Sunday, October 05, 2008

Black Weekend

It's entirely possible that this has been my worst week since starting medical school. Thursday was another full day of rounding and scut, so it wasn't any more boring or awful than any of my other days on IM so far. But on Friday, I found out that my last surgery patient had died. Even though I wasn't on the surgery team any more, I had been checking his electronic chart each day all week to see how he was doing. I knew he wasn't doing too well since he had been admitted to the ICU earlier in the week, but I kept hoping that he'd pull through. When I checked on Friday, I saw that he had been disconnected from all life support and had died soon after. That put me in an even worse mood to begin my black weekend.

A black weekend means that you get no day off for the entire weekend. In other words, you work for 12 straight days, from Monday of one week until Friday of the next week. Whenever you have a Saturday call, that's a black weekend because you come in Saturday morning at 7 AM and leave at 1 PM on Sunday. Then you still have to come in Monday morning at 6:30 AM like normal. I came in on Saturday already feeling cranky because I didn't find out that we had a 30 hour call until Friday afternoon. My confusion was because on surgery, weekend calls started at 6 PM and were over the following morning at 8 AM. So I blithely made plans for yesterday, only to be told by my intern the day before that no, I had to be here all day.

Being in the hospital on Saturdays is not much different than being in the hospital on weekdays. You still round on the patients, do scut, and write notes. The school gives us money for our call meals, which is a really nice perk. But as I found out, that call money can't be used at lunchtime, only for dinner and breakfast. So I still had to pay for my lunch even though I was on call, which annoyed me too. After lunch, I went back up to the floor and was standing right outside of a patient's door when a code was called. It wasn't one of the patients that I was following, so I didn't really know her. But I went into the room with everyone else.

Codes may look cool on TV, but they're pretty awful when you're there in the room for one. The code team members were compressing the patient's chest, and she was flopping around in the bed like a doll. I could hear her ribs cracking, and then the anesthesiologist intubated her. The team defibrillated her a few times and got her pulse and blood pressure back. The patient's family was outside the room, and her husband was crying. I went out to be with them just as the chaplain arrived. A few minutes later, one of the code team responders came out to tell the family that the patient had been resuscitated and they were moving her to the ICU. He said very matter-of-factly that the patient was in very bad shape and might die. The husband started sobbing even harder, and the responder just said, "sorry," turned, and walked away.

There have been plenty of times here and there when I have thought that I probably made the wrong decision to go to medical school, but that was one of the times it hit me the hardest. What really got to me was watching that responder's back as he walked off to go fill out his paperwork.


. said...

"What really got to me was watching that responder's back as he walked off to go fill out his paperwork."

--This attitude was what drove me to go into hiatus after passing my medical board exams. I don't what to be hardened, blase' or whatever these senior doctors are now after years & years of seeing death every minute. But I know that if I got involved with a patient, it will be my undoing too. It's hard to be an emphatic human & be an objective "this-is-only-work" doctor =( Since I wasn't able to resolve this issue within me, I opted for a hiatus from the medical field.

SarahharaS said...

Thanks for your blog. I'm starting at Case Med this year and I've enjoyed reading about your experiences as a medical student.

CCLCM Student said...

I'm sorry to hear that you had such a hard time. My discovery has been that all of the people I work with are great teachers. Some have shown me how to be a better clinician. Some have enhanced my medical knowledge. Some have inspired me to be more empathetic. And some have served as examples that I should strive to avoid emulating. :-P

I will do my best to feature teachers of many types, because all of their lessons make up the reality of my medical school experience. You will probably find the next entry more inspiring. If you have the chance, I hope you will read it and let me know what you think.

CCLCM Student said...

SarahharaS, I really love Case and I hope that you will, too. :-)