Walking out of the MICU today, I had an overwhelming sense of accomplishment. In the last couple days I've placed 5 central venous catheters and intubated 2 people - one of whom looked to be a few minutes away from dying when I walked in the room. I've started to really hit my stride.
I swung by Trader Joe's after work in my scrub bottoms and t-shirt. I used to keep an extra pair of clothes in the car so I didn't have to walk around in scrubs, but at some point I got too tired to make the effort. I figure taking off the scrub top is a good compromise.
As I was checking out, the cashier struck up a conversation.
"Just going on, or coming off?" she asked, brightly, "You look a bit tired, so I'm assuming coming off."
I smiled, "What gave me away?"
"Well, the scrubs, for starters. You haven't shaved in about 4 days. And you've just got that... look about you."
"What look?" I asked.
"You look like a tightly coiled spring. Calm at the surface but ready to act in a heartbeat. I'll bet you know exactly where the AED is in the store."
I chuckled. I had noticed the AED. Back corner, newer model. It's become unconscious, that quick assessment. It has served me well in the ICU and the ER so far. A year ago I doubt I would have been able to make that snap decision to intubate just by looking at someone.
I finished bagging my groceries and thanked the cashier. As I walked out an elderly gentleman walked in, breathing hard and barrel chested, nicotine stains on his fingers. "COPD," I thought to myself, as I strode to my car.
Like a tightly coiled spring.