Brainphreak

I forgot to describe what it’s like teaching the med students. In a word: satisfying. It lets me know that I’ve actually learned something in the intervening years since I was in their shoes. Also, they help me get my work done. The best thing about them, though, is that when I say things, they write them down. I’ve never had this happen to me before. It’s very flattering. Everyone should have one of these.

This morning, I picked up a patient who had been admitted overnight for massive facial swelling. Turns out, he had a crown on his left front tooth that came off at some point and was now infected and, by turns, infecting half his face. Ok, cool. This’ll be interesting. I grabbed my favorite med student and we went to check him out. I saved looking in his mouth for last, so I wouldn’t forget to listen to his heart and all the other basic important stuff. When it came time, I asked him to show us the infected tooth. He lifted his upper lip to reveal a tannish, pointed stump of tooth, but that’s not even the gross part. As I was angling to get a good look at the tooth itself, what can only be described as a blorp of stuff came out of the area where the former root of the tooth was. It was pinkish and kind of thick. It was all I could do to hold breakfast in. Bleah.

…that I’m grateful for the gift of my work. For being smart enough to learn how to really make a difference in others’ lives.

But I am infinitely grateful for my two healthy, gorgeous, sweet baby boys, who make my life a true joy.

I had a tough call night last night, with some very sick kids and very little sleep, but all the while I thought about Max and Theo and how lucky I am to be their mom. They really are the greatest gift I ever got.

This is the kind of thing that never happens on those medical shows. In fact, I think that’s probably because it’s mighty rare that it happens at all. My infectious disease team, which consists of me, a second year resident, and our attending, was consulted about a kid with pneumonia who’d been doing very well but was suddenly starting to spike fevers when they’d been planning to send him home. His chest x-rays and labs all looked the same, so what was up? ID team to the rescue!

We were looking over his chart, and my attending noticed that the boy had been on steroids for asthma during his hospital stay, which could easily suppress his fever. Great! This is a reasonable explanation, and it makes perfect sense. “Go in there and tell Dr. Roy that you figured it out,” Dr. Surasak says. Ha ha ha, that’s very funny, pretending the intern got it all figured out when the attending is the one who did all the work.

I headed into the room where the floor team was rounding on patients with Dr. Roy. Dr. Roy, I should mention, is my program director and, ergo, my boss. Unfortunately, the combination lock on the door stuck while I was trying to let myself in, so the rest of my team had to come help me get in. Before I could collect myself, I heard Dr. Surasak say, “Dr. Sheldon has figured out why your patient is spiking fevers.”

I did what now? Evidently, the whole “giving me credit for figuring it out” thing wasn’t a joke at all.

Hmmmm, how to play this. I went ahead and explained our theory. Dr. Roy was impressed. My fellow interns were impressed. I was in deep now. Do I say anything? I’m feeling awfully good about them being impressed. And I don’t want to upset Dr. Surasak by contradicting him in front of everyone. But what if this is one of those tests of character? Aaaargh!

By the time I’d puzzled over this in my head, the conversation was over and we were leaving. I went with plan B: graciously thank my attending for making me look good in front of my boss. He seemed happy and pleased with this and told me he didn’t need any more credit for good ideas. He’s kind of a funny guy, but fair enough. I felt better later when my senior resident confirmed that I’d handled it as she would have and that she was glad the lock on the door had stuck to give me that chance.

Picture this: it’s 9:30am on my second day of work. The loudspeaker comes on, “Pediatric Code Blue, Christ Hospital, Main Lobby.” The voice repeats it several times, but we’d started running before it finished the first time. We ran and ran and ran, because Christ Hospital is the grownup hospital and we’re at Hope, the children’s hospital. It wasn’t close, and I’m not in the best shape. Meanwhile, my senior resident twisted her ankle on the cute shoes she’d worn expecting an easy day and pens were flying out of my breast pocket as we hauled ass to save a young life.

