Sunday, July 24, 2005

PTT

“What do you mean a PTT made you anxious?”
“Well, I just never had to face that kind of pressure before”
“That kind of pressure? Wait until it’s your post-call day and you’re exhausted and the admission from last night is going down the tubes and you can’t even remember your own name”
“That’s too much for me”
“THAT’S TOO MUCH? But you’re going into Emergency Medicine”

The look on the face of my intern made me realize just how innocent she really was, how little she knew and how little she worried. Still, no battle scars. The reason for my anxiety is that I realize things can get out of hand rather quickly. When complications happen they usually happen suddenly and only experience reveals the warning signs. The eye cannot see what they brain does not know. My intern has seen nothing yet.

I left her there on our post-call day after I saw all our patients. Helped her with a few notes and then I decided that my dues were already paid and that staying late on a post-call day is an intern’s job. I have no right to rob her of this experience.

On my way home the pager went off. It was the fourth floor and the lack of typical warning signs on the face of the beeper caused me to believe it was another nurse trying to reach me when she should be calling my intern. I had no way of calling back now and so I continued home. After arriving at home I found out that the patient from last night decompensated. I hear it was quick and chaotic. I also heard that my intern panicked. That she wasn’t ready for this and that the patient was rushed to the unit and later died.

The news didn’t surprise me. It was a patient who was really sick and it was certainly a possibility that she would crash. Somehow though, I don’t think my intern realized what I meant. Tomorrow she will.

At home I played with Jordan after not having seen her awake for nearly a week. And when the time came to bath her, feed her and put her to sleep I jumped at the opportunity. It was Jordan and I sitting in the spark of the nightlight in her bouncer. She was clean and sucking on her bottle and my thoughts waned and I remembered my intern. She is home now and she’s tired and her new life just smacked her in the face.

She’s wondering if this is really what she wants to do with her life now. Can she endure like this? Can she be a witness to such tragedy and be critical at critical situations. She is double-guessing everything she did today and likely herself.

As I sat there feeding Jordan I thought of my tortured intern. She must be going through shock but it will eventually make her stronger. But its misery now and it’s something she must experience. My intern was in hell and I looked down at Jordan and thought about the patient from the fourth floor. We were both in Heaven.