Pushing Back On Pushback

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.

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An ER Doc’s Primer On The COVID Vaccine

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.)

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The COVIDpocalypse is Here and I’m Coping By Writing Again

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.

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Coronavirus FAQ

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

Third Year Sucks Less

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.

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EM Senior

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

Not My Hill

The journey through second year of residency is an interesting one. As I’ve mentioned before, we are tasked with two major, new responsibilities: performing most procedures and seeing a much greater volume of patients. We’ve all gone through a substantial adjustment period. It’s been hard.

One of these journeys is toward two, or greater, patients per hour. I hit this milestone rather infrequently. In fact, it is about as likely for me to achieve this as I am to win a game of Oregon Trail. It is far more likely that I will die of dysentery, or make it no further than Fort Collins before my oxen quit on me. Continue reading

Discharge to Home

When you go to the ER for medical care and are discharged home, almost every ER will send you home with “discharge instructions.” In a perfect world, this would contain information that is actually relevant to the patient’s medical condition and cover what was done in the ER, the results of lab tests and imaging studies, and “return precautions” – when to come back to the ER. Continue reading