WHEN IS A CITY LIKE AN ARM

Sun Su is doing fine.  He has a couple more weeks to wear his cast.  Thankfully he didn't actually need surgery.  The orthopod just had to push his radius and ulnar bones back into place while Sun Su was under anesthesia.

Two days before the procedure I ran into the ortho surgeon who was doing it.  He reminded me of Andy Garcia if he were a new car salesman.  Dark slick hair, shiny complexion, fast talker, interesting expressions.  (He looked a little too shiny to be a used car salesman.)

"I don't think we're gonna to have to do any surgery.  I'm just gonna set the bones back in place.  Heck, if we were in Botswana, we'd just do this right in the office," he said to me two days beforehand.

Right before the procedure (and the day after hurricane Katrina hit), Dr. Garcia said to Amy, "I'm just gonna set the bones back in place.  Heck, if we were in New Orleans, we'd just do this right in the office."

I found it amusing how quickly he substituted a major U.S. city for a third world country in his expression.  Still, sad but true.

Two weeks more and Sun Su will be able to wreak two-fisted havoc again.  Although I haven't noticed any difference so far.

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THE RETURN OF THE SCHWING

Living in a university town is tantalizing this time of year.  The students have all come back.  The traffic blows.  At this point in my life, I can kind of see above it all.  The whole subconscious mating dance.  The flaunting of new virility.  The race for reproduction (under the guise of casual sex).  The inquiry of self-identity.  Nature's way of grabbing the reins of testosterone in your veins with that same old trick - nubile secondary sex characteristics in tight tee-shirts. 

Of course, there's always that other thing that testosterone is good for.  Fighting. 

With the new school year, our official Brazilian Jiu Jitsu classes have started again.  Damn, there were like fifty guys (and half a dozen girls - booyah!) on the first day in one gym room, barely large enough for half that.  Just practicing a single move was like mass melee.  My newbie partner's elbow gave me a fat lip while some another new guy behind me rocked the back of my head with his knee.  This is supposed to be grappling, not Thai boxing.  That means "no hitting."  Now give me your arm while I drop my forearm on your larynx.  Good times. 

I'd like to write more about jiu jitsu.  Sometimes it's intimidating beforehand, but it's also exhilarating afterwards.

For now, I just logged one of my nights on call, below.  Those usually hurt more than a few "accidental" elbows and knees.

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FRIDAY NIGHT EPIC

As I've said before, the worst part about this job is the nights on call.  At least you get to go home, but sleep isn't a given on those nights.

5:30 PM.  Call from another hospital to transfer a 19 year old (!) girl who is being discharged from a psych unit there (!!).  The neurologist wants her to get an MRI sooner rather than later to rule out a clot in her brain.  Their hospital doesn’t have MRIs.  The transfer woman on the other end sounds overly nice, but timid.  Makes me nervous.  The St.Azrael Hospital (my hospital now) transfer woman doesn’t like this at all.  “The ER is already full with patients that actually belong here.”

6 PM.  The in-house doc calls me about a new patient he just saw.  Chest pain, nausea, the usual.  M.I. (myocardial infarction, heart attack) or not M.I.  That is usually the question. 

6:20 PM.  ER calling.  Old lady, chronic bleeder, from her bowels.  Needs transfusion.  Figure it out in the morning when G.I. comes to stick a camera up her ass.

7 PM.  Floor call from nurse.  “Can Mrs. Renalfailure use her peritoneal dialysis equipment from home?”  Sure.  Click.

7:15 PM.  Floor call from nurse.  “Mr. B is eating and drinking really well.  Can we stop the IV?”  Sure.  Click.

8:15 PM.  New patient from ER.  Woman passed out (syncope) at The Olive Garden.  Three times.  Leave the canoli. 

8:20 PM.  Again, the ER.  Old woman wasting away.  “Failure to thrive” at seventy-five.  Also called the "dwindles."  Seriously.

8:25 PM.  This is starting to suck.  Old man waiting to die (home hospice), only the family doesn’t want him to do it at home anymore.  A classic Friday night dump.

9 PM.  ER again.  Potassium’s too high.  Cardiac arrhythmias.  Renal failure.  I’ll See You in the ICU.  Stop already.  

10:10 PM.  Patient in ER can’t swallow anymore probably due to radiation scarring from his treatment for lung cancer.

Up to midnight, I get three or four more floor calls.  Patient wants a sleeping pill.  Can we try a different anti-nausea medication.  Something else I forgot.  Amy and I manage to get warm, wet, and satisfied for twenty minutes without being paged.  Now I AM convinced there's a full moon tonight.

I go to sleep on the couch after that.  When I'm on call, I can't sleep in the same bed with Amy.  That would just be cruel.

12:55 AM.  Radiologist calls to tell me that the scan was negative for pulmonary embolus (lung clot), but there’s fluid on the lungs.

1:00 AM.  CCU resident tells me about the Mr. Hipotassium from the earlier 9 PM call. You can tell he’s a new resident (or intern actually) because he tells me way more than I even need to know in the daytime.

2:00 to 2:30 AM.  Two more patients hit the floor from the ER.  A third one is in  the ER.

4:17 AM.  I wake up and discover I’ve missed two pages due to sleep.  One is a new patient with diverticulitis in the ER.  The ER doc describes the verbose CT report as “epic.”  Takes me a while to understand what he means by that.  "Epic," I kind of like that.

For a minute I think it might be easier if I just stay up the rest of the night.  Then I remember that’s why I feel like shit in the first place.

For the next minute I look at porn blog pics.  Then I crawl back to the couch.

7:31 AM.  I’ve gotten at least five pages since the last time.  I've gotten almost no sleep, it's time to get up, and I'm already going to be late. 

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FEEDING THE ANIMALS

That's my brother Mark (black shirt and lambchops) to the far left, above pic.