Pace without Pause

I am done with my (first) month of OB. Phew. What a rough one.

I think the hardest thing for me has been getting used to the pace which, at this busy public hospital, is relentless. People kept telling me on Friday, "you just have to make it through today!" "You're right," I'd say, while reminding them that I had to take terminal Friday night call (grr); however, the day wasn't any easier to get through and I couldn't quite see the light at the end of the tunnel, I was so whipped. It was crazy, as usual.

We had a patient with preeclampsia by blood pressure and neurologic criteria (but normal labs) have an eclamptic seizure in Triage and have to be rushed back for a code-C-section for fetal bradycardia. We had a class C diabetic with a baby with multiple congenital anomalies being induced to deliver after a gestational abortion. We had the run-of-the-mill no prenatal care patients who were dating by 36-week ultrasounds in triage. We had another 26-week IUFD (intra-uterine fetal demise), a buttock abscess in triage, some more mild preeclamptics who got delivered, lots of people in triage with early pregnancies and abdominal pain, as well as a full "green" board (lots of laboring patients). Busy, busy, busy. Triage was hopping all night, and my pager again filled up with pages from the gyn-onc people. There is not even time to breathe.

I'm the learner type who kind of likes to sit down and go over (systematically) the rationale behind doing certain things, but honestly, there's just not time. You don't even have time to pause for a second to think about what you're doing. We have to round on so many postpartum patients that, if one of them has "issues," it really throws your whole plan and day off because you can't get to the other patients. I think it's horrible. And as someone who wants to be meticulous and thorough about everything, the suggestions that, "don't worry. You'll just stop caring as much as you go through this year" really bother me. I'm kind of poky in general (ask Hans who always finished med school tests first and last!), so this pressure really throws me off, but I still want to do a good job of taking care of patients!!!

I came home yesterday, after my 317-hour work month (somehow keeping me just under the 80 hour/week "average" cutoff) and just slept. And slept. I heard things buzzing periodically (ended up being my pager [DARN PAGER]) and my phone a couple of times), but didn't get up. I woke up "for good" around 10:40 p.m., mad because my whole day was gone. But I know that my body just needed to recuperate from my week/month of working my butt off. Two hours later, I was back in bed for the longest night's sleep I've had in a while :)

I don't think I really ever comprehended how hard it is to work 80 or more hours per week. I mean, in med school I might have done 70 sometimes, but the responsibility is much less. You also don't have to then come home and deal with dictations, returning patient calls, and checking up on labs. I don't have enough (waking) hours in the day to go to the store, pay bills, return calls or e-mails (which is really tough on me-- it's very unlike me to not be ontop of communication), or work on research papers (I'm kind of happy about that one, though, although it just means it will be hanging over my head for longer). I don't know how I can keep doing this, all year long. I really do feel like a big ball of stress-- like I'm constantly juggling like 12 things and rushing around trying to get them all done-- I'm multitasking with talking on the phone and cleaning my kitchen, writing patient notes and trying to frantically swat at the flies that have appeared in my apartment. I feel like I'm constantly treading water and never quite getting anywhere, and never quite getting a real break. Oof da, as they'd say up north.

I've been constantly battling what I do do in my days/time off. I actually have today entirely off, which is AMAZING (before I start up with Internal Medicine at the VA tomorrow)! Do I just veg at home and truly relax, or do I try to be social and get out to explore this fun place, because I know that being with people genuinely makes me the happiest?. I did make myself go for the Fleet Feet run this morning- Kate and Lisa also came. It was good-- we did about 65 minutes, and I feel better about not having been able to exercise much AT ALL on my own. Let's just say that scrubs are very forgiving and my pants are feeling very tight. I hope to correct this soon-- the half is on Oct. 7. I also joined them for brunch at Cafe Bernardo. In a bit, I am going to go to the state fair with some FP classmates. And after that perhaps dinner with Sarah and Aline. Not much relaxing going on, after all, but hey, I have to make the most of life (and time off), right? :)

The fast pace continues! Gotta run...