Tuesday, October 23, 2007

6 down, 2 to go

This rotation is winding to a close--technically, I have a week with two call nights left, but since I get the weekend off (!!!) it seems like less. As I have said, this has been a very valuable rotation for my over all development as a physician, but it is somewhat exhausting.

We've had some very sad cases recently. One is a 3 month old boy who underwent horrible parental abuse that left him severely brain-damaged. My last two call nights I've been called to see him several times for trouble breathing/low oxygenation. Sunday night was particularly bad, and after several hours during which time we had to call the critical care fellows and attending in to see him, he was finally transferred to the PICU. Unfortunately, he will likely continue to worsen--what makes it particularly sad is that his mother (father is in jail) refuses to look at the situation realistically and thinks that the infant will heal completely. Underlying this denial is the fact that if the infant dies, her boyfriend will be tried for murder instead of child abuse. His grandmother is very on top of things and is in the room constantly--she is trying to reason with his mother.

The saddest case so far is an 11 month old I admitted last week. She had a heart defect which had been stable for the last couple months. She developed mild shortness of breath a couple days before her admission. Her parents had decided to transfer her care a month ago, so rather than go to the hospital at which she was established, they came here. She was very stable, and didn't seem to be very bad off. The cardiologist decided to do an echo in a couple days. I left Friday night, everyone thinking she was fine. When I came back Sunday morning, I found out that out of the blue she had suddenly worsened Saturday evening, was transferred to the PICU, and then died early Sunday morning. I can't imagine how devastated the parents must feel.

On a happier note, the little girl who has been here for months is going to get a new heart tonight.

On a different note, for some weird reason I just cannot stop eating on this rotation. Usually my diet is pretty healthy, but these last few weeks I have found myself with an insatiable craving for greasy food. It's worst on call nights, which I think is reasonable as my body is unusually stressed and fat has the most calories per gram. However, today for instance, I had lunch, then went to the resident lounge to get coffee and a danish. After the danish, I ate a donut. Then I came home and ate a chocolate bar. I'm really going to have to watch myself in residency.


Blogger Helen said...

I think that is what happens when your body is tired. That is how police officers got the reputation of liking donuts so much; too may night shifts!

5:51 PM  

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