I want you to picture a dumpster. A bad one, full of rotting fast food, like a McDonalds-parking-lot-at-3am dumpster. One that no one bothers to lock or protect from animals because even the racoons will stay away from the fermenting, rancid waste.
Got a mental picture? Now place that dumpster aboard a Viking funeral of a ship, ablaze, sailing toward an enormous waterfall with nothing but jagged rocks below.
I will preface this story with a disclaimer: I am not exaggerating the following.
On one short-handed urgent care shift right before Christmas, wait times to see the doctor (me) stretched to four hours, at which point people started a light riot.
The urgent care where I was working normally has two providers at once: an MD and either a nurse practitioner or a physician assistant. That day, the nurse practitioner called out sick with COVID, leaving me alone.
Guess who graduated residency… but is still in training!?
So now I’m starting my toxicology fellowship. I’m now at a different large academic center, still on the West Coast, and am six weeks in.
Fellowship is going well, except that I wake up every day consumed with a blinding and violent rage – not toward my training program but toward the university’s HR department.
I was working on writing this gigantic 4,000-word monstrosity of a post where I tried to align specialty services with the old-school Dungeons and Dragons “Lawful/Chaotic vs Good/Evil” axes for character generation, and it was exactly as complicated as it sounds.
As I worked my way through it, I realized that half of what I wrote was about convincing specialists to come down to the ER and see my patients. At large academic centers where we residents train, we are almost always calling other residents for this task – and therein lies the rub. Like us, they are overworked and underpaid a flat salary to do their jobs. When I call the surgery resident for a consult, for example, I am creating work for them.
Hello! Once again it has been forever, but I don’t care. I’ve been too busy trying to prevent my head from exploding from, once again, people being stupid.
(I am a tiny bit frustrated with vaccine hesitancy, which I sort of understand, and very frustrated with COVID deniers and other conspiracy theorists, who I think should be first boarded onto a 13-hour Spirit Airlines flight and then forcibly ejected out the emergency exits at 35,000 feet.)
I would like to blame my prolonged absence again on COVID-19. To be fair, it does dominate about 95% of my work life and probably 50% of my personal life, but honestly, I’ve just gotten lazy.
The last time I published here was March 5, where I started with “it seems like we are inevitably headed for a massive, global pandemic.” For once on this blog, I get to say I WAS RIGHT ABOUT SOMETHING IN RESIDENCY! No attending or dad can correct this.
As of this writing, my area’s daily hospitalization rates look like a Space-X rocket launch. We’re out of ICU beds, regular beds, gurney, cots, sleeping bags, and patience. The worst is somehow yet to come. I am coping with this impending doom by playing with my dog and, finally, writing again.
Well, from listening to the news it seems like we are inevitably headed for a massive, global pandemic. Millions of people will die. Soon thereafter, the zombies will rise, coughing and sneezing coronavirus loogies on the few healthy people left.
COVID-19(/the coronavirus/SARS-nCoV-2019/whatever) is likely to be, if it isn’t already, a pandemic. Hundreds of thousands, if not millions, of people are probably going to get sick. Some will die. As an ER doctor, I am almost certain to catch the disease. Seriously. Continue reading
Yes, it has been very long. This is because my life outside of residency lately has been consumed with raising a small weapon of mass destruction named Otis.
This is Otis when I got him:
This is Otis now:
As you can see, he is a) much bigger and b) a Systematic Toy Destroyer. A well-meaning resident gifted me a plush toy for him; Otis ripped it in half in about thirty seconds.
Another July has come, and with it an upgrade in my rank and nominally in my salary. I make a whole $2.75 an hour now!
In the third and fourth years of this program, I’m considered a “senior” resident. Senior residents have some additional responsibilities over those of juniors: we are supposed to keep an eye on the entire emergency department, make sure everyone is pulling their weight, lead resuscitations, and teach novice learners. Continue reading
In a little more than a month, the new interns will arrive. Much like last year when I wrote “Intern Year is Over,” I greet this milestone with joy and relief – not because I am thrilled and excited for the interns to roll in, but because I am thrilled and excited to be DONE. WITH. SECOND. YEAR.
“Why?” the interested reader/grandma may ask. After all, if intern year is when you learn the byzantine system that is medicine at two different academic centers, second year is when you focus on your actual medical knowledge. Your procedural skills. Your team-based communication. Continue reading