Crap.
Curtis just bought an altitude tent on Ebay wicked cheap for 'cross season.
That sounds like birth control as far as I'm concerned. I don't want to sleep in an effing tent.
I don't race bikes anymore. In 3 weeks when Phoebe starts kindergarten I am planning on getting my fat ass in shape with all that spare time, but within reason. The only thing I plan on racing to is the buffet table.
So my natural hematocrit at sea level when I was training and racing hard was always between 47 and 49, ALWAYS above the legal limit for women.
I'm just freaky that way.
Curtis runs in the high 30's. I always feel like I'm telling him he has cancer when I read him the numbers.
So I'm going to end up as a spinning class doper, rocking the hematocrit of 55.
All you other bitches get outta my way.
Monday, August 18, 2008
Tuesday, August 12, 2008
Rhode Island is the Belgium of New England
It's really gotten unbearable.
Where to begin.
I've been home for less than 24 hours.
There's a new detour sign off my highway exit that makes absolutely no sense.
I had to tell someone at work today that it wasn't okay to be verbally abusive to me. Hey I'm just the doctor, sorry to bother you with all these pesky questions and interrupt your cell phone call and argument with your family.
My lab coat came out of the dryer wrinkled and I refuse to iron or pay for a dry cleaner out of my own pocket. Someone suggested that I should put it in the hospital laundry. A week has gone by and even the one English speaking person who works in the hospital laundry couldn't tell me where my coat is. A real model of service and efficiency right there. It only has my name and fucking department embroidered on it.
Some creppy looking guy with a clipboard who looks like he is Vice President of the Water Sprinklers keeps writing down my license plate in the patient lot closest to the ER. I think I'm suppoesed to park half a mile away and take a shuttle. I'm trying to fuck with him by switching it up between 3 different cars. There's some really great retention of physicians right there. I can't wait 'til my boss gets their printout on my parking offenses and I get a scolding.
Tonight I took Damian to golf practice. I still can't tell the "normal" people in Pawtucket from the retards.
I cruised around with an open White Ale on the way home from golf-it isn't possible to be pulled over for any traffic offense in Providence no matter how badly you drive. I keep trying and they keep not pulling me over.
We attempted to engage in our favorite low class Rhode Island pasttime tonight-returning 6 months worth of empties to the packy in nearby Massachusetts.
The bottle room had just closed for the night.
Denied.
WTF???
Every time I come home it's more and more like the Bulgarian Embassy around here. The stupid leading the useless.
Where to begin.
I've been home for less than 24 hours.
There's a new detour sign off my highway exit that makes absolutely no sense.
I had to tell someone at work today that it wasn't okay to be verbally abusive to me. Hey I'm just the doctor, sorry to bother you with all these pesky questions and interrupt your cell phone call and argument with your family.
My lab coat came out of the dryer wrinkled and I refuse to iron or pay for a dry cleaner out of my own pocket. Someone suggested that I should put it in the hospital laundry. A week has gone by and even the one English speaking person who works in the hospital laundry couldn't tell me where my coat is. A real model of service and efficiency right there. It only has my name and fucking department embroidered on it.
Some creppy looking guy with a clipboard who looks like he is Vice President of the Water Sprinklers keeps writing down my license plate in the patient lot closest to the ER. I think I'm suppoesed to park half a mile away and take a shuttle. I'm trying to fuck with him by switching it up between 3 different cars. There's some really great retention of physicians right there. I can't wait 'til my boss gets their printout on my parking offenses and I get a scolding.
Tonight I took Damian to golf practice. I still can't tell the "normal" people in Pawtucket from the retards.
I cruised around with an open White Ale on the way home from golf-it isn't possible to be pulled over for any traffic offense in Providence no matter how badly you drive. I keep trying and they keep not pulling me over.
We attempted to engage in our favorite low class Rhode Island pasttime tonight-returning 6 months worth of empties to the packy in nearby Massachusetts.
The bottle room had just closed for the night.
Denied.
WTF???
Every time I come home it's more and more like the Bulgarian Embassy around here. The stupid leading the useless.
Monday, July 28, 2008
Dear PMS
What the hell? You again?
