Better days

I will give a little narrative of my day. Not because it was one of those great days that you will remember for years to come with a smile, but simply it is easier to find things to laugh about than to cry.

I am on call this weekend. I am not actually in house on call this weekend; I am just covering Thoracic. Usually this means that I go in each morning, round on my patients and then go about my business for the rest of the day. My life is seldom that simple. I went in this morning to round on my four relatively boring patients, and ended up spending 4 hours. We had 3 consults that had to be seen, and time has a way of escaping at the hospital.

I left work - made a quick run to Target and then headed home. I received LOST 4th season for Christmas and am trying to rewatch the old seasons to remind myself of things that I had missed. Therefore, I was happily camped on my living room floor putting my LOST puzzle together from Season 1. Then it started. A patient that I had just met that morning - NOT on my service - had a syncopal episode. For some reason, they wanted me to evaluate her. I took a trip back to the hospital - stated she did not drop her hemoglobin from anything that I could fix, and suggested a CT scan. I returned home.

Two hours later, I am told that she now has free air in her chest. Free air is a surgical expression that is completely ridiculous. It simply means that air exists somewhere in the body outside of the boundaries of where it belongs. It has escaped "free". It usually portends some form of surgical emergency - bowel perforation, lung collapse, esophageal perforation, etc. It almost always requires some type of intervention that is quite expensive. Regardless, I now have to go back to the hospital a third time to evaluate.

I was muttering quite a bit as I got ready to leave. It is not that I had huge wonderful plans, but it is cold outside and I was comfy on the floor with my new blanket. I got downstairs, dropped off my rent and walked out to the parking deck. This is where I encountered problem one - no car keys. Correct, I had walked out of my apartment without my keys. GREAT! I have to ring the bell to get back into the building - it automatically locks and you need a key fob to get in - and head to the front desk. I am told that the on site maintenance man is currently not on site. It will take at least an hour to get me back into my apartment. Free air waits for no one, so I caught a cab to the hospital.

Once there I head to the ICU where the patient now is living. She looks great, but definite problems exist with her CT scan. It becomes obvious that she at least had an esophageal perforation recently, and I need to see if she still has an opening. I take out my phone to call my attending, and it dies. Not battery low death - electronic black out dead. Usually not a huge problem. I am the nerd with two phones (work and personal). Of course, my other phone is sitting right next to my car keys - at my apartment.

Eventually I am able to contact all the right people and arrange for the study. Even though I have ordered an emergent study, I am not naive enough to think that it will happen in under four hours. Therefore, I decide to head home and pick up my car and my working phone. I only had my hospital ID and my license with me. I spent the only cash I had on the taxi into the hospital. Therefore, I get to walk home in the dark with a dead cell phone. I go out all the time at night here in Center City, but let's just say that the hospital is not in a great neighborhood. I was a little freaked out the first 10 minutes of my walk, and I am not easily freaked.

Needless to say I made it home quite safely if not warmly. I was able to get back into my apartment and have some dinner. Swallow study just finished (3.5 hours after ordered) and no ongoing leak. So at least I don't have to go back in to operate. Some days, it just doesn't pay to get out of bed. Hoping for a better tomorrow.