Monday, March 17, 2008

24 Things (Vol. 5)

Abe & Ande & Ty,

As preface, this list of 4 is all about my job, since I’ve spent the most time actively learning about it this year.

17. Twelve hour shifts mess with the mind. Suddenly, it believes that cafeteria food is delicious. Working 5 days a week is one step above indentured servitude and two steps above slavery (madness to only have 2 days off). Down-time is as illusive as mermaids, substantial tax returns, albino elephants and the yeti. Thing learned… when you work, you work long and hard. You eat a lot of soup and potato pearls. You pray each night you won’t spend the whole night dreaming about work.

18. This year I’ve learned how to phrase all statements as questions. Examples: “Dr. _____, don’t you agree Mr. _____ should be getting this dose of Cardizem?” or “Dr. ______, why don’t we first order a chest x-ray for Ms. ______ to assure her chest tubes are even positional?” A question is a magical thing. It presents an idea gently. It provides a compromise for a large ego. It encourages a person to think in a different direction. It prepares you for answering correctly on Jeopardy. On a side note, 90% of my patients all watch the same shows on TV. Every 7:30 pm everyone watches Jeopardy. USA will continue to have great ratings as long as they still show the Walker, Texas Ranger reruns. Most of my incarcerated patients watch either ultimate fighting or movies like Ever After, Sleepless in Seattle or Big. What people watch on TV… fascinating. Thing learned, Alex Trebek is in a position to be the ultimate manipulator.

19. Sometimes when CPR is done on a patient, ribs are cracked. People that've always wondered if they have it in them to throw a good, hard punch; people that also secretly wondered if maybe they could be a Million Dollar Baby are abruptly made aware of a simple fact. Muscle size is not always indicative of strength. Those same people then have to go find that patient a few days later and apologize for the cracked ribs. Though they feel sick their epiphany on the subject of strength came at that awkward time, these people still smile a little wider when they consider that maybe this will be the year they defeat their brothers in arm wrestling. Thing learned, sometimes Helena puts it best “and though she be but little, she is fierce.”*

20. My job has transformed my mind into a pendulum. I alternate between seeing a person as a human being versus a scientific collection of systems that are incredibly volatile. This is especially the case during a Code. In the beginning they are a person, then suddenly they swing over into systems; systems that need epinephrine, atropine, dopamine, an ambu bag and fluids. In the middle of “system calculations” I notice a ring on a finger, see painted toenails or feel a bounding pulse, and then just as suddenly this is a person again. One minute, a collection of systems that quit working together, and then a person for whom you are removing IVs and changing the linens, so the family can view them and say their goodbyes. Thing learned, every day I feel increasingly in awe of my career choice.

* Shakespeare’s A Midsummer Night’s Dream

Monday, March 10, 2008

Humor in Uniform

Mrs. Lambert, my piano teacher in 8th and 9th grade, subscribed to two magazines… the Reader’s Digest and Highlight. In 8th grade (sitting there waiting for Abe to finish with his piano lesson) I was strictly a Highlight reader. More accurately, I never read anything; I just turned to the “can you find these objects hidden in the picture” section. However, once I started 9th grade, I decided it was time I took the BIG step. I was in high school now, practically an adult; I needed to start reading Reader’s Digest. At first it was painful. I didn’t want to read about “Everyday Heroes” or risk factors for congestive heart failure and colon cancer. Good thing I kept flipping through, because then I found “Humor in Uniform” and “All in a Day’s Work.” Unfortunately, it’s ten years later and I still skip past most of the stories and head straight for those two sections.

In honor of my giant plunge towards adulthood that didn’t make it past the humor sections… here is my “Humor in Uniform.”

1. When Abe switched from BDU’s (Battle Dress Uniforms) to ACU’s (Army Combat Uniforms) this past year, he got to laughing when he told me their patches are now held on by Velcro. This was funny because people kept losing patches when they were doing training that required they crawl on the ground. Suddenly a captain loses all his rank because he's crawling in the grass. I reminded him that this could be a good thing. All he has to do is be the one crawling behind the captain and suddenly it is a lot easier to “pick up” rank (pun was most absolutely intended). Anyway, a week or two after we were talking about this, he sent me this picture. It turns out there’s another perk to wearing the new ACU’s.
2. Ty’s first year at the Air Force Academy, I e-mailed asking how his day went. He replied back with this:
A USAFA cadet lent an upperclassman his paintball gun and CO2 bottles for the afternoon. The gun and bottles were in a cardboard box with his name on it and held together with duct tape. As the borrowing cadet was carrying a bunch of stuff up from the barracks lobby to his room, he couldn’t carry the box with the paintball gun in it, so left if on the pool table and planned on coming right back down to get it. Another cadet walking by saw the box. This is all innocent enough except the owning cadet’s last name is BOOM. The box was reported to security, and security stated they found an UNATTENDED box, wrapped in DUCT TAPE, with BOOM written all over it. After a couple of hours, all 1,000 cadet were allowed back in their rooms after the contents of the box and its story were discovered. This all happened at 2200. It was dark, cold and all the other buildings were closed and locked up.

3. I think this picture stands on its own. I’ve already written about how many squirrels there are at West Point. Well, now there is one less. This squirrel single handedly proves Darwin’s idea of “survival of the fittest/smartest.” I guess he forgot to hibernate. What I really want to know is how he got in this position… laying on his belly with arms and legs outstretched?