On call yesterday. Highlights of my day include:

1. providing anesthesia for a skinhead who's chest said, "In God's grace is the white race", and, "skin head" across his shaved eyebrows. He was also covered in swastikas. He killed 3 people and was being guarded closely. You know the guy is a bad dude when the sheriff actually puts on scrubs and escorts him to the OR with us and stays until he is asleep. I was glad when we finally put him to sleep, I was tired of listening to him talk. In the holding area, he kept asking me where he can find a bone saw like the ones orthopedist's use because he thinks it would be "fun to cut people up". He also likes to dine on fried blood, so he said.

2. Gang-banger trauma: My next case was a gangbanger who got shot. We spent $100,000 worth of blood products (120 units of blood) alone trying to save a man who is going to die in the next day or so no matter what we do. He was apparently wanted by the fugative task force for murder, and they called us last night wanting to know if they should take him off the list. Not yet, but probably soon.

Of course, as I'm finding out, the only people who ever die are nice people. It's hard to kill a drug addict or a gang banger.

I drove home this morning wondering if I really did society a favor in the last 24 hours. My job is so depressing.

Thanksgiving Harvest

I survived being on call on Thanksgiving. We actually were not very busy so I got to get some work done and watched football most of the day. Around 10pm we got called to do an "organ harvest". Somebody who has been pronounced brain dead and their family wishes to donate their organs. In this case, it was a teenager killed in a drunk driving accident. They took his heart, kidneys, pancreas, and liver. Organ harvests are strange. The person is legally dead, but they are on a ventilator so their body is still alive. It's actually easy from an anesthesia standpoint. There's really not much for me to do. I just have to watch his blood pressure and give some heparin when the surgeon says to. During the whole case, his chest was open and you could see his healthy heart pounding away. I could have reached out and touched it. After they clamped the aorta, the alarms on my monitors went nuts. His heart went into irregular rhythms, then asystole. My job was officially over and I turned off the ventilator and the monitors. I peeked over the curtain and they had poured ice all in his chest to cool the heart (a cold heart needs less oxygen). About 10 minutes later, it was put in this ice chest. An ambulance arrived to take the surgeon and the heart to the airport where he boarded a private plane to go out of state to perform the transplant. He has 4 hours from the time the heart comes out of the donor until it must be in the recipient, and the surgeon who performs the organ harvest comes from the recipient's hospital. That means, whoever is getting the heart is already in surgery and has his chest open and ready for the transplant when the heart gets to the hospital. Our surgeons are not involved at all. The other organs have a lot more time before they have to be transplanted, but they cannot be harvested unless there is a recipient ready and waiting. A lot of paperwork takes place before the harvest can be started.

My guess is, 5 people had a very happy Thanksgiving.

Not-so-glamorous-life

Anyone out there who thinks residency is glamorous like it is on Grey's Anatomy should think about this: I have to work two 24 hour shifts this Thanksgiving break. One on Thanksgiving and then again on Saturday. But wait! No fair! I've already worked 44 hours over the last 3 days! Oh... I'm a resident. I forgot. No family, friends, or yummy food for me. Instead, I get to hang out for 24 hours tomorrow eating a greasy cafeteria burger while all my loved ones get to eat tasty turkey and nap on the couch.

Sigh. Tell me again why I'm doing all this?

Another sigh. And Hillary and John think doctors make too much money. I'd be willing to bet THEY are spending Thanksgiving with loved ones.

Oops. I got political. I get a little edgy when I'm tired. ; )

On an interesting note, I had to provide Malignant Hyperthermia anesthesia precautions today for a man who that condition runs in his family. A very rare disorder. I'll probably never have to do that again for the rest of my career.

over-the-top embarrassing moments

1. yesterday: I'd been at work for about an hour when one of the nurses informed me that I had a big tear in the back of my scrubs and you could see my underwear.

2. Today: I was living life on the edge and took two Tylenol at the same time to treat a headache. One of the pills promptly got lodged in my throat. I started choking and eventutally couldn't breathe. One of my attendings had to perform the Heimlich maneuver on me. It worked, as evidenced by my being able to write this blog. It scared me so bad I started crying afterwards. Too bad the doc is married. That would be a great "how we got together" story.

See Robyn? This is another reason you should go to medical school. There's always a doctor around to save your life if you ever need it.

Nobody puts Baby in a corner!

I found out today that this year is the 20th anniversary of Dirty Dancing. Somebody please tell me how this happened! How did I become old enough to celebrate this momentous occasion! Pink? Michelle? Robyn?

You guys are right here with me you know...