I'm not usually the one to blog, even though I did start the blog, I think that Meredith uses it as a good way to keep things written down like a journal or diary. She is pretty amazing. She works part time from home while the kids are in school. She maintains the house, is able to keep groceries in the fridge, make meals, take care of the kids and her calling at church. All of this is done with little or no help from me. It isn't so much that I don't want to help it is more of a I'm at work all the time. All that being said she is a pretty amazing woman. I'm lucky to have her for wife and a friend.
I just wanted to also say a little about residency. What a growing experience. Our program has a tradition that as the first year it is your opportunity to take care of the really sick people that come to the Emergency Department. Now I'm not talking about the bad trauma people I'm talking about the ninety year that has pneumonia and is septic, or the four year that is struggling to breath because of asthma. It is a humbling experience to have someones life in your hands. I have had two experiences in the last couple of month's that really stand out that I wanted to share.
First I had a man that came to the department. They got him in a bed about 30 minutes before shift change, which is always a tough time because the workup takes about 2 hours for the average person, so I was debating about leaving it for the oncoming resident. I picked it up anyway. Turns out that the guy had a story that sounded very much like acute coronary syndrome, which is his heart arteries are blocked to the point that he gets pain in his chest if his heart has to work to hard, so I got him admitted to our chest pain unit. The next day I find out he had an aortic dissection that went from his heart all the way down into his abdomen. This is very very bad. The aorta has three layers to it and one of the layers had sheared off and became a flap inside the vessel. People die quickly from this. I wasn't the one that diagnosed this but I could have sent him home for an outpatient heart workup and he probably would have died.
Second the other day a older lady came in with difficulty breathing. In most older patients like this it comes down to if the have congestive heart failure or pneumonia. During the process of her stay we ended up intubating her, or putting a breathing tube in her and admitting her to the ICU. What a very scary decision that was.
It is experiences like these that make my job so fulfilling and so very humbling. Someone is willing to put their life in my hands and trusts me to make the right decision for them. I love being in the emergency department. Ok I think I have ranted long enough. Life is good.
