9 am
There’s an old-testament sky roiling over the lake this morning, and I’m on my 3rd cup of coffee after my third night in a row of sleep disrupted by trips back to the hospital for emergencies. As with all ER’s, the problems range from the mundane to the horrendous and I’ve encountered all of it already. They tell me it hasn’t been this busy in the ER for years; I guess that’s the good news and the bad news.
I have discovered over a lifetime of work that there is no predictability to the needs of patients, and Cordova proves no different. I might go for over 24 hours without an ER visit, and then have four people show up at once, for our two designated beds. Triage then becomes more critical—eyeballing the patient for the level of “toxicity” and presenting symptoms so that I can order what’s appropriate and prioritize staff efforts. Truth is, the supporting personnel here are pretty good at knowing what to do before I tell them: I suspect, like all excellent ancillary workers, they’re just humoring me—my orders are often anticipated.
Mostly the phone just startles me awake. One memorable night it was the police pounding at 5 a.m. after the phone failed—OMG—that was a heart-thumping event. First order of business in an emergency (according to the classic, cynical but accurate, accounting of medical internship, The House of God)–take your own pulse. Early in our marriage, when I was on 24/7/365 for the Clark County Jail, Rob commented on how he’d never seen anyone so instantaneously alert when the phone rang in the night. He’d be sitting up, thrashing, trying to orient himself to the ringing in the darkness, gradually aware that I was giving orders as though I’d been lying there awake, calmly, expectantly, for the call. After years of training, this has not changed. What is noticeable though is that I require longer to reset. No longer can I go for days, or weeksof sleep deprivation from parenting duties + patient demands without accommodating. I had no idea my skills at napping would be as critical here as those of doctoring. I can come home and rest anytime, and I do. Like now. See ya later…
