PICU & JP

PICU-SLAMMED yesterday. Crawled into bed at 330 am, out of bed at 4am, and never made it back. Had breakfast with Amy (The Pedi Ward Senior who got us dinner at 11pm!), and the Pedi Surgery resident, who kept rubbing it in that she had gone to bed at 9pm! So, it was really hectic, a few sick kids, but overall it was a great day for learning. At one point the PICU was closed to admission cause we FILLED IT UP! Kids with trachs with chronic respiratory problems, 2 head injury kids (one who kept me up all night), hemopericardium for unknown causes, aplastic anemia and sick, lupus nephritis and hypertension. Honestly, it doesn't get better. But know what was great, at about 5am, a sense of calm settled over the PICU. The guy with the really bad head injury started to settle down, the girl with the really bad fever started to look a bit better, the girl with really bad hypertension seemed to finally settle down, the kid who had the stroke was awake and talking (although he has lost his vision). And at 5am, there was a little joy, in knowing that kids were better. A few would be transferred out of the PICU, a few would go home. It was also good cause I got to finally think on my own, learned quite a bit as well..

JP... JP is a kid slightly less than a year old whom I have taken care of in July on the pedi ward and again earlier this month in the PICU. She is "my girl." I know this kid well, think about her regularly when she's not in the hospital, get updates regularly from her specialists. She is chronically unwell. If you saw her in the grocery store, you'd think she was maybe 3 months old. When I was in the ED last night I saw her down there , and my heart sunk. (She almost came to the PICU, but ended up on the floor where she was almost constantly observed by us neurotic residents and nurses who care about this precious girl). I can't even describe how shitty this situation is. Nobody knows why this kids is sick, some metabolic/genetic/endocrine disorder. Talking to mom last night (who just learned that her pregnancy is going to be terminated due to a non-viable fetus) she broke down and has finally realized that JP is not going to make it. My gut feeling changed yesterday too, and I don't think JP is going to make it. I'm convinced that we're slowly watching her die. And while I think it is horrible for me to watch her die, it breaks my fucking heart to watch her mom who knows that she's losing 2 kids. I can't even imagine...

PICU Part Two

2:30 am. just finished tucking in the kid I just admitted. interesting day. Like running a neurosurgical service. broken heads today. bleeds in the brains. two 20 y/o girls, and now a 2 year old boy. girls were preventable. bike helmets are a good thing. not driving drunk is a good thing. having a 2 year old with a brain mass is not a good thing. nice people today. great nurses. It's been a pretty decent month. I hate to complain cause on the one hand i know that next month is going to kick my ass (when I'm in the Adult ICU working more hours than any human should), whereas this month the work has been actually mellow, but I don't think I'm learning as much as I had hoped. partly my fully, of course, haven't really had the time/motivation to read much outside of work.

Anyway, life is really good right now. It's going to be a crazy few month (on-call 3 of the next 4 months), with a vacation to Ireland, and then home for New Years.

Ok, going to get some much needed precious sleep now. Oh, funny thing, we had a lecture on sleep deprivation earlier in the week, would have been nice had they allowed us to take a nap instead of going to a conference on sleep deprivation.

Neurotic Friends

First of all, I'm the neurotic friend. Well, that's a total lie, cause "birds of a feather..." yeah, you know the rest of the saying. However, as of late, I'd just like to thank my friends for putting up with my neurotic issues (life, love, and the pursuit of happiness), cause god love the people who I have called multiple times to hash out a few things going on in my life recently. You know who you are, and all I can say is thanks. And I might add that I listened, for once. This post won't make sense to many of you at this time. C'est La Vie.
-BPB

Mountains Beyond Mountains

I had the chance tonight to hear one of my heroes speak. Maybe "Mentor-By-Proxy" is a better term. If I've never tried to convince you to read the book Mountains Beyond Mountains about the work of Paul Farmer, have a look at THIS SITE on the group Partners in Health and find a copy of the book (or come visit me and read mine). It's a medically oriented book, but everybody I know who is non-medical has been inspired. So really, drop the smut novel, and read some real chicken soup for mankind kind of book. Really, trust me on this one... PICU is good. My favorite kiddo got transferred to the pedi ward today. Will miss seeing her, but will keep tabs on her.

g'night, it's very late.
B

PICU Part One

So, had my first overnight PICU call (they are all going to be overnight by the way) last night, and, um, I hate to admit it, but I wore the lucky socks, AND THEY WORKED! I actually didn't have a single admission, and went to bed and didn't get called til 0530! Amazing. Granted, I'm sure that means I'm going to get nailed on the next call, but that's ok.. It's certainly nice to be engaging my brain again.

I'm taking care of one of the kiddos I took care of in July. It's tough cause I was pretty worried about this kiddo in July, she's failing to grow, failing to reach milestones, has had a pretty thorough work up this far, and nothing is coming up. It's tough. And let me tell you, her mom is a Saint. It kills me each day when I have to tell her that we still don't know what's going on. FOR TWO MONTHS!

Ok, I need to get some reading done...

Cheers,
B