My Mirena IUD is clearly ceasing to spit out enough hormones because you're back. Last month about this time my tits felt like they were going to explode. I was so confused that I thought I was pregnant.
Since it's been 10 years since I had PMS I'd forgotten the hell that is you. Then brown gunk started collecting in my underwear. Oh yeah, periods. I forgot about that too. I don't even own tampons it's been so long. I was so slick on the birth control pills for the 5 years before I got knocked up that I hadn't had one of those since 1997.
Ok, it was wimpy, but it still sucked. At least my tits stopped hurting.
PMS, you are my sworn enemy. I remember the lost days when I was a teenager, in bed puking and bleeding through to the mattress, my pelvis in a vise. I remember that bathroom stall in Berlin when I got my first period in 9 months after weighing 95 pounds on the track team, thinking I was bleeding to death. My mother told me it was all in my head.
Funny. My head felt fine.
Even more unwelcome was the day when I was 19 when I puked at work, went home to bed on Motrin and Alice Cooper's "Only Women Bleed" came on the radio.
That was spooky.
Remember that stage when I had cramps on the start line and spent the first 20 miles strongly considering crossing the yellow line just to put myself out of my own misery? Then I bled through my chamois to my white Turbo saddle and still finished in the money? That was a real Uta Pippig moment.
PMS. You are mean. Period. You are gross.
As I type, PMS, my breasts are so engorged and sharp with pain I keep checking them to make sure there are not knitting needles sticking out of them.
I figured out after that BS last month in a couple days I'll get one of those wimpy old lady periods again.
This isn't funny anymore. Knock it off. I'm old.
My Mirena IUD is clearly ceasing to spit out enough hormones because you're back. Last month about this time my tits felt like they were going to explode. I was so confused that I thought I was pregnant.
Since it's been 10 years since I had PMS I'd forgotten the hell that is you. Then brown gunk started collecting in my underwear. Oh yeah, periods. I forgot about that too. I don't even own tampons it's been so long. I was so slick on the birth control pills for the 5 years before I got knocked up that I hadn't had one of those since 1997.
Ok, it was wimpy, but it still sucked. At least my tits stopped hurting.
PMS, you are my sworn enemy. I remember the lost days when I was a teenager, in bed puking and bleeding through to the mattress, my pelvis in a vise. I remember that bathroom stall in Berlin when I got my first period in 9 months after weighing 95 pounds on the track team, thinking I was bleeding to death. My mother told me it was all in my head.
Funny. My head felt fine.
Even more unwelcome was the day when I was 19 when I puked at work, went home to bed on Motrin and Alice Cooper's "Only Women Bleed" came on the radio.
That was spooky.
Remember that stage when I had cramps on the start line and spent the first 20 miles strongly considering crossing the yellow line just to put myself out of my own misery? Then I bled through my chamois to my white Turbo saddle and still finished in the money? That was a real Uta Pippig moment.
PMS. You are mean. Period. You are gross.
As I type, PMS, my breasts are so engorged and sharp with pain I keep checking them to make sure there are not knitting needles sticking out of them.
I figured out after that BS last month in a couple days I'll get one of those wimpy old lady periods again.
This isn't funny anymore. Knock it off. I'm old.
Sunday, July 20, 2008
alpha female sighting
I've fallen in with a social circle that calls themselves either "Patti's list" or "the nice girls." Patti started the list as an alternative to the mean girls. In one way or another all of us have at one time or another been a victim of the mean girls, and we just have no patience with it. It reminds me of trying to be friends with the Junior High cheerleaders, and going home crying every night. At some point you have to have some self-respect and realize they are the insecure losers, not you.
The mean girls are lead by a woman I referred to last year as "the alpha female." It's kind of funny because I think I said that once to the husband of her tennis partner, and it's taken off like wildfire, the husbands must have gossiped about it and tend to whisper it to me because they totally get what I'm talking about.
So last night I arrived late from work out to dinner with the tennis partner of the alpha female and her husband. I hate to say it but my dinner companions are in fact mean girls. I think they mean well, but sometimes they bulldoze. I tolerate them because our daughters are best friends. Alpha female sidles up to the table and starts chatting up my mean girl friend and her husband. Alpha female is completely invading my space, didn't acknowledge Curtis's or my presence and starts yacking on and on to my friends. I was so tired from my long day at work and now so irritated that it was all I could do not to walk out.
