ER

I started a rotation in the emergency department of a level 1 trauma center this week.  In a twist of events that I did not foresee, I feel as though I have ended this week as a completely changed person.  Have you ever felt like you went through an accelerated methaphorical personal growth spurt?  I feel like I found myself far outside anything close to a comfort zone, and instead of panicking, I just put my head down and jumped to the other side.  Well, maybe there was panic, but it was all internal, which for me is leaps and bounds my friends.

Things that have struck me so far about the ER:

1.  Wow some people utilize the healthcare system faaaaar more often than I do.  This actually was a realization I had when I was in my family med rotation, and I would open up a patient's chart to read their last clinical note and BAM there would be like fifteen interactions in their chart between the medical staff and them in the past seven days.  Holy cow, it never even occurred to me that I could even call my doctor and ask them questions, and these people are actively doing that on a multiple-times-per-day basis!  And in the ER, this is no different, which is weirder.  I saw a patient who was there for a viral upper respiratory infection, and who had been seen in the ER every single day for the past three days, and in fact was even there at 1am that morning, but left halfway through because he didn't want to wait any  longer.... Now that's just weird.

2.  Seeing kids in the ER is a whole different ball of wax than seeing them in the outpatient pediatrics.  Kids in the ER are terrifying.  They are crying and inconsolable, or lethargic and blue, and not easily distracted, and probably have bad things wrong with them that I am about to miss because I just spent six weeks seeing a parade of "worried well" children and thus have the mentality that they all probably have a viral illness of no significant consequence.  Case in point, I missed pneumonia in a 9 month old and then felt like a jackass.  I see a baby pop up on the bed board and I immediately wish I could just go see the guy who was here yesterday with a cold.  No thanks. 

3.  ER docs are some of the most badass people ever.  We had multiple cardiac arrests and heart attacks occur within minutes of each other, and the providers were so level headed and systematic.  My brain was like "oh no, ______, think things elise! ______remember all of the things!!______" and instantly all of the things I am supposed to know made hasty exits out the back door of my brain.  I was slowly processing I think these are the drugs that we should give, maybe, or is it this drug?, no that's right I think, the first drugs, let me see if they are giving those drugs.  That thought process took me five minutes, and they had already administered two rounds of epi and were five minutes into CPR while I grasped for shards of information in the far recesses of my brain about what they were going to do next.  It was pretty sad on my part, and pretty spectacularly amazing on their part. 

That's all I can think of for now.  I'm gearing up for three night shifts this week, and in thirteen days I will be flying to Belize to finish this rotation out in a clinic in Punta Gorda.  My life is pretty awesome.