My brain was doing something like this: “Ohmigod! It’s only my second day! I’m going to be part of this! I’m going to save someone’s life! That’s so awesome! Oh crap! I have to remember my CPR! Okay! Airway! Breathing! Circulation! I can definitely handle the chest compressions! That’s what I’ll volunteer for! Chest compressions! Right on!” And so on, except I started running low on exclamation points and high on “puff, puff, puff” as my large, postpartum behind hustled down the hall.

We rounded the corner and headed into the straightaway. I tried not to slow to a walk, as did my senior, whose feet may have been bleeding by this point. We were starting to hone our focus into a fine laser beam of rescue skills when one of our colleagues passed us heading the other way. “It’s a mock,” she announced bitterly. Words were said. Four letter words, and more than a few of them. See, a mock code is where they make sure that the correct responders show up and/or actually run a code on a mannequin. Fine, great, very important in a place dedicated to helping people in times of sickness. WOULD’VE BEEN NICE TO HAVE IN THE LOBBY OF THE CHILDREN’S HOSPITAL, SINCE ALL THE PERSONNEL RAN OVER FROM THERE!!! Seriously. If you’re going to fake die, do it in a place where the people equipped to fake rescue you are. It just makes sense.

Here is a true story from my second day of work.

I was sitting at the nurses’ station on the fourth floor looking up labs and vitals on my patients when I heard the floor secretary calling my name. “Dr. Sheldon?” she said, “I have a phone call for Dr. Sheldon. Has anyone seen Dr. Sheldon?”

I thought there was no way this could be me. Who would be calling for me on my second day of work, and who on earth would be calling me Dr. Sheldon?

My senior resident, that’s who.

This is the part of the story where Dan, when I was telling it to him, said, “But eventually you clued in and took the call.” Yeah. I’m afraid not. Instead, when my senior resident got to the floor and told me she’d tried to call but I must’ve stepped away for a minute, I was forced to use my infamous, noncommittal “Hmmmmm…” perfected over years of not having a good answer and truly hating to lie.

I’ll get there. Don’t worry. In fact, at the end of the day I remembered that the right response to the patient’s dad who asked me my name was, “Sarah Shel, uh, Dr. Sheldon.”

There are not enough o’s in smooth to describe my intern year thus far.

My first day on the floors was Thursday the 28th. Unfortunately, much like he was for my first day on the job, Dan had to be out of town. I was a bit nervewracked, but I got the boys to school and myself to morning report on time. In fact, because I’d been shooting for 7 instead of 7:30, I was quite early. I sat in a corner of the conference room (I love a corner, then your back’s to the wall on two sides…though you only have one back…I’ll have to think about that) and tried to look like I knew stuff about infectious diseases. That’s because I’m starting on the Infectious Disease elective rotation, not because I chose a topic at random. The half hour went by in a clammy, edgy kind of way and then we settled into morning report, which I was more comfortable with. Sadly, I was permitted only about 7 minutes of calm before my cell started to vibrate. Thank God I’d at least put it on vibrate. I looked at the caller id: “Max work.” Uh oh. I swiftly traversed the conference room and hit “answer” as I stepped into the hallway.

“Mrs. Sheldon?” said the pleasant woman from the daycare.
“Yes?” said I
“I’m so sorry to bother you at work…” said she.
“Then you should’ve called me Doctor Sheldon,” thought I (not to be snotty, but it would’ve softened the blow).
“…But Max has had very watery, explosive diarrhea with some black sesame seeds, did he have sesame seeds?”
“A poppy seed muffin, yes.”
“With sesame seeds in it, and our policy is that if he has another episode he’ll have to go home.”

Madre de dios. On my very first day! I pulled myself together and considered that he’d pounded a whole sippy cup of juice before heading into school. Sure! That could do it! He’ll be fine!

Just in case, I called my dad to make sure he could be on tap for an emergency swoop to the rescue. Indeed he could. And, sadly, indeed he was. At 11:00, the call I’d been hoping not to get came. Dad came and got Max, and all was well that ended well. It did, however, tie my stomach up in knots.

I should note, though, that my attending on the ID service is the nicest person ever and kept offering to let me go home if I needed to take care of my son. Furthermore, he let me go home at 2:00 anyway, prompting my father to ask what was wrong when I pulled up in the driveway. I told him I’d healed all the sick.