Days 5-7: Crunch Time

I will skip Sunday as a day of rest which was really a day of feverishly working to prepare for Monday and Tuesday.

Consults has been tough.  Not by volume, but by the incredible learning curve that comes with each new one.  I thought I knew a little palliative care.  I was wrong.  Devastatingly wrong.  In the vast swath of knowledge that goes to palliative, I know a minuscule amount.  Each day, I add to the list of things I need to read up on, only to find myself swimming in a sea of topics.  I am too slow of a reader to make it to the top again.  Not for lack of trying, mind you.  I think one of the biggest hurdles is the mentality that pervades other areas.  A mentality, mind you, that I used to have: that of the "end game" being to get the patient and/or family to do what you want them to do.  The selfish mentality that the only "right" decision is your decision.  Despite the fact that we aren't the ones who have lived day in and day out with a terminal disease.  I realize the frustration with having to continue what feels like futile care for a dying patient, but at the same time, I can't imagine any of us would be convicted enough to sentence a parent or sibling to death who had only been healthy what felt like a few days prior.  I also can imagine that any of us would feel guilty, as a young parent, if we were faced with leaving our children to fend for themselves without us around.

I sometimes do feel like a hypocrite, preaching that I can't make anyone do anything they don't want to.  I feel like, as a resident, I tried and failed to make people see what I saw only to be frustrated when things didn't go the way I felt they should.  I have begrudged the family that forced many hours worth of resuscitating their loved one on me, despite the fact that my team had it within their power at that time to say that the patient was no longer able to live if resuscitation had not brought her back to life without CPR.  I feel like I've aged in just the year of geriatrics.  While not necessarily wiser, less bent on forcing people into a corner.  Is it the fact that I'm not the one directly dealing with the daily repercussions of a person's imminent likelihood of coding?  Is it knowing that I will be asleep while the other team anxiously awaits the need to intubate?  Is it the fact that I'm not on the other end of the phone when a patient transfers to the ICU?  I hope not.  I am thankful I am no longer the one with sleepless nights in the hospital managing ill patients on a skeleton crew, but I hope I have not become so distant from that time.