The transitions have been tough lately. Moving to Seattle, working 80 hours, the learning curve, losing a girlfriend to distance and stress, losing my best friend's mom to an early death. Some lead to transformation some just suck...I hope that I can grow from these transitions but thats not really what I want to hear right now.
Its definitely a new part of life and I am excited about the outcome.
I think one of the hardest things right now is running the code blues. After hearing the page overhead armies of doctors, nurses and respiratory therapists run to commence compressions, shocks and tubes. The outcomes are dismal. Usually it involves broken ribs, brain damage, myocardial damage and other end organ failures... The funny thing is we ask every one regardless of illness, age, condition whether or not they would want us to do chest compressions and intubation when they are admitted to the hospital... we ask them to make an "informed" decision. Now most of us don't want to die... but can one every really be informed? I don't think so.
I have one patient who is dying. He has TB which is treatable but he is weak, malnourished, and demented. His quality of life is horrible. His wife understands this and doesn't want us to go to extraordinary or invasive lengths to bring him back... he wouldn't survive cpr and she knows this. His children are very angry at their mom for this decision and want us to do anything to bring him back... to be perfectly honest I think this is selfish. Don't get me wrong, they love their father and if there was a chance we could save him if his heart stopped we should... but what would likely happen is we would break his ribs and IF his heart started again he would likely never come off of the ventilator. There is a huge difference between this emergency and treating things we can treat... his TB. THese are complicated things and make life interesting. It adds to the emotional and psychological drain of residency. The lack of sleep is rough as well, but...
Its all okay and although some days are really tough, I also love my job and the patients, doctors, social workers and nurses I get to work with... Life is curious but good... here's to remaining positive ;). The amazing residents I get to work with help too.
Jeremy! I miss you! A lot of things about this road are rough, but we know that we fall in the footsteps of those who have gone before...others have made it through this, and so will we. It doesn't make the hard parts any less hard, but maybe it makes them a little more bearable. I know you are learning a ton--from other docs and, because you are you, from patients. Hang in there. The transitions are rough, but the chord resolution at the end of the stanza is worth sticking around for!
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