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| I hate calls like yesterday | |
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| Tweet Topic Started: Nov 25 2011, 04:41 PM (247 Views) | |
| George K | Nov 25 2011, 04:41 PM Post #1 |
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Finally
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Being a holiday, I sorta expected it to be a quiet call yesterday. And it was. I stayed home, checking on OB throughout the day to see if anyone in labor was going to need me (2 ladies delivered without my services). No surgery, nothing. I always sleep at work, however. It's just easier, if anything comes up, to roll out of bed, walk downstairs and put in an epidural than to get out of bed, get dressed, drive in, change clothes, and then go to work. So, last night, I drove in at about 10PM. Went to sleep at 11 or so, falling asleep with the TV on. I sort of woke up at 2:30, turned off the TV, and thought it might be safe to go home, since I'm awake, and there's probably nobody in labor. I fell asleep thinking that thought. My pager went off at 3:30. A woman who had had a hysterectomy at another hospital came to our ER with sudden onset of vaginal bleeding and the OB wanted to take her to the OR for an exploration (long, complicated story). So...we started the case at 5:00, and I was relieved at 7. At least I took a nap this afternoon. |
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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| Mark | Nov 25 2011, 04:47 PM Post #2 |
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HOLY CARP!!!
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I cannot imagine having your work schedule. You sir, are pretty friggin amazing in my book. |
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___.___ (_]===* o 0 When I see an adult on a bicycle, I do not despair for the future of the human race. H.G. Wells | |
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| George K | Nov 25 2011, 05:01 PM Post #3 |
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Finally
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You know what gets me? People don't understand that 3 out of 5 days, I have to be immediately available. That means, I have to be within 15 minutes of the hospital. No movies, no shows, concerts, trips to the north side of the city, downtown, etc. And when the pager goes off, I have to leave *right now* - not in an 30 minutes, or an hour. Right now. Fortunately, the Mrs. and I lead pretty anti-social lives, so it's not a big deal. Nevertheless, if I have to go shopping, I always have, in the back of my mind: "How far away am I?" Here is my schedule for October. The "Off" means, I don't have any responsibilities - I don't even have to go to work. "No Call" means I work, and my day starts at 6:45 and can go to 5 (or later). "Kidney Stone" means I start at 6:30 and can work until 10, though on Saturdays, we're usually done by noon. The days with my name in them are the days I'm on call. ![]() You can see that I have to be immediately available for 23 out of 31 days. |
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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| jon-nyc | Nov 25 2011, 05:04 PM Post #4 |
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Cheers
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If one of the Georgettes were considering anesthesiology, would you counsel them against it? |
| In my defense, I was left unsupervised. | |
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| George K | Nov 25 2011, 05:14 PM Post #5 |
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Finally
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Tough call. As medicine becomes more and more corporate, the days of the private practice group (like mine) seem to be disappearing. More hospitals are hiring docs, with contracts to define what services will be provided, and at what salary/benefits. One of our sister hospitals has that arrangement, and, in the long run it's probably OK. When I started in private practice (1989) I had more vacation, and less call. To maintain our income we've changed our practice model. That's a choice that everyone makes, in one way or another. Do I work more or less; do I make more money or less. As a reference, I'm making (in inflation-adjusted dollars) only 75% of what I earned in 1995, with an increase of time commitment of more than 25% - just about half the vacation, and an increase in call of about 30%. In compensation per time, it works out to about 60% of what I was earning a decade and a half ago. University practice can be nicer - much MUCH less call (once every 10th night is what I had, and once every 10th night backup call). Once every 10th weekend (Sat and Sun). But the money was about 2/3 of private practice, and the vacation was about 2/3 as well. Add to that that the days were longer, and add a commute from the Western suburbs to downtown. None of my kids have expressed any interest in medicine. Do you think that it might be because they see the way I live? I don't know. |
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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| Aqua Letifer | Nov 25 2011, 05:48 PM Post #6 |
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ZOOOOOM!
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Reminds me a bit of my cousin's schedule. He's a state trooper, and his dream job is to be one to bodyguard the governor. Tough job, though. When you're "on," you're with the governor and that's it, it doesn't matter what else might be going on. And kinda like your job, George, there'd be a lot of down time, even on call. But on those rare occasions where sh!t actually goes down (and for my cousin's dream job, that day might never come), you're one of the most important people involved, if not the most important. It's all on you. I have no idea how well I'd fare in a situation like that. |
| I cite irreconcilable differences. | |
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| George K | Nov 25 2011, 05:59 PM Post #7 |
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Finally
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Many years ago, when I was in my fellowship in critical care, I was on call. At that time, the fellows took call (1/3) from home, and they were the backup for the resident who was in the hospital (I did that a couple of years earlier). The fellows were backed up by an attending. When I was early in my fellowship, I was, understandably, anxious about not being able to do some things. So, one time, I asked my attending, "Barry, suppose that the resident calls me that he can't put a tube in the trachea, and he's in big big trouble. I come in, and guess what? I can't do it either! Because I can't put the tube in, the patient dies. What do you do?" "Well, you have to look at it this way. If you can't put the tube in, you have to understand that it's not because you're incompetent or poorly trained. The patient has some anatomical problem that's prevent you from getting it in, and it's NOT YOUR FAULT. You, yes YOU, are the most competent, best-trained person in the hospital that night to do it. If YOU can't do it, no one can." Wow. It sounds harsh and cold, but Barry was right. If I couldn't do it, no one could. I carry that philosophy to this day. And no, no one has ever, ever, died because I couldn't get a tube in. Not yet, at least. |
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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| apple | Nov 25 2011, 06:50 PM Post #8 |
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one of the angels
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hats off to you Geo. happy thanksgiving |
| it behooves me to behold | |
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| LWpianistin | Nov 25 2011, 07:10 PM Post #9 |
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HOLY CARP!!!
