Pilgrims at Oak Ridge

Due a freakishly light day call yesterday (I only admitted ONE patient and I admitted her to another physician) this morning I started my day with only TWO patients. Upon my arrival at the hospital, I promptly discharged one of them - he's from a nursing home and if you want to get them back there you gotta get 'em out early and definitely before the weekend. He was actually doing quite well and ready to go, so I got him sent back. My second patient is pretty stable and MAYBE could have gone back today, but he sort of still had some issues, so I thought he should stay a little longer. (As another nursing home patient, he'll be here until Monday.) My very gracious upper level, when he realized I wasn't on call or in clinic, told me I could leave early! So I got to come home around 2:30! And what did I do with my time off?? Promptly fell asleep on the couch. Now I'm ready for some fun!

I feel like many of my recent posts I've written after a call night, so I thought I should balance things out with a pre-call post. Going into a call night is somewhat exciting as many questions run through my head: Will I get any sleep? Will someone code ? Will I have some interesting patients? Is there going to be good dinner at the cafeteria? Will I know enough? Will my PDA run out of batteries? Where did I leave my stethoscope? Then come the answers: I hope so. I pray not. Usually. Occasionally. But there are always milkshakes . Never. Absolutely never. Only if there is information on it I absolutely need. Who knows, but I hope all of you appreciate that even with becoming a doctor, deep down I am obviously still the same absent-minded person.

I wanted to clear one thing up. Since the night I thought would never end , most of my call nights have been relatively painless. I don't want my entire readership to think that every call = no sleep and lots of work. I've had several where I got to sleep for more than 3-4 hours. :) It is best, I think, just to expect the worse so that when it happens you are not too disappointed. Last night, for instance, I was SO close to getting to lay down, but then got paged because one of our patients got very sick and had to be intubated. One thing I am learning from the nights when I don't get to sleep: I can ALMOST fall asleep standing up if I'm still enough. This I discovered while scrubbed in to watch my upper level resident put a central line (large IV that goes into a vein that is close to the heart) into a sick patient. I've also decided that between 4am and 6 am is the absolute WORST time for me to be awake. I do NOT do my best learning at that time. I've noti...

This week it became obvious that we needed a new piece of furniture in the house. And since I always dread the many hours spent flipping through catalogs, deciding on colors, hiring interior decorators, feng shui analysts, and of course spending all the money, I decided that I would just go ahead and make the piece of furniture myself. Fortunately it was just a small bookshelf. And it was going to go in the closet, so asthetics were of low concern. Unlike some of my more mechanically minded friends, I don't do a lot of woodworking, so this was somewhat of a big undertaking for me. I always get frustrated when I have to work on things, usually because I don't have the correct tools. After all, its hard to build things when your only tools are a 192-piece ratchet set and a tape measure. And lately I can't find my tape measure. As part of my preparations before starting construction, I went to Lowe's to buy a saw. I found a few that caught my eye, like this one . B...

I came home from work two days ago to find to large, heavy boxes awaiting me from amazon. I was somewhat surprised since I hadn't ordered anything from amazon, but briefly wondered if they just decided, out of the kindness of their collective hearts, to supply me with one of the many items on my wish list . Upon opening the box, I was surprised to discover something much better and more useful for my current life, given that I don't have time to read, listen to music, or even watch very many movies, since sitting too still in the evenings leads to me rapidly falling asleep. This is what awaited me: Two whole cases of CHOCOLATE soy milk, in a very portable form for me to enjoy at work!! I have been thinking for weeks about how I wanted to get some single-serving soymilk containers since the cafeteria of course doesn't have it, and I'm pretty sure that even ASKING for it would either elicit severe confusion (What? Ya mean they can milk a bean?) or get me run out of town (...

There are celebrations going on at the Tell household this month. We have a big birthday that we are celebrating. Yes, every year around this time Aubrey and I are starting to gear up for birthday season. Aubrey closes out the season with her late October birthday, I'm right in the middle of things with my mid September birthday, and you know who kicks everything off with their August birthday........ Junior!!! We don't know his exact birthday, but we traditionally celebrate in August because it was August, 1994 that Junior became a part of the Tell household. Yes, we adopted him when he was 8 years old, and this is now his thirteenth birthday with us. Junior was the first truck I ever had. My dad and I went in together to buy him (Dad buying the lion's share) when I was 16 years old. Yup, its true, I'm one of those spoiled ones who got an awesome bright red truck when he was 16 years old! I think I was probably the envy of the school, although no one dared voice...

So today I undertook the much neglected task of organizing and labeling all of my seminary notebooks. I have some hope that they might actually be of use to me in the future, rather than just sitting in boxes in the closet. I got a little extra ambitious and decided to rearrange a few of them so that they are color-coded by subject. All the Bible classes are in black notebooks, the systematic theology in blue, church history in red, etc... As it turns out, (unplanned, I remind you) I have three notebooks worth of Ethics notes, and they are in gray. Seems vaguely appropriate.