Unbelievable.
She may be able to crush my soul on the tennis court, and be incredibly rude, but I know in my heart that I can put her front wheel in the curb.
The mean girls are lead by a woman I referred to last year as "the alpha female." It's kind of funny because I think I said that once to the husband of her tennis partner, and it's taken off like wildfire, the husbands must have gossiped about it and tend to whisper it to me because they totally get what I'm talking about.
So last night I arrived late from work out to dinner with the tennis partner of the alpha female and her husband. I hate to say it but my dinner companions are in fact mean girls. I think they mean well, but sometimes they bulldoze. I tolerate them because our daughters are best friends. Alpha female sidles up to the table and starts chatting up my mean girl friend and her husband. Alpha female is completely invading my space, didn't acknowledge Curtis's or my presence and starts yacking on and on to my friends. I was so tired from my long day at work and now so irritated that it was all I could do not to walk out.
Unbelievable.
She may be able to crush my soul on the tennis court, and be incredibly rude, but I know in my heart that I can put her front wheel in the curb.
Friday, July 18, 2008
the tennis skort cameltoe
I'm not sure why women tolerate this.
I don't know if my ass is too big or too small, whatever, I'm just SICK of picking cameltoes and wedgies out of my bits and bobs.
I vastly prefer the 1970's granny panties with the little pockets.
I swear, I'm cutting all the compression shorts out of my tennis skirts and going Fancy Pants all the way.
I wouldn't want to be caught dead with them on for a date, but damn are they comfortable.
I don't know if my ass is too big or too small, whatever, I'm just SICK of picking cameltoes and wedgies out of my bits and bobs.
I vastly prefer the 1970's granny panties with the little pockets.
I swear, I'm cutting all the compression shorts out of my tennis skirts and going Fancy Pants all the way.
I wouldn't want to be caught dead with them on for a date, but damn are they comfortable.
Tuesday, July 15, 2008
stealing pennies from homeless people
I'm one of those people who loves finding money in the street.
I love it so much that Curtis put pennies in the driveway just to make me happy.
I imagine some 400 pound mouth breather too obese to bother bending over for a penny.
It's a small victory, and I know I'm penny wise and pound foolish.
Last night I went in the room to evaluate an ER drunk I've known for 20 years. He's a big guy and depending on his mood he scares the shit out of me.
So I went in the room and he was completely passed out drunk, pretty much his usual pattern the first few hours he's in the ER.
On the floor right next to his stretcher was a nickel.
It could have been his nickel, maybe not, but now it's mine.
Is it okay to steal a nickel from a homeless person?
I love it so much that Curtis put pennies in the driveway just to make me happy.
I imagine some 400 pound mouth breather too obese to bother bending over for a penny.
It's a small victory, and I know I'm penny wise and pound foolish.
Last night I went in the room to evaluate an ER drunk I've known for 20 years. He's a big guy and depending on his mood he scares the shit out of me.
So I went in the room and he was completely passed out drunk, pretty much his usual pattern the first few hours he's in the ER.
On the floor right next to his stretcher was a nickel.
It could have been his nickel, maybe not, but now it's mine.
Is it okay to steal a nickel from a homeless person?
Sunday, July 6, 2008
I'm taking suggestions: part deux
I played big girl tennis today-lost 3 sets but looked good trying in my baby doll tennis dress with the red granny panties.
Here's my problem. I need a country club matriarch nickname, like Pookie or Sugar. Today I played against a woman who goes by "Birdie." I'm not kidding.
So I'm open for suggestions on the country club nickname. It has to evoke idle time spent drinking gin and tonics courtside, an obsession with needlepoiint, and an obnoxiously rich husband.
Here's my problem. I need a country club matriarch nickname, like Pookie or Sugar. Today I played against a woman who goes by "Birdie." I'm not kidding.
So I'm open for suggestions on the country club nickname. It has to evoke idle time spent drinking gin and tonics courtside, an obsession with needlepoiint, and an obnoxiously rich husband.
