Friday, November 17, 2006

The CCU

I had it easy. I keep thinking that.

When I was an intern in the Coronary Care Unit last year, I had some fun. I really did. My resident was great; she looked out for me and didn't give me too much work. She let me sleep after midnight. She read EKG's with me. She showed me how a balloon pump worked.

Now, I've taken on her role. I have an intern. My intern is sad. He is overworked, overwhelmed, miserable. I took him out for a drink the other night, at which point, after two amaretto sours, he confessed all this and said, in addition, "And I haven't learned anything!" I was crushed. I resolved to help ease the stress on him in the CCU. I took on all the admissions after 8PM and made him go sleep or read or watch the newest episode of Lost.

But what happens when I feel overwhelmed? I'm still trying to juggle my roles of resident and teacher, runner-of-unit and friend. Challenging, soul-pulling. I feel as though I don't know enough to be able to handle the additional responsibility and help my intern not be so sad.

The CCU at my hospital is notorious for being demanding at times. Especially in the winter/holiday months. We have seven CCU beds and about 25 step-down beds. Often, I am moving people out of the CCU soI can at least keep one bed open. If I have to fill the unit, if people are just that sick, then I close the unit. But even if I close the unit, even if ALL MY BEDS ARE FULL, the ER can still hurt me. At first, I thought they were simply in denial.

"OK, I have a lady down here..."

"Wait, you know the CCU is full, right, and that all the step-downs are full, right?"

"That's not my problem."

"I'm sorry?"

"I have a lady down here with chest pain!"

"But I'm telling you, I have no more beds."

"OK, you and I have to work together, for the benefit of the patients."

Again, I'm not sure what part of "WE HAVE NO MORE BEDS" that particular resident didn't understand. People often will hear what they choose.

The best part of this medicine hell called CCU q3 overnight call is that every six days, I get a much deserved day off. The sad thing is that I spend it sleeping. A lot. I make like my cat and turn into a bowl of sleepy jelly. I will occasionally wake, maybe eat something, and watch saved episodes of Grey's Anatomy on my roommate's TIVO. Sometimes, I will fall asleep during these episodes, I'm that exhausted. I try not to interact with my mother during months like this, because she often thinks I'm running myself into the ground. On purpose. I don't think she remembers her own medicine residency, what it was like to be pushed to human limits.

Not to worry, my friends. This will soon be over. I have one more week. One more week to keep saving lives, preserving lives, teach my intern something remotely cardiac-related, and to improve on my interactions with the ER staff.

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