Saturday, April 14, 2012

Of mice and men. Or dogs. It's the same, really.

The pager’s shrill scream blasted into my stream of consciousness. I immediately put down what I was working on, glanced at the screen to see an unfamiliar name, and dialed the provided number.

The clinician on the other end of the line immediately began babbling in doctor speak: elderly gentleman, multiple bilateral pulmonary emboli, Warfarin, heparin, coagulopathies, ICU, transfer….

My brain immediately skipped over all of the information until it heard the words “pulmonary emboli,” “thrombolytics,” and “coagulopathy.” Inwardly I groaned at the thought of dealing with a coagulation question. Coagulation questions aren’t all that frequent during call, but they tend to be difficult and confusing (for me, at least) and I rarely have a good, immediate answer. It usually takes a fairly detailed search before I find an answer I am completely happy reporting to the cinician. I don’t mind the search if I’m in a coagulation kind of mood, but at that moment coagulation was something I was loathe to consider. So was I looking forward to whatever this particular physician was requesting? Not in the slightest.

The physician kept rambling for another minute, spewing laboratory values in a voluminous verbal emesis with words dripping from her vocal cords faster than I could possibly write. I cleared my throat, about to interrupt her with the age-old, "Can you please repeat that?" and “aside from spitting numbers at me, what are you really wanting from me?” spiel, when the provider abruptly stopped and then said…

“And then, we were going to transfer him to YOU for his coagulation needs, but well…he died and the family wants an autopsy and I’m not sure how to do this particular transfer but we need to transfer him to your morgue.”

Then something terrible happened. I smiled broadly, cheered silently, and fist-pumped the air. No coagulation questions for me after all! Hot dog! Just a morgue question and a call issue that I could punt to the junior-level resident covering the weekend autopsy issues. It took me a full minute to realize that my brain was cheering for something terrible, something sad, and something for which a mental cheer was wholly inappropriate.

It is at times like these where I realize that somewhere along the medical journey, I have lost some perspective. I (still) absolutely believe that I help to make the world better but some days my passion is slightly lacking. There are moments wherein I am so jaded, bitter, overwhelmed, overworked, exhausted, and numb – all things I swore to myself that I would not become. Sometimes I wonder who this cynical skeptic is that stares intently at me from the confines of my bathroom mirror. I wonder how to get rid of her. So I vow to be less cynical, less irritated, less grumbly, more accommodating and a little more passionate. I promise myself that I will remember that wide-eyed college student out to save the world - and that I will find her and bring her back.

Then I remember that sometimes my skepticism and irritation are perfectly allowable.

Like the time that I was called in to the hospital for a STAT CBC with differential for a "sick patient." Try as I might, I could not find them in the computer system and the tech didn't know much about them. So I got into the car, drove for 40 minutes, and discovered upon arrival in the lab that the "sick patient" in question was a dog by the name of Fly.

And on those days where my passion, enthusiasm, and naiveté have been chewed on like a dirty, used tennis ball in the mouth of Fly, I feel somewhat justified in my cynicism. I guess it all balances out in the end.