There’s no crying in surgery

July 9, 2007 at 11:55 pm | Posted in internship | Leave a comment

Sunday was my first real call day. It seemed incredibly busy, although I know that it’s largely due to my own inefficiency. It was the same way in retail pharmacy: when I started out, everything seemed to take so much time, and I got bogged down in work so easily. I would walk in to take over from the other more experienced pharmacist, who was usually standing around, caught up and calm, then ten minutes into my shift it would turn into a madhouse. Or I would start the day and it would be crazy, and then the other pharmacist would come in and clean up my mess almost before I walked out the door. After a bit, I got to the point where if it was crazy when the other pharmacist got there, then it took both of us working full speed for an hour or two to catch up. But it was a good year or so before I could consistently handle whatever got thrown at me, and know how much time it would take me to do each task so that I could get it all done in a timely manner without delaying any particular task to the point where it would be a problem.

It’s pretty safe to say I am not at that point as a resident.

In fact, leaving aside all my patient care duties, there were a number of small errands I had planned to do and never got to at all. Since I can’t say much about the patients, I thought I’d include that list to give some indication of how busy I was:
1. I carried two letters around in my pocket the entire time, and never mailed them. I know exactly where the mail room is at the hospital, but I could never get over there to do it.
2. I left my call bag out in my car, and everytime I thought about going to get it, there was something else I had to do first. I never did manage to go get it.
3. I had planned to call the outpatient pharmacy and transfer my anti-inflammatory meds there, and get them filled. It never happened. And I was out of my main one, so I just went without. I did call them to ask a question about discharge paperwork, though. The other two were out in the call bag, so I ended up not taking those either. I’ve been off prednisone since February, so being off schedule with my medications is not nearly the huge deal it used to be.
4. I had intended to change scrubs at some point while I was on call. I didn’t have quarters to do laundry beforehand, so I wore a pair I’d worn earlier in the week. However, this To-Do item was less important than sleeping, and I never even came close to doing that, so…
5. I had to pee pretty badly for a number of hours before I finally got a chance to. It’s always a balancing act between “how badly do I need to pee?” vs. “how badly does X need to get done?” It seems I never have to pee quite as bad as that. Not to mention that I’m a little leery of using public-access restrooms at county hospitals.

I did manage to eat lunch and dinner on Sunday, and I had some SweetTarts in the ER early Monday morning. But breakfast is my favorite meal of the day, and I missed it both days.

When I left the hospital this morning, I was seriously questioning my career choice. I was tired, punchy, and I ached all over. And I was frustrated by all the conflicting demands on my time throughout the day and night. I’m still in it, though. Not because I’ve come to any profound philosophical conclusion in the meantime. But I’ve slept, and gotten my prescriptions filled, and mailed my letters. And I have quarters, now. So I’m good for another day at least.

The thing I really worry about is the fact that I hate to see people suffer. I’m profoundly reluctant to do things that I know will cause pain, and I absolutely have to get over that or I can’t be a surgeon. At the very least, I have to be able to ignore my discomfort over causing the patient short-term pain for their long-term benefit. Theoretically, I get it. But it’s difficult to remember when you’re causing the patient severe pain right then and there. On the one hand, I hope I never really get over it. But on the other hand, I can’t allow myself to be incapacitated by empathy.