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28th November 2008

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28th November 2008

Gray Friday

*grumble grumble*

My chief resident sent out the holiday schedule earlier this week, so we would know who was covering each service and could plan our time better. I noticed that I wasn’t listed to work at all until Sunday, which I knew wasn’t right. We have 4 days off a month, and my four days are later. Because I know from personal experience how overwhelming the neuro ICU can be on the weekend (splitting 12-16 patients between 2 people is hard enough; when they’re sick enough to be in the NICU, it can take you a half hour to just gather information on each one, much less actually see them) and since that’s the service that I now belong to, I decided to do the morally right thing. Instead of sleeping in and going out to shop* for Christmas presents and a Christmas tree, I went to work. We were promised that even though it wasn’t an official holiday per the hospital, the neurology department was still treating it as such and therefore only needed to be there until approximately 12-1pm. Half days are so deliciously refreshing (sun! air! couch!) that they almost feel like a full day off.

I was done with everything by 1:30. I had admitted a new patient, talked the plan over with the fellow, written orders, confirmed results from the consult services, rechecked labs, finished notes and updated the signout sheet. And my fellow wouldn’t let me go. First, it was making sure the radiology would do the study we needed. Then it was signing out to the resident who was on call that day. Then it was waiting for the fellow who was going to start on the service starting that day; he was supposed to show up at 3, he didn’t arrive until almost 4. Then it was the back and forth decision of whether or not to place a central line in our new patient (patient left for the above study, removing that decision). Finally, both of the fellows left, leaving me to go around and write all of the orders that they had decided were suddenly needed.

I finished at 5:30 pm. Happy holiday to me.

(Did anybody understand the above paragraphs? I swear I really wasn’t trying to be cryptic.)

This is an important month for me. I love neuro critical care. I love the complexities of patients broken down into easily managed systems. I like the procedures (even though it’s been over a year since I did a central line or an art line. At one time I liked them). I like that it’s evidenced based. I just don’t know if I like it enough to do another 2 years of fellowship. More years of training, with long hours and which would require starting to do research now so I have a resume that looks impressive. And I don’t like research. All for a career that will always be demanding and time-consuming and I don’t know if I have the physical or emotional endurance for a lifetime of being an intensivist. I’ve been trying to make up my mind about this for months, mulling over both sides and never quite getting to a decision that felt right. So I’ve given myself this month to figure it out.

*Actually, after the news of the worker getting trampled to death at the Wal-Mart in Long Island, I’ve decided to continue my tradition of avoiding shopping on Black Friday, permanently. Because, that’s insane.

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