More Human Than Human

It's been a good 4 weeks. I did 2 weeks in cardiology and 2 weeks in nephrology. I've learned a lot and am a lot better prepared to deal with stuff when stuff goes down my intern year.

I decided to call it a day early today. Just got home from a code in the dialysis lab. Nephro patients are really sick. We've had 3 die on our service this week. It's funny. You visit people in the morning and they look great. They're eating, talking, farting, the works. A couple hours later, when you're walking by their room, you hear that they just died...then you cross off their name and move on to the next patient.

What it's like to die in a modern hospital.

Code Blue tower 6. You start seeing people swarm toward the room from all across the hospital. Usually there are 15+ people standing around your bed, staring down at you. If it's a cardiac code, you've got some guy pumping your chest and breaking every rib in your body. People are trying to stick huge ass needles into your legs and arms to get fluid into you. If they have trouble, they're gonna cut ya. There's usually a guy bagging air into your face, then they'll intubate you. You'll be paralyzed and won't be able to scream. If you're lucky, that's where the story goes.

If they get pressors into you with some epi and jump start you, you'll end up in the ICU. There, you'll be stuck on some breathing machine. Unfortunately, the inflammatory process in your body has been sucking the blood out of your veins and into other parts of your body so that you swell like the michelin man. It's called 3rd spacing. To keep you heart pumping blood to your organs, they're pumping fluids furiously into you. A lot of those fluids end up in your lungs, making you feel like you're drowning. You sound like you're gurgling, while the ventilator tries to pump air into your lungs. Eventually your kidneys and heart and everything else starts shutting down. You start getting nasty infections that never really go away. You're usually paralyzed this whole time so that you don't fight the ventilator. In your mind, you wonder, when is this going to end? When does the pain stop? Maybe you'll have another cardiac arrest. Repeat above paragraph. Good times...

Man, I kind of sound down, huh? It's been a rough few weeks, surprisingly. I saw a woman die from a broken heart (caught her hubbie in bed with another lady) - takotsubo. Her heart eventually recovered, but she had taken some meds which wrecked everything else in her body. Got to see a young girl, 23, get into a car wreck. Third spaced, a total wreck. Her arm died due to ischemia, and she needed a bedside amputation, civil war style.

Anyhow, I guess the thing that has been really bothering ms is that last thursday I got a call in the morning from one of my residents down at USC. They told me that Dr. Stein had passed away. He third spaced, fasciotomies, then coded. It basically means he was filleted. This guy is one of my heroes. Legendary work ethic, super nice, rides his residents like crazy, but in the end of the day really cares about you. He believes in what he is doing and he does the research to back it up. It's really rare to find a mentor that inspires you like that. He was the person who recruited me to SC and was the one I wanted to learn how to operate from. They were going to offer him the chairman position the day he passed away. He has young kids in high school. It's a lot of badness. I didn't know him that well and I'm surprised at how shockeded I was to hear about him. I keep picturing the bro getting gutted up. Man, life is rough. Gotta do what you love and love what you do. Keep your friends and family close. Looking forward to this weekend. I'm done.

-bender