Memorial day weekend

Of course I was on call memorial day weekend. Luckily because it was a long weekend and they split up the call between two people so I had to endure a mere 48 hours on call.

For the first part of it, I worked a full day on Friday... an old lady with three valves that needed to be replaced. Uncharacteristically I got to leave at a reasonable hour... There had been rumors abound about a case to go Saturday morning... in fact I had first heard about "the emergent case for Saturday" on Thursday... so i waited all day on Friday for the surgeons to book it so I could plan my day better for Saturday. All day long... no case booked... everyone from the surgeon's secretary to the surgical PA to the perfusionist had heard that the case was going Saturday "for sure" Still it hadn't been booked by the time I left. I guessed they would page me when it was booked so I could set my alarm etc... imagine my surprise when I woke up Sat morning to no pages. Yipee...

I got about halfway through the day and then decided I would go grocery shopping and buy some food to grill out... steaks, pasta salad, corn, the works... no sooner than I get home from the store. [beepity beep beep] I call the OR front desk. "Type A dissection to arrive at the hosiptal in 30 minutes, Dr. *namedeleted* wanted everyone in" Fine. A Type A dissection is a tear in the first part of the aorta after it leaves the heart. This is an emergency because in that portion of the aorta is the blood vessels that supply the heart itself, and the beginnings of the blood vessels to the head. If this rips further then the heart or brain (respectively) will have no blood supply. Steaks in the fridge... hop in the car. I get the the hospital... perfusion is there, the cardiac nurses are getting there. "Where's the patient?" asks the perfusionist, "Lets get the show on the road" I don't know I think they're being flown in. Okay. Quick call. "They say they're not flying anyone in, but I could be another helicopter service". I find out that the ER doesnt know about the patient, the cardiothoracic resident if fact is at home on the couch because he hadn't heard, and no one knows about the patient. Yikes...

So we're sitting around for 45 minutes waiting for the word, when the surgeon calls in to the room. "She's in the ER, we need to go now". I grab the resident and we head downstairs, I find a woman in her late 20s, slightly tearful. I go through my history with her quickly and explain what's going to happen, she's no longer slightly tearful, but very tearful now. I reassure her and we start wheeling her back.

*time warp*

12 hours later it's 6am and we've just finished her operation. Lots of bleeding, but she's doing fine, I'm exhausted from being up all night. Luckily I get to go home, the resident needs to start an "emergency LVAD that we heard about 2 days ago" Hopefully his staff will let him out for a nap.

I know I need one

death in the or

Somehow as morbidly ill someone is when you are in charge of their case, as little chance as they had of surviving.... you can't help but take it a little personal when they expire in the OR.

More later... maybe.