Saturday, May 24, 2008
The Get Down Countdown
More thoughts on my 25 year college reunion:
I was in a crazy senior dorm in college, Pearsons Annex. There were 13 of us in the most desirable dorm on campus. I had a conversation this evening with Jan "Scoop" Snyder about our escapades.
My favorite Pearsons Annex activity:
At the end of our weekly dorm meetings we would review (drum roll please) The Get Down Countdown.
The Get Down Countdown was a scoring system for our sex lives. Here's how it worked:
Making out: 1 point
Home plate: 3 points 1 scratch mark plus a solid black box
Somewhere between first and home: 2 points (scratch mark plus a dashed black box)
Too intoxicated to recall specifics: 2 points (scratch mark plus a dashed line black box and question mark)
Amherst: purple points
Dartmouth: green points
Harvard: crimson points
All others: black points
A maximum of 9 points could be earned per sex partner, per person, so monogamous competitors couldn't win the game by having regular sex with their longterm boyfriend, but they could get on the board.
We had our own term for sex. The traditional male oriented terms such as nailing, banging, screwing were anathema to us, so we preferred "strapping", i.e. strapping one's legs around a hot dude. Our favorite comment when overworked: "I'd rather be drunk and strapping."
We had sexy code names to protect our identity in case someone found the chart. Mine, since I was a bike racer was "Pump."
I can't say I ever strapped anyone simply to raise my ranking, my score was just an honest reflection of what I was doing anyway.
I jumped to an early lead in September which held until the end of the fall semester by doing the following:
1) flying in my Marine Corps boyfriend for the first weekend: 9 points but only black points
2) reuniting with my freshman year boyfriend from Amherst: 9 purple points
3) finally strapping that crew guy from Harvard who drove me nuts emotionally all year and for several years afterwards. I got an A in poetry writing second semester because of the torture: 9 crimson points
Unfortunately, and unknown to me at the time I was already maxed for the year, and fell in the category of monogamous also-rans, even though I had 3 going simultaneously. I was way too busy juggling 3 guys, premed, rowing and cycling to put any effort into one-nighters. Even the townie lumberjack from Junior year got the cold shoulder.
I thought I was in good shape but I was overtaken by a competitor who got drunk at a Christmas party and made out with 8 guys. We argued vociferously but witnesses at the party verified that these were all slutty kisses.
After the winter break, the competition became way out of my league. The other girls had a taste for Dartmouth flavor, and we had to implement the dashed line connecting duplicated partners among different competitors.
One girl had a 3 way on acid in a Winnebago in March. No way could I compete with that. Drunk and strapping was one thing, but I could never emotionally handle mixing drugs and sex. If I was going to an Amherst art party for the evening, I would disable (leave my diaphragm at home).
It became a tangled web as the year progressed, and I was left in the dust. I finished in the middle of the pack.
xxoo
Pump
I was in a crazy senior dorm in college, Pearsons Annex. There were 13 of us in the most desirable dorm on campus. I had a conversation this evening with Jan "Scoop" Snyder about our escapades.
My favorite Pearsons Annex activity:
At the end of our weekly dorm meetings we would review (drum roll please) The Get Down Countdown.
The Get Down Countdown was a scoring system for our sex lives. Here's how it worked:
Making out: 1 point
Home plate: 3 points 1 scratch mark plus a solid black box
Somewhere between first and home: 2 points (scratch mark plus a dashed black box)
Too intoxicated to recall specifics: 2 points (scratch mark plus a dashed line black box and question mark)
Amherst: purple points
Dartmouth: green points
Harvard: crimson points
All others: black points
A maximum of 9 points could be earned per sex partner, per person, so monogamous competitors couldn't win the game by having regular sex with their longterm boyfriend, but they could get on the board.
We had our own term for sex. The traditional male oriented terms such as nailing, banging, screwing were anathema to us, so we preferred "strapping", i.e. strapping one's legs around a hot dude. Our favorite comment when overworked: "I'd rather be drunk and strapping."
We had sexy code names to protect our identity in case someone found the chart. Mine, since I was a bike racer was "Pump."
