der hexenhammer

seriously, how do people who write blogs find the time and energy to do it everyday? maybe if one is getting paid, but for real, do these people have jobs? i know there are plenty of jobs that require less work time than mine, but egad, some folks post extensively 4-5 times a week or more! i've been working 12-13 hours a day, 6 days a week since mid-october and i tell you, i don't have the energy to write much. yeah, boo hoo for me.

i'm rotating again on the trauma service, and the patients are just as dysfunctional as they ever have been. in case you never read my prior entries from my time on trauma as an intern (if those actually exist in print or in my mind is something of which i am unsure)the majority of trauma patients fall into 2 catagories: first, the sunstance abusing sociopath who gets beat-up, shot, punched, stabbed, kicked, etc. population number 2 are the demented old folks who fall of ladders, crash their cars, fall down stairs, fall out of wheelchairs, or fall after they have been hit by cars because they were walking in the middle of a dark street at 9pm. people from catagory number 2 are intoxicated about 1/3 of the time, and it's not just alcohol these geezers are imbibing. about 3 weeks ago a delivery van ran over a nice 76 year-old female who, in her own words, ran across the street against a red light because she wanted to be sure to meet her crack dealer before the weekend and it was getting past the time he generally hung out in front of the liquor store. she later admitted to being high on crack when said poor decision was made.

there has also been a steady stream of old men falling off roofs and out of trees. i guess fall (the season) encourages ladder climbing. to be fair, it's not always men who fall; take for example, the following story about an unfortunate 65 year-old female: it seems that she ascended a ladder to clean the gutters and remove other debris from her roof. a portion of the roof is flat so she was actually off the ladder for 10-15 minutes. during this time, her demeted (i use "dementia" here in the actual medical sense)husband thought that she had finished her task and neglected to put the ladder back in the garage, so he did it. now returns the female to find an absent ladder and no means of egress from said lofty locale. fearing a chilly night outdoors, she leans over to see if the ladder has fallen or if anyone is around to retrieve said ladder. i guess she leaned too far because she is now the proud owner of a fractured pelvis and a shattered elbow. ouch.

*****

i will close with an explanation of why i pray for pediatric trauma between the hours of 6-7pm. i don't actaully pray for kids to get hurt, what i wish for is that when traumas come in that time period, i hope they are of the pediatric variety. this is why: i have a pager, it makes noise whenever a trauma arrives. there are different codes for adult and pediatric trauma, and there are also 2 levels of trauma activation depending on the severity (or presumption thereof) of the injury. from 7am until 7pm i have to see every single adult trauma patient who arrives at the hospital. this is not so bad--somedays are slow and i can fit in a nap here and there, and when it's bust it can be fun as trauma patients often need procedure performed upon their injured frames; tubes, lines, stitches, etc. as you might imagine, it can take a good amount of time to deal with a trauma, and they often come in in rapid succession. at 630pm, the night shift comes in and we sign-out the patients on the service--basically, we tell them about all the patients and make them aware of any active issues or things that need to be completed or follow-up overnight. then it's time to go home.

idiots and assholes all over our fair city must know this because there is often a rapid influx of trauma between 6-7pm. the problem here, is that the disrupts the sign-out process, which must happen, so both the day and night teams respond to the trauma and sign-out doesn't happen until after the patient is stabilized. depending on the severity, this can mean extra hours in teh hospital. i do like my doctor-type work, but after 13 hours in the hospital (even if there has been a siesta) i am ready to hit the road.

the caveat is that we don't respond to pediatric trauma. thus, anytime after about6pm when the trauma pager goes off, there are at least 6 people here hoping that it's a kid who has been injured and not an adult. although i can't speak for the others, i always pray for minor injuries.