2000: I arrive at the hospital, bright eyed and bushy tailed.
2005: I realize I forgot my stethescope at home. Fuck!
2012: I arrive at the hospital again, somewhat less bright eyed but equally bushy tailed.
2020: I pick up my first patient, a woman going through alcohol withdrawal.
Woman: "I'm going to have a seizure."
Me: (checks her pulse, which is 65) "No, you're not."
Woman: "I really am."
Me: "I don't think so."
Woman: "I definitely am."
Me: "OK fine, here's 1mg of ativan."
Woman: [falls asleep]
2200: I see a guy who cut his leg open with a bandsaw. After cleaning it off, the wound is judged to be "too deep" for me to be allowed to suture it by myself. Lame. At least I got to cause him lots of pain by injecting inside the wound with lidocaine.
2230: I'm discussing my shifts with the PA on duty. When I tell him that I have to do five 11-hour overnight shifts in a row, he says, "Wow, that really sucks!"
And I think to myself, "Hey, yeah... that DOES really suck."
I spend the next half hour wallowing in self-pity.
2300: Suicide attempt. 16 year old bipolar girl swallowed 50 Tylenol... not to kill herself, mind you, but just to "get sick or go into a coma". I spent a while talking to her. That poor girl was a mess.
Attending: "Is there a diagnosis code for bad fashion sense?"
2345: Most uninteresting patient ever. Guy who can't pee has foley catheter placed. Tries to take shower and foley falls out. Patient comes to ED. I write order that says: "Put in foley catheter." Learning value: 0.
0030: Baby with fever. There is nothing I hate more or suck at worse than looking in little screaming baby ears.
0130: Guy from prison with vomitting and diarrhea after eating some burritos. Apparently there were two other prisoners in the back of the ED who ate the same burritos. It's a prison diarrhea outbreak.
Prisoner: "Can I have some orange juice?"
Me: "You want orange juice? But I thought you're nauseated and you can't stop vomiting?"
Prisoner: "Yeah, but isn't orange juice, like, medicinal?"
0200:I discover that the box of free candy I've been taking candy from the last few days actually has a sign that says "$1 each".
0300: Woman who just had abdominal surgery presents to ER with abdominal pain. She didn't take any of the painkillers that they gave her after the surgery. Maybe I was misinformed, but I heard having your belly cut open kind of hurts. (I'm being a little overly sarcastic, but I later found out that the symptoms the woman had were exactly what the surgeon told her to expect.)
0330: Woohoo for testicular pain, especially when associated with lots of psych comorbities and no health insurance.
0400: Girl who accidentally poisoned herself when she locked herself in the windowless bathroom and tried to clean with a new mold remover product. What did she think was killing the mold? Sugar water? (OK, I've done it too.)
0430: I take a half hour break, where I hide in the family conference room, drink a glass of water, and eat three marshmallow cookies. I feel guilty for it.
0500: Woman with severe migraine who looks like she's in a hell of a lot less pain than I'm in right now.
0530: At this point, I realize that although I feel really dizzy and tired, if I pass out and fall to the floor, they'll have to scan my head and I'll never get out of this fucking emergency room.
0535: Another screaming baby with fever.
0600: 16 day old baby boy who has little boobies.
Me: "I wouldn't worry about it. It's very common for newborn babies to get a little bit of breast enlargement due to the mother's hormones during pregnancy."
Father: "Are you a pediatrician?"
Me: "Uh... no..."
Father: "Well, we want to get a real professional opinion."
[I bring in attending.]
Attending: "I wouldn't worry about it. It's very common for newborn babies to get a little bit of breast enlargement due to the mother's hormones during pregnancy."
Father: "Oh, thank you, Doctor."
0630: Hypertensive guy who woke up with arm numb, now resolved. Differential: transient ischemic attack vs. arm fell asleep.
0700: "Well, the sun is up. I guess you can go home."