I can't say I ever strapped anyone simply to raise my ranking, my score was just an honest reflection of what I was doing anyway.
I jumped to an early lead in September which held until the end of the fall semester by doing the following:
1) flying in my Marine Corps boyfriend for the first weekend: 9 points but only black points
2) reuniting with my freshman year boyfriend from Amherst: 9 purple points
3) finally strapping that crew guy from Harvard who drove me nuts emotionally all year and for several years afterwards. I got an A in poetry writing second semester because of the torture: 9 crimson points
Unfortunately, and unknown to me at the time I was already maxed for the year, and fell in the category of monogamous also-rans, even though I had 3 going simultaneously. I was way too busy juggling 3 guys, premed, rowing and cycling to put any effort into one-nighters. Even the townie lumberjack from Junior year got the cold shoulder.
I thought I was in good shape but I was overtaken by a competitor who got drunk at a Christmas party and made out with 8 guys. We argued vociferously but witnesses at the party verified that these were all slutty kisses.
After the winter break, the competition became way out of my league. The other girls had a taste for Dartmouth flavor, and we had to implement the dashed line connecting duplicated partners among different competitors.
One girl had a 3 way on acid in a Winnebago in March. No way could I compete with that. Drunk and strapping was one thing, but I could never emotionally handle mixing drugs and sex. If I was going to an Amherst art party for the evening, I would disable (leave my diaphragm at home).
It became a tangled web as the year progressed, and I was left in the dust. I finished in the middle of the pack.
xxoo
Pump
Thursday, May 22, 2008
Guest blog by Parke: Dawn's 25 year college reunion is tomorrow
By the way - I have a suggestion for your reunion:
When they give you the name tag to fill out - you know, the one that starts with the preprinted "hello, my name is"...Well, you just fill in:"Irrelevant. All you need to know is that I'm a successful MD, former pro athlete and musician, caring mom, and I get my pipes cleaned every night by a trophy husband 8 years younger. Who the fuck are you?"
You can have an arrow pointing to Curtis a la "I'm with stupid" if you like.
God bless you Parke. This really puts it all into perspective.
When they give you the name tag to fill out - you know, the one that starts with the preprinted "hello, my name is"...Well, you just fill in:"Irrelevant. All you need to know is that I'm a successful MD, former pro athlete and musician, caring mom, and I get my pipes cleaned every night by a trophy husband 8 years younger. Who the fuck are you?"
You can have an arrow pointing to Curtis a la "I'm with stupid" if you like.
God bless you Parke. This really puts it all into perspective.
Wednesday, May 21, 2008
in search of the perfect eyebrow high
My eyebrow situation has been getting out of control. As much as I like freaky Puerto Rican numerologist West End Ana, she keeps fucking up my eyebrows. Last time she took some length off my right eyebrow and that was the last straw. I've never had to pencil in length and I'm not about to start.
I live in the high rent district and and have been secretly slumming my salon stuff at my friend's salon in the West End. A girl has to save money somewhere.
Well screw that. I had a full acetone East Side French pedicure yesterday. It's the first one this season that isn't fucked up and it was worth every penny. Damn my feet looked pretty in my stilettos last night.
So today I went in search of the perfect eyebrow high and I know where to get it. Big Scary Karen.
Under the 300 pound exterior is a very sweet girl with the fine motor control of a brain surgeon and the visual judgment of a master sculptor. She moves around alot so at the end of my bike ride this morning I went to the last salon where I knew she worked. She was one street over and about 10 streets down. I stopped by in full kit to try to book an appointment. Her book was stacked but she had just finished up a facial early and took me right in.
Psych. She pulverized my moustache and soul patch too.
So other than the redness and swelling, I look pretty.
Tomorrow: dermatologist.
Why the sudden paralytic vanity?
Friday/Saturday: College 25th reunion.
I live in the high rent district and and have been secretly slumming my salon stuff at my friend's salon in the West End. A girl has to save money somewhere.
Well screw that. I had a full acetone East Side French pedicure yesterday. It's the first one this season that isn't fucked up and it was worth every penny. Damn my feet looked pretty in my stilettos last night.
