Transplant

This is a new thing for me. I'm not sure how I feel about the whole thing so far.

We "did a donor" tonight.

As in, a gentleman who had had a massive stroke a few days previously, and who had been declared brain dead shortly after that time, by very rigorous criteria, and whose family had requested in their grief that his organs, if possible, be used to help other people, had his liver and kidneys retrieved this evening.

As I write this, there is a man having that liver placed in his body to replace the one that has been failing him. Two people are being woken from a sound sleep and told that they may be able to stop having dialysis and go back to something like a normal life.

And though I know that the gentleman in question had died and the machines were breathing for him, it was still disturbing to see doctors do things to his body that would certainly kill him. I know that makes no sense.

An organ donation is a great gift. I signed my donor card years ago. This unsettled feeling doesn't make me re-think that. I just feel unsettled.

Saturday Night

This has been a great week:

Sorting out CaRMS documents. I have to PROVE that I am a Canadian, and that I did an undergraduate degree, and that I passed my ACLS. I didn't bother to prove that I can speak French, that's easy enough to prove in person. Du fonne, toujours.

For some reason they also wanted a photo of my smiling mug.

So that's done. The application and schools selection and letters are just about finished. Still panic-inducing every time I log in. Because what if I don't get accepted to a surgery programme? I can't picture myself doing anything else at this point, I have the "surgery bug" (as one of my mentors put it) so badly.

Working on a research project, just silly grunt-work, but someone has to do it. Chart reviews, not much judgement required. Nice to be involved with anything to do with trauma.

Got my airline tickets to England and Africa. My husband's uncle is getting married. And then I am off to Malawi. To deliver babies and do gyne clinics in a very badly underserved area with a doctor who has been there forever despite her annual threats to give it all up and move back to the States. She's a star.

Bought car parts on ebay. And earrings. And The World According to Garp on DVD.

Caught up on some sleep. Studied a little. Start in hepatobiliary on Monday, and am a smidge nervous.

Grand rounds

Wowee, this whole blogging thing.

If you want to see some excellent medical blogging, click the title line to visit Grand Rounds 3:5. It can get really late when you're enthralled. I especially recommend Tundra Medicine Dreams.

Money

I don't think I'm in it for the money.

It would, on the other hand, be nice to be able to afford to pay off my ginormous debt and buy a house, like a normal person.

So, I am working on my CaRMS, and it tells me what I will earn in various parts of the country as a first-year medical resident. This is salaried, for an 80-hour workweek, with moonlighting illegal here in QC, though not necessarily elsewhere.

And I was reading the papers, about the cols-bleus in TMR with a 36-hour week (paid hourly, with opportunity for overtime) demanding an 11% raise, and throwing a hairy fit when they were refused.

You know what? Even with no overtime, their gross salary is $5000-$12000 more than what I will earn, wherever I go. And, of course, if I was to stay here, once I finished my residency I would have to pay the government $300 000 to stay.

Remember that when you have to wait six months to get your gallbladder out.

Molly

Meet the newest of my nieces, Molly.

I don't think she has a middle name yet. Her daddy suggests "Ed's a nice name...."

And her uncle, my husband, continually insists that "Molly James" has a certain ring to it.

And of course, little Molly will need to be aware that if she had been born into a more traditional family she may well have gotten stuck with her grandmother and great-grandmother's names. No disaster, you might think. Oh yeah? How would you like to be called Verna Gertrude?

Personally, I think if you are going to name your child something out of a fifties rock tune, you may as well go whole hog and call her Molly-Sue. Which, if you ask me, is pretty darn cute. And also, it includes the name of another aunt, Ed's sister Susan.

(And she is, isn't she? Pretty darn cute, I mean.)

***** Congrats to Ed and Amy *****

Trauma draws to a close

Yesterday I was rounding on a group of patients. There was one young lady I went to see who is generally catatonic, but recently her meds have been changed, and she seems to be responding well.

So I tap on the door. I can see very well what she's doing, and when she notices me, she doesn't bother to stop.

"Hello, Mrs. B, how are you."

"I'm okay." She looks at me, then looks at her finger. "I'm just picking my nose."

"Mmmhmmm."

Well, what can you say?

*****

My trauma rotation has been incredibly interesting. I learned a lot about my city. I learned that a lot of trauma is predictable and preventable, and that carelessness can easily cost a life.

I liked not having to read the newspapers.

I liked being part of the team that took care of the hockey players: "Did you see that hit?! I guess we'll be meeting that guy at rounds in the morning... cool."

I loved taking care of patients in acute, unexpected situations. I loved that they got better fast and went home. I loved the decisiveness, the confidence in the training.

I'm on call tonight. Wish me luck.

Unsure

I don't know how you are supposed to feel when you are told a horror story by the police, and then you have to go in and provide top notch care for the person who they tell you is the creator of that horror story.

What we have to do is remember that maybe, just maybe the story is missing some details, and maybe things aren't as they seem. We have to remember that the person in front of us, monster or not, is still a person. We have to remember that even if the story is true, this person should be allowed a trial, and that we are not the judge or jury.

You know what? Never mind all of that. When you are in the middle of a trauma, your training takes over and you think about the circumstances later.

But it is still difficult.

Early morning fun

So, I try to arrive a little early most days to make sure the patient list is accurate and everything is ready for us to round.

A couple of days ago I did just that, and ten minutes before everyone else was due to arrive, I was riding alone in the elevator watching the floors pass by.

*ping* and the elevator stops on the ninth floor. My colleague peers into the elevator, and says "Oh, good, it's you." He's been on call all night and looks harassed.

"Have a good night?"

He grins and hands me two phones and two pagers. "Here, take all of this; Ali and I are heading into surgery. There's a guy who got stabbed in the heart and he's bleeding again... give them to the team taking over."

"Cool! Have fun!" The doors glide shut and I keep going up. And as I arrive where we round and note that our team has not yet arrived, you can guess what happens:

"beep, beep, ring, beep ring!!!!"

GAH! Trauma!!

All I could think was oh-no-I-have-everyone's-pager-how-on-earth-will-they-know-there's-a-trauma-I-am-just-the-medical-student-I-think-we-may-be-needing-a-tad-more-backup-than-that!!!

Life is fun. Sometimes it really does like to bite you in the ass at 6:56 am.