"Oh my goodness, you have to come watch this!"
I have no idea what inspired my wife to channel-surf and find the show Millionaire Matchmaker on TV, but there it was: relationship candy for a psychologist. What can I say? It was another Big Night at home after a long day's work: we sat, we laughed, we decompressed.
Until 10:38 pm when the beeper sounded.
"Awww. Don't you want to see how it ends?" she asked. I felt like I wouldn't be missing much and as it turns out, it was the ER. "Heart rate 26," they told me.
"Wide or narrow QRS?" I asked.
"Wide"
"Meds?"
They listed them.
"Potassium?"
"Not back yet."
They explained the situation further. It wasn't much of a decision, I had to go in.
"I'm so sorry," she said from the couch looking back.
It was a bit of a drive on a nice summer night. While tired, I still noticed the feeling of anticipation that comes with such a call. "I can still function," I thought. And so the night progressed:
11:00 pm - Arrived, potassium 6.4, creat 2.0 "Has he gotten the glucose and insulin?"
11:45 pm - Not much change in rhythm. Pressure stable. Vomiting. "Patience," I thought. Better call the team in for a pacer.
12:00 midnight - Consent signed, family witnessed.
12:15 am - To lab
12:45 am - Temp wire in.
01:00 am - Start the pacer. Access challenging, but accomplished. Pt moaning, more alert, wants more information. "You're in surgery, sir. I need you to hold still!"
01:30 am - RV lead in. Atrial lead started.
2:00 am - after considerable struggle, area of atrium that is willing to pace is identified and lead placed succesfully. P waves? What P waves?
2:45 am - Pocket closed, pt moved to post-op holding area. Met family, charted, orders written.
2:58 am - head home. Police stop to ask why I was doing 7 mph over limit. Explain my night. They get it. ID checked. "Drive carefully doctor."
3:20 am - Arrive home. "I'm too old for this."
3:28 am - "So let me tell you what happened to the OCD guy... and that narcissist multi-millionaire? Oh. My. Goodness! On and on she went, describing the scenarios that had occurred earlier as my head hit the pillow, her voice growing softer...
Maybe it's all the years together we've learned to cope with these disruptions. Still, I'm grateful we can still pick up right where we've left off, especially when such important plot summaries have occurred.
-Wes
3 comments:
sq2m
such a great story.
It always seemed as if the ER had an alarm on my pillow! I could have sat all evening, twiddling my thumbs, but as soon as my head hit the pillow: Ring!! Frequently an MVA who arrived at 6:00PM. In radiology for hours. Facial lacerations to repair now at bed time! And a full day of work tomorrow... or rather... today!
All those shift workers wonder why you might be in a bad mood. The ER doctor, fresh on the evening shift grins like I should just be glad to get the call. "Don't talk to me if you work a shift! I don't take any... crap from shift workers!"
Bylaws at both my hospitals only require ER call for your first 20 years. When I passed that point, I bid a fond farewell to both ERs. Then, I got more calls in the first 3 months I was off call than I did the last 6 months I was on call! I finally had to get the hospital CEOs to intervene. Though I still have to take calls from my patients, having no ER call makes life bearable. Out of 20 years on call, conservatively, I clocked over 13 years of call nights!
Wes, check your bylaws to see if you can be as lucky as I am!
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