So today I went in search of the perfect eyebrow high and I know where to get it. Big Scary Karen.
Under the 300 pound exterior is a very sweet girl with the fine motor control of a brain surgeon and the visual judgment of a master sculptor. She moves around alot so at the end of my bike ride this morning I went to the last salon where I knew she worked. She was one street over and about 10 streets down. I stopped by in full kit to try to book an appointment. Her book was stacked but she had just finished up a facial early and took me right in.
Psych. She pulverized my moustache and soul patch too.
So other than the redness and swelling, I look pretty.
Tomorrow: dermatologist.
Why the sudden paralytic vanity?
Friday/Saturday: College 25th reunion.
Tuesday, May 20, 2008
end the recession! get a pedicure!
The owner of the Cambodian nail joint down the street says business is down.
Ladies, let's band together to fight the recession and thumb our noses at murderous Republican 1970's foreign policy at the same time.
Get a pedicure!
Send your husbands to get their backs waxed while you're at it!
Ladies, let's band together to fight the recession and thumb our noses at murderous Republican 1970's foreign policy at the same time.
Get a pedicure!
Send your husbands to get their backs waxed while you're at it!
Thursday, May 15, 2008
you can't make this shit up
Today at work I got bodychecked into the nurses station and called a bitch by a deaf-mute drug addict.
Tuesday, May 13, 2008
why Obama will be our next president
I'm not really into roleplaying in the bedroom, but last night I proposed a round of "Low Self-Esteem College Girl and Lacrosse Captain."
I understand from a campus nurse that girls are handing out unreciprocated blowjobs to jocks to climb the social ladder. This is why women under 30 won't vote for Hillary.
I understand from a campus nurse that girls are handing out unreciprocated blowjobs to jocks to climb the social ladder. This is why women under 30 won't vote for Hillary.
Monday, May 12, 2008
wow...this is embarrassing
I was climbing a local hill by myself and singing loudly along to Marvin Gaye's "Let's Get It On" on my Ipod.
The men's group ride rolled past me.
Umm, hi guys....
Note to self: I really need to be climbing a bit harder so I'm rendered incapable of sound.
The men's group ride rolled past me.
Umm, hi guys....
Note to self: I really need to be climbing a bit harder so I'm rendered incapable of sound.
Friday, May 9, 2008
Best job EVER!!!
Endoscopy suite recovery room nurse.
Why?
Because farting always cracks me up no matter how old I get.
In the recovery room you get to point and laugh at unconscious people farting loudly all day long after colonoscopies.
Plus if you have gas just stand next to one of them, let fly, and blame it on them.
Why?
Because farting always cracks me up no matter how old I get.
In the recovery room you get to point and laugh at unconscious people farting loudly all day long after colonoscopies.
Plus if you have gas just stand next to one of them, let fly, and blame it on them.
Thursday, May 8, 2008
small town country doc vicissitudes
It's a weird adjustment doing the small town doc thing. Every day I hear secondhand about someone I took care of, like, "My daughter was drunk and smashed her finger in a car door Saturday night and you fixed it." People know about me before I meet them. I called one of the docs to admit a patient and he started telling me his patients, my in-laws, told him I had started working there.
The nurses at the small town ER call me "the Shit Magnet" because someone hardcore crazy sick usually comes in whenever I'm on. I've always had a white cloud so I haven't accepted the shit magnet label yet.
I'm used to a complete disconnect between my work life and social life. Not here.
The weirdest of all happened Monday. There was a lady who fell hiking and hurt her ribs. She had come in Sunday and was told she bruised her ribs and prescribed pain medication. She had returned because the pain was worse and she was short of breath. I walked in the room and it was someone I know well from the ski hill. Up to that point she had no idea what my day job was.
She was in extremis and I couldn't hear breath sounds on the right. This meant she had dropped a lung. I ordered a chest X-ray and ran over to radiology to review her X-ray from the day before. It had been read as negative by the ER doc on duty, but still unread on the radiologists desk. We looked at it together and a small pneumothorax was present. It was small enough that it probably would have been watched as an outpatient, so not the most egregious miss, but still a miss. I always take it personally when I'm the one who missed it.
