#47: Last call...

This is a retrospective post. My last call night on Surgery Oncology wasn't too bad. I slept for about 1.5 hours but there was a really sick guy that I inherited by cross-covering a service. He was an 80 pound cancer patient that had just had a minor operation and had the normal amount of post-op fluid resuscitation, but he was so low on protein in his blood that he leaked all the fluid into and around his lungs. He had an increased O2 requirement all of a sudden his lungs sounded like he was underwater. I gave him about 60 mg of Lasix (a diuretic) but he didn't get better and so he ended up getting transferred to the ICU to give him more O2 than was allowed on the floor. He got a CT scan because there was a concern for a blood clot that might have broken off and gone to his lungs but it turned out that he just had a lot of fluid around his lungs.

In the morning, I called my chief just as I thought she might be waking up because I was worried about another patient in the ICU. I asked if she might have any ideas that I might try before she came in but she said that she wouldn't be rounding in the morning because she had to go straight to the OR. So it ended up being the medical student and me who went around rounding on the patients. It took longer than it would have taken had the chief been there, but I went down to the OR and it turned out that I came up with some decent plans for the patients without my chief, so I was pretty proud of myself. About one hour later, I was post-call and my chief sent me home even though there were still things to do. She said "have a good vacation" so I left... Thank you Chief!

Last call night: Friday January 12th
Amount of sleep: 1.5 hours
Currently reading: Heat.
Currently watching: An important basketball game between two rival schools.
Currently listening to: The sound of silence (unfortunately my wife is in the ER on her rotation with an evening shift.)
Next call night: Tuesday January 30th (after vacation!)