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+1
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| And how are you today? | |
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| Dewey | Nov 26 2011, 12:01 AM Post #10 |
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HOLY CARP!!!
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+2. Now I'm going to go take a nap before *my* pager goes off again... |
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"By nature, i prefer brevity." - John Calvin, Institutes of the Christian Religion, p. 685. "Never waste your time trying to explain yourself to people who are committed to misunderstanding you." - Anonymous "Oh sure, every once in a while a turd floated by, but other than that it was just fine." - Joe A., 2011 I'll answer your other comments later, but my primary priority for the rest of the evening is to get drunk." - Klaus, 12/31/14 | |
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| George K | Nov 26 2011, 04:55 AM Post #11 |
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Finally
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Your pager hasn't gotten to you until you have the "flush it down the toilet" thought. Are we there yet, Rev? |
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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| Dewey | Nov 26 2011, 05:49 AM Post #12 |
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HOLY CARP!!!
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Oh yeah, it definitely got there last night - starting not two minutes after I made that post. |
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"By nature, i prefer brevity." - John Calvin, Institutes of the Christian Religion, p. 685. "Never waste your time trying to explain yourself to people who are committed to misunderstanding you." - Anonymous "Oh sure, every once in a while a turd floated by, but other than that it was just fine." - Joe A., 2011 I'll answer your other comments later, but my primary priority for the rest of the evening is to get drunk." - Klaus, 12/31/14 | |
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| George K | Nov 26 2011, 06:05 AM Post #13 |
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Finally
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Have you gotten to the "I hope it's only a phone call, Sh!t, it's not. I hope it's just an epidural (insert something benign here) - I can be back in bed in an hour. Sh!t, it's the ER. Hopefully they just need someone intubated. Sh!t, it's a case - a bad one that's going to go for hours. F*ck, f*ck, f*ck, F*CK!" phase yet? You know, where you "bargain with the pager" hoping that it's not something too bad. |
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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| Dewey | Nov 26 2011, 01:45 PM Post #14 |
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HOLY CARP!!!
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You must be channeling my brain. That's *exactly* what last night was. And after that kind of night, when I went off duty, I was right in the middle of one death (it never fails - one particular unit seems to have patients die right about dawn, a half hour before shift change), and the pager had just gone off with another death on another unit as I handed the pager and all the paperwork over to my replacement - without a moment of guilt, and without looking back. I usually go home and sleep a couple hours, then get up by ten or ten thirty, and have a relatively normal Saturday. Today, I slept until almost 2:30pm. I'm still just hanging out in an old pair of long johns. An odd and frustrating shift last night. |
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"By nature, i prefer brevity." - John Calvin, Institutes of the Christian Religion, p. 685. "Never waste your time trying to explain yourself to people who are committed to misunderstanding you." - Anonymous "Oh sure, every once in a while a turd floated by, but other than that it was just fine." - Joe A., 2011 I'll answer your other comments later, but my primary priority for the rest of the evening is to get drunk." - Klaus, 12/31/14 | |
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| George K | Nov 26 2011, 02:13 PM Post #15 |
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Finally
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Ahem... When I was a resident at the VA, we used to take call for a weekend at a time, in the house. Now, obviously, this was before cable, before the internet, and the TV in the call room was a carppy 17 B&W. To say it got boring would be a gross understatement. At that time, we had to keep a record of any time that we went to an arrest. So, one Sunday afternoon, I started looking at the book with those records - it went back several years. So I started looking at when people arrested: 7 AM Noon 3 PM 6 PM Midnight 7 AM - breakfast and change of shift Noon - lunch 3 PM - change of shift 6 PM - dinner Midnight - change of shift In other words, people died, or at least arrested whenever there was a reason for someone to go into the room. It may have been just a fluke, but knowing the VA in the 70s, I doubt it. Oh, and I certainly never feel guilty about leaving when my time's up either. My call ends at 7 AM, and I was relieved on this case at 7:05. I gave report, and handed off the case. No guilt - whatsoever. I did have a nice nap yesterday afternoon, as I said. |
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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