The new X-ray was much worse. The lung was so deflated that she was starting to get tension pneumothorax, a life-threatening emergency. I heard that the surgeon on call had left the hospital. We tried his office, the OR, his house and his beeper and nobody could find him.
I had to pull the trigger. Dilly-dallying any longer would have killed her. Ideally a pigtail catheter should be used but I've never done one, so I opted for the old school chest tube, which I've done hundreds of times in the ghettos of Philly and Providence. I've been living in a pay-for-performance world for the past few years, so I've been farming out the chest tubes to PAs and surgeons lately in the interest of time management. I do them maybe once every couple years now.
I will never get over putting in chest tubes. You're really stabbing someone in the chest in slow motion, and you have their life in your hands.
The last one I did the patient and his brother were counting the rosary. It was surreal.
There's a point in chest tube insertion where you use blunt forceps to push through the rib muscles and into the plueral space. No matter how much sedation and local anaesthetic you use, it still hurts the patient like a bastard. In tension pneumothroax there is a dramatic woosh of air as the tension is released when you get into the pleural space.
So I'm stabbing this lady I know, and she's talking to me about my kids inbetween groans. She trusts me completely, and I'm scared to death.
Woosh. I'm in.
I got the chest tube in and she immediately looked and felt better. The lung was back up on the chest X-ray.
The surgeon had been on an afternoon bike ride and couldn't hear his beeper.
This was one of those moments I longed for when I applied to medical school, the opportunity to intervene in badness and fix it. To do this for someone I know socially is an unbelievable honor.
I think I'm going to hear all about this at the ski hill.
The nurses at the small town ER call me "the Shit Magnet" because someone hardcore crazy sick usually comes in whenever I'm on. I've always had a white cloud so I haven't accepted the shit magnet label yet.
I'm used to a complete disconnect between my work life and social life. Not here.
The weirdest of all happened Monday. There was a lady who fell hiking and hurt her ribs. She had come in Sunday and was told she bruised her ribs and prescribed pain medication. She had returned because the pain was worse and she was short of breath. I walked in the room and it was someone I know well from the ski hill. Up to that point she had no idea what my day job was.
She was in extremis and I couldn't hear breath sounds on the right. This meant she had dropped a lung. I ordered a chest X-ray and ran over to radiology to review her X-ray from the day before. It had been read as negative by the ER doc on duty, but still unread on the radiologists desk. We looked at it together and a small pneumothorax was present. It was small enough that it probably would have been watched as an outpatient, so not the most egregious miss, but still a miss. I always take it personally when I'm the one who missed it.
The new X-ray was much worse. The lung was so deflated that she was starting to get tension pneumothorax, a life-threatening emergency. I heard that the surgeon on call had left the hospital. We tried his office, the OR, his house and his beeper and nobody could find him.
I had to pull the trigger. Dilly-dallying any longer would have killed her. Ideally a pigtail catheter should be used but I've never done one, so I opted for the old school chest tube, which I've done hundreds of times in the ghettos of Philly and Providence. I've been living in a pay-for-performance world for the past few years, so I've been farming out the chest tubes to PAs and surgeons lately in the interest of time management. I do them maybe once every couple years now.
I will never get over putting in chest tubes. You're really stabbing someone in the chest in slow motion, and you have their life in your hands.
The last one I did the patient and his brother were counting the rosary. It was surreal.
There's a point in chest tube insertion where you use blunt forceps to push through the rib muscles and into the plueral space. No matter how much sedation and local anaesthetic you use, it still hurts the patient like a bastard. In tension pneumothroax there is a dramatic woosh of air as the tension is released when you get into the pleural space.
So I'm stabbing this lady I know, and she's talking to me about my kids inbetween groans. She trusts me completely, and I'm scared to death.
Woosh. I'm in.
I got the chest tube in and she immediately looked and felt better. The lung was back up on the chest X-ray.
The surgeon had been on an afternoon bike ride and couldn't hear his beeper.
This was one of those moments I longed for when I applied to medical school, the opportunity to intervene in badness and fix it. To do this for someone I know socially is an unbelievable honor.
I think I'm going to hear all about this at the ski hill.
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