies open and Dr. X say to me “so, what is it?”

“I don’t know” is my sheepish reply.

“Oh come on, it’s so obvious”

“I just don’t know. It’s not obvious to me”.

“Think about it. It’s so easy. It’s the only irregularly irregular tachycardia”

I rhyme off a few arrhythmias in vein, his frustration becoming increasingly acute. The patient is helplessly saddled to her stretcher, forced to watch this train wreck.

“It starts with A” he says. At this point, I begin some kind of a phonics exercise, repeating the letter A over and over at varying speeds and tones. He is not impressed.

Finally, he blurts out “It’s atrial fibrillation. How could you not know that?”

Now here is where things really go downhill…..

“It doesn’t look anything like atrial fibrillation” I fire back.

“What? It’s typical”

“Fine, but that is not what I thought A-fib looked like”.

So, he asks the patient to do a vagal maneuver, which sometimes will unmask the arrhythmia on the monitor. Sure enough, there is A-fib staring right at me.

Oh, but this story gets even worse….

As all of this is happening, the patient, my new friend, turns to me (in front of Dr. X unfortunately) and says “I’m sorry I couldn’t be more helpful”.

Dr. X turns to me, and I have never seen such a look of disgust before in my life. I think he might vomit as he looks at me and says, very slowly and quietly, with utter disdain in his voice, “you asked the patient to tell you the answer? Why would you do that?”

I’ve been practicing my water off a duck's back routine for several months now, so without missing a beat I retort “I’m a resourceful girl, I’m just using my resources”. I’m smiling broadly so as not to cry.

The lovely patient jumps in “I can tell she’s very resourceful and smart”. She’s trying to help smooth things over but it is just too late.

Dr. X sneers at me and leaves.

You’d think that would be the maximum embarrassment for one day, but I managed to pull off two more humiliating stunts before the shift was through. I inadvertently insulted his intelligence, and his handwriting.

Better luck next time Tabby!


Blogger Jampaq said...

Tabby, you have abandoned us! What, you have something more important to do, like saving lives or something?

12:25 PM  
Blogger telltale tabby said...

Dear Jampaq,

I miss you too. Unfortunately, I've had a fairly traumatic week. Yes, even this upbeat, resourceful kitten can get stuck up in a tree from time to time.

I will try to write something entertaining soon. I just need a couple of days to lick my wounds.

much love,

12:47 PM  

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