And just when you think you've gotten into the swing of things...
It's been a quiet night. Nary a peep out of the frequent fliers. The department is a ghost town, nurses are tidying up loose ends. The calm before the storm.
Then the calls come. Trauma Code 1... times three. Ten minutes out by helicopter. Ears perk up. Medics coming to rooms 8, 14, 17, and 18. Rumblings of dissatisfaction begin. Overdose transfer to room 4. Audible anxiety from the staff.
We gear up. There are only three of us physicians. The attending heads to one room, the senior resident to a second. I take the third. And then the fourth. And fifth, and sixth, until my head is spinning. Everyone is sick, everyone needs attention, and everyone is just slightly too complicated. It's 4 AM on Christmas eve and Santa has dropped a few presents off for us early.
It's times like these when you just put your head down and run with it. I go from taking care of three patients to eight in the space of a few minutes. And so things get missed; a patient has a blood pressure of 220/100 - dangerously high - but I see him before the nurses do, so I don't hear about the abnormal result. A man is found by the side of the road, complaining of back pain and reeking of booze and weed. He doesn't really remember how he got there; in my rush to get him to the CT scanner for traumatic injuries I forget to draw an alcohol level. A woman who took half a bottle of klonopin turns out to also have an occult pneumonia, but is so altered she can't tell me she has trouble breathing.
Thankfully, I catch a breather an hour later. The intricacies become clear, and I dot my i's and cross the t's, correcting blood pressures and sugars. But still. Emergency medicine would be easy if you had only one patient and the luxury of infinite time to work them up. In reality, shit seems to hit the fan at the most inopportune moments.
I'm starting to understand why we physicians refer to our jobs as a "practice". We're always learning. Always striving to be better. I'm getting there.