Ohhh, pleeeeeeeeeeeeeeeeease???????

Since I've been on medicine, I have a whole new definition of what it means to have a good day. Yesterday, on my afternoon off, I got to swim, read some, AND sew (a little). Today, on my day call, I've only had to see three patients so far, and I got to lay down and watch a little What Not to Wear on TV. It's been a good weekend, and I'm counting down the hours until my wednesday off.

It's currently 10:45 in the morning. And I am at home. Done for the day!! Now let the fun begin. (we'll probably start with a nap.) And in other news... Yesterday, I became something I never expected.... a seminary wife. Jeff had orientation to start his Th.M. at Erskine Seminary in a few weeks. So now I'm the seminary wife. Weird.

I realize that most of my posts these days seem to be about my job. Sorry. But here's another one. One of my patients died this morning. This has happened a few times to people I was taking care of, but this patient is one whom I admitted to the hospital and have been taking care of for a few days now. She didn't even seem that sick when we brought her in- she'd been falling down more and having increasing trouble with confusion. She had many health problems, but we were trying to figure out why she was dizzy. We did various tests over the course of a few days, and nothing really came up, and we even started thinking about sending her home. But then, rather suddenly, her blood pressure dropped and stayed very low. We put her on medicine to keep it up, and started giving her lots of fluids. Still it didn't come up. She was obviously a beloved lady with lots of family who all began to come in to see her. We made her as comfortable as we could, and I felt like I got to kno...

Yesterday, I came home from a long day of work to find: Laundry washed and folded Kitchen Cleaned Living room straightened Onion Pasta cooked and... homemade focaccia in the oven. That's right....my husband can make focaccia. From scratch. It was soft, warm, and delicious. And he's (very) good looking, too. I'm not sure what I did to deserve him.....

For all you non-medical folk who read this blog (most of you, I'm assuming) I thought I'd give you a small sample of what it's like when you are on call. 0500 - Alarm goes off. Hit snooze. 0508 - Goes off again. Feel bad for husband, who doesn't have to get up, so drag yourself out of bed. Shower, pack a bag, and try to ignore the pitiful look the dog is giving you since you don't have time to walk her today. 0613 - Arrive at hospital. Begin seeing patients, starting with a sweet 97 year old, who you get to pray with as she is very open in her love for Jesus. Get a little teary when she prays for you and tells you she loves you. 0645 - Work your way down each floor, stopping and writing notes on all of your patients. Realize that none of them are going home, and since you are on call today, your patient list is going to get huge. 0745 - Meet Jeff for breakfast. ( french toast - yum) 0800 - Start rounds with the attending and the other team. 1000 - Still rounding. As...

1. You are admitted to the hospital because you are having symptoms of withdrawal (high BP, tremors, hallucinations) while your blood alcohol level is 0.450 - as in five times the legal limit for driving. As in still drunk. But withdrawing. 2. Your emergency contact number when you can't get in touch with your family is the owner of a liquor store. No kidding.

Apparently, our hospital has a whole list of "codes" that get called in different situations. I guess I sort of knew this, but most of them are very rare compared to Code Blue . This weekend I learned a few more... Code Red - This (logically) means fire or that a smoke alarm is going off. Over the weekend, as I was sitting in the ER finishing up some admission paperwork, there was actually a Code Red IN A PATIENT'S ROOM. Looking on my master list of all our patients, I realized it was one of OUR patients. I decided at that moment it is probably poor form if you know that something/someone is burning inside your patient's room not to respond and make sure they are ok. On arrival, I discovered that the reason for this was because the patient's wife, in spite of numerous posted signs and good common sense, decided she could light up a cigarette in the bathroom in a hospital where numerous people are on OXYGEN. Code Silver - This one apparently means that there is vi...

Working in a hospital, I often see people at their very worst - sick, tired, anxious, and scared. They get angry with us doctors, or at the nurses, or at their family as they lash out in the midst of these emotions. But we also see heartbreaking examples of people at their best, the academic theology I studied in Seminary revealed in the lives of the saints, faith in Jesus played out in front of me. I have been watching a 38 year old mother die for a few weeks now. She has been holding on with severe liver disease and lung disease for a long time. We, as physicians, haven't had much (or any, really) hope for her survival for a long time. Every day, though, when I came in, her sweet grandmother was by her bedside, praying over her. She had the kind of faith Jesus talks about when he uses the term "faith that can move mountains." This morning, though, this mother was no longer able to fight, and passed away. Her earthly body, eaten up by the fruit of her sins, betrayed her....

I knew there were lots of reasons to love my family practice program at Self Regional. Today I discovered one more: Milkshake Rounds Apparently they have this tradition here every few weeks. Instead of our normal rounding in our conference room, we go down to the Veranda, order milkshakes, and discuss our plans for the day on the patio. While eating milkshakes. The only thing better than being a doctor is being a doctor while eating a chocolate milkshake.