Hey, but the jury’s not in yet. I’ll give it a little more time to see what it’s like before I make up my mind. I’m on call Friday night with a senior resident who sort of drives me crazy. She’s reasonably intelligent and she seems to know what’s going on, but she really lacks self-confidence. It wouldn’t be so annoying if she didn’t keep turning to me for reassurance. Me, can you believe that? I mean, I have absolutely no idea what the hell is going on! The other night she did something that I think was probably wrong. She wanted to intubate this kid for having one bad blood gas. And she asked me if I thought it was the right thing to do. I said, “No, it doesn’t sound right. I think you should just turn up the oxygen and repeat the gas before you do anything.” That was just common sense; this kid was perfectly pink at the time. I hope I’m not that unsure of myself next year, when I’m in a position of authority. Hah! Boy, we’re all going to be in trouble when that happens!
Thursday, January 30, 1986
It’s nine o’clock and I just got home. Things are looking up: I cut an hour and a half off the time I finished on Monday night. Why, if this keeps up, I’ll have so much free time this month, I may actually get to cook my own dinner one night! I think washing the dishes’ll still be out of the question, though. That’d be just too much to shoot for.
Here’s some news on the Moreno front: Today’s head circumference was forty-nine and a half centimeters, up one-half centimeter from yesterday’s closing. And you know what? I don’t give a shit! I just don’t care!
I don’t like the neonatal ICU. I’m not positive, but I just don’t think I’m going to grow up to be a neonatologist!
I’ve got this nervous feeling in my stomach all the time. I stopped at a drugstore on the way home and bought this great big bottle of Maalox. Either I’m coming down with gastroenteritis or I’m beginning to burn a big hole in my gastric muscosa.
Monday, February 10, 1986
I’m post-call. There’s nothing like being post-call when you’re in the NICU. It’s at least a hundred times worse than being post-call anywhere else in the world, including Infants’, which until this month had won the prize hands down as the Most Horrible Post-call Experience in the Bronx. I should be asleep now, but I haven’t recorded anything in over a week. I’ve wanted to; I just haven’t had enough strength to push down the “record” button on this silly machine. I don’t want to let this fabulous experience escape immortalization on cassette tape, so, at great expense (at least ten minutes of precious sleep), here goes.
Working in this nightmare has now settled into a nice, regular, predictable routine of devastation and misery. Take yesterday, for instance. It was Sunday and I was on call. I walked through the doors of 7 South with a smile on my face at seven-thirty and was completely and overwhelmingly depressed by eight o’clock. Iris Davis, who’d been on call Saturday, signed out to me. She was in a great mood. When she gets real tired, she starts to cry, so it took her about an hour and a half and at least three boxes of tissues to get through sign-out. All I got out of it was a scut list about a mile long and a terrible headache.
Most of what Iris signed out to me was checking bloods that had been drawn earlier in the morning. So I started calling the labs to get the results, a very rewarding experience. Each lab had a different and very novel explanation for why the results weren’t available. The chem lab claimed they had never received any samples, even though Iris assured me that she hand-delivered them. The hematology lab said that all the specimens, every one of them, was QNS [quantity not sufficient]. That’s a polite way of saying, “We poured the blood down the sink, so you’re going to have to draw them all over again.” And the blood gas lab said the machine was broken and they wouldn’t be able to run any samples for at least another hour. What this all meant was that I was going to have to spend the next two hours redrawing all these bloods and then spend another half hour delivering the samples to all the different labs.
Okay, so I did all that, and then I got to spend the next six hours writing progress notes. I love writing progress notes! You have to write a note on every patient every day or else the administrator on duty swoops down at about midnight and puts an evil spell on you. And these notes aren’t just “Patient still alive. Plan: Make sure he stays alive until tomorrow morning.” These notes go on and on, listing problem after problem. Each one can take an hour.
It wouldn’t even be so bad if all I had to do was the scut and the notes, but that’s all broken up by the endless rounding. First the attending showed up at about eleven so that he could view the patients close up for about an hour. He also has to fill his daily quota of yelling at the house officers. Then in the evening, there were rounds with the senior resident, who managed to come up with a whole new list of scut for me to take care of during the night. So I got to draw some more blood, have more fights with the lab technicians who have perfected the art of denying having received blood samples you handed them not an hour before, and write more long notes in the charts documenting what the results of those fights with the lab technicians have been.