After a bad Christmas on call.


While the snow outside piled deep,

Inside sometimes I’d sleep.

      But through the thin and the thick

     The people came sick,

To laugh, perchance, then, to weep. 

If you want to make a psychotic rat, you put EEG (brain wave) electrodes on it, wait till it gets to rapid eye movement (REM, or dream) sleep, and wake it up by ringing a bell. 

Christmas call did not go well.  I felt like a rat in the psycho experiment.

With reasonable volume and intensity the pace stayed steady through the night, and every time I got to REM sleep the phone went off.  Ripped from very pleasant dreams, time after time, I drove through the bracing cold the half mile to the hospital.  With one exception, the patients were sick human beings who just wanted to get better, and who had come at the right time.  I can look for no one to complain or whine to; my job snatched me from sleep’s warm and healing embrace so many times that I gave up and slept in the call room at the hospital.

Most hospitals have one place for doctors to sleep, and another for doctors waiting for a baby to deliver.  Van Buren County Hospital has both; the better room, called the ‘Doctors’ dictation room,’ near the inpatient nurses’ station, has a refrigerator, sink, and shower.  Nicer by a  long shot than the studio apartment I lived in my senior year of medical school, the mattress there provides the foundation for a good night’s sleep.  I just didn’t spend enough time on it.

My fellow human beings in distress kept seeking my training and experience so that they could feel better.  I can write about things in general without writing about people in particular.

For two of the pediatric patients I worried more about the parents than about the kid.  For another patient, inherent stubbornness provided more of a challenge than the diagnosis.

I had to dialogue with the sheriff about another patient.  After I certified neither a danger to self nor others, the sheriff made sure the person got to the other side of the county line and notified the next agency.

Three quarters of the work came from the destructive influence tobacco smoke has on human tissue. 

One quarter of the time apparent alcoholism served as smokescreen for the real problem. 

Our CT machine stopped working, won’t be functional till tomorrow, and I had to send a patient up the road to Fairfield. 

When a person comes in with press of speech (talking fast), flight of ideas (giving voice to racing thoughts), and tangential associations (can’t keep track of what they’re talking about), only four diagnoses come to mind: hyperthyroid, cocaine use, meth use, and mania.  But that person hadn’t come to see me, rather to accompany the patient.  I made the recommendation to check with their habitual doctor and ask for a thyroid test.

Putting pressure on a wound stops the bleeding almost always; elevating the bleeding part above the level of the heart speeds the process.

Shortly after a human being turns into a man, stupidity takes over and only slowly releases its grasp, if ever.    

The accumulated sleep deficit has piled up since Thursday.  My appetite control has evaporated; carbohydrates lurk near me at their own risk.  (See my post entitled Rage, Hunger, Lust, and Sleep.)

I’ve fallen asleep twice at the keyboard since I started this post.  Good-night.

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