Friday, April 13, 2007

The best of both worlds

My usual week at the county hospital, a hospital I spend much of my time in as a surgical resident, involves a number of things that may seem overwhelming to one who might work a standard 9 to 5 office job (particularly when that office job rarely involves blood, pus or excrement of any kind). Things like…

…a work day that starts around 5 AM.
…a work day that ends anywhere from 5 PM that same day to noon the day after.
…an average of 80 hours a week at work and four days off a month.
…a fair amount of sleep deprivation due to that which is listed above
…an even fairer amount of blood, pus, excrement (and a myriad of other bodily fluids for that matter).
…at least once a week, no less than one categorically drunken, drugged-out patient either spitting at me or, equally as charming, calling me a bitch.
…patient upon patient with bullet wound after bullet wound…with bullets that sometimes, oftentimes just by luck, have just grazed the skin…others that have penetrated through the sternum right into the left ventricle of the heart…still others that have miraculously managed to hit a rib anteriorly, ride it all the way posteriorly, and lodge themselves right by the spinal cord without any injury to any organ system whatsoever. Not surprisingly, the latter is the least common of the three listed scenarios. And sadly, there are infinitely more scenarios.
…swollen ankles from hours on end of standing in the operating room.
…ultimately, and what makes me do it, the satisfaction of diagnosing an operable disease, and performing the necessary procedure to take care of the patient (regardless of whether he or she spat at me or not). (And usually, even the spitters are grateful once the anesthesia has worn off.)

It goes without saying that the job is somewhat demanding. And after three solid years of working 80 hours a week, I was very much looking forward to the “break” that a stint of research would give me. Last July I signed on for a two-year leave from my usual clinical schedule to do breast cancer research. Cancer, for reasons near and dear to my heart, is something I’ve had an interest in helping abolish since early on in my medical education. Surgery can be an effective cure, and it’s certainly very satisfying when it is…but oftentimes it’s not. So looking for the reasons for this and finding ways to anticipate and prevent them, is very exciting to be a part of. The breast cancer research community as a whole, a community that spans the entire globe, is at a very pivotal point right now…and participating in it all is fulfilling in a way that is much different from my usual day at the hospital.

Plus! The added perks of a research job are things like…
…a work day that starts around 9 AM.
…a work day that ends anywhere from 5 PM to 7PM.
…an average of 40 hours a week, evenings and weekends off.
…a fair amount of sleep.
…absolutely no blood, pus, or excrement.
…a sheer lack of obscenities being screamed at me by patients
…no bullets
…ankles that do not protest when I attempt to zip up my boots!
…time to do other things…like visit friends and family, dance, and write this blog!

This is temporary…as I’ll go back to my usual clinical schedule in June of 2008. And I suspect that by then, I’ll be ready to jump back in to the chaos of it all. Afterall, I already miss working closely with individual patients and I certainly miss operating. And, sometimes, strangely enough, being screamed at, spit at, or called something profane at 3 AM by a perfect stranger, is more awakening than a stiff cup of coffee!

1. Yes, this means some of my shifts, usually around one to two a week, hover around 30 hours long.
2. To which I usually reply, “That’s ‘Dr. Bitch’ to you, Sir.”


Catherine said...

Dr. Bitch. I like that! Although I don't like the sound of June 2008. I'm thinking blogging will probably be moved to the backburner of your life! That's shitty. And bloody! And pustulent!

edvard moonke said...

I think it's quite sad that people who do extraordinary work, like you, are expected to work such ridiculous hours. what about human error due to lack of sleep? what about properly valuing professioanls who do invaluable work?

p.s. dr bitch does sound kinda cool.

TLM said...

damn skippy... you earned that title!

La Cubana Gringa said...

cathrine - Not necessarily! (It just means there will be more posts about that which is shitty, bloody and pustulent!)

edvard - Would you believe 80 hours is, by law, the upper limit of hours we are supposed to work a week? Before it became law, surgical residents used to work upwards of 100+ hours a week!! 80 hours does sound a bit nuts (and I'll be the first to admit that it kind of is) BUT there are a lot of issues at play here and there has to be a balance between quality of patient care, continuity of care, exposure of the resident in training to all of the surgical procedures that they need to learn, and decent work hours for the resident physician. It's tough, but do-able!

La Cubana Gringa said...

tlm - I'll take that as a compliment! Thanks!

heartinsanfrancisco said...

You must be referring to SF General.

My family has a terrible history of breast cancer, so I'm especially gratified that you're joining in the research for this terrible disease. Thank you.

I mean, thank you, Dr. Bitch. That has a certain ring to it. Although only a drunken moron would insult someone with the power of life and death over him.