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osodecanelaThe older I get, the less I like being on call.
With four left in the call group, each of us gets one day during the week and then Friday, Saturday and Sunday, rotate through the four of us. Monday nights are mine.
LJ and I had a potluck to go to last night. We got home shortly before 10. Fifteen minutes after walking into the house, my answering service texted me. Angelica was in labor. When I spoke with her, it didn't sound urgent at least not yet, but it was her fourth delivery. I'd been about to head off to bed, but held off awaiting the verdict from the nurses at labor and delivery. No use getting undressed, only to have to get dressed again.
At 11:30, the word was 2 cm. I told them to have her walk for an hour or so, and if she made no change, I wanted her to have enough morphine she would go to sleep. After 22 years, I know this lady very well; the worst thing for her would be to be awake all night in prodromal labor. I needed her to have some 'oomph' left when it came time to push. At one in the morning, L & D called. She was still 2 cm and wanted to go home. "Great," I thought. "That's the last thing she needs. She'll be awake all night, biting her nails, if I know her." I asked her nurse to put her on the phone. It took me only a moment or two to convince her that she was already in a bed in which she could sleep, if she had a little chemical help. Some morphine sent her right into the arms of Morpheus. She slept straight through till change of shift at 7 AM.
I however, was not so fortunate.
ER physicians seem to have little pity, and certainly little awareness that while they are working the night shift, you as a primary care physician just might be asleep. Now, I can understand if the emergency room is packed and the ER doc must get people out, in order to get people out in the waiting room in, but honestly, at 5 AM is that ER waiting room really packed? I'm a night owl, not an early bird. If I'm awake at 5 AM, generally it's because I haven't gone to bed yet. Perky, and conscious is generally not my MO at a 5:15. Not true for the gentle Dr. Patel. The dulcet tones of her voice remind me somewhat of a TV weather woman. Perky doesn't quite do her justice. She's a solid doc, and I'm glad to know she's awake and making the world safe for those truly in need of medical attention in the middle of the night. One of my call partner's patients, an elderly man in his dying process, who for reasons that I do not understand is not yet on hospice care, had arrived in the ER in respiratory distress. The good Dr. Patel had worked some of her medical magic and the man was now stable for the time being, in need of admission. I inquired if she was desperate for beds, which surprised her; she responded, "um, no actually." I countered, "would it be all right with you, since his primary provider comes back on in an hour and a half, if you simply held him in the ER until then?"
My alarm went off at seven. I called my call partner and gave him the heads up, leaving him his sad gentleman to take care of, but not before asking if he intended to refer the gent for hospice care. Then I called labor and delivery to find out that my laboring mother had gratefully slept through the night, thanks to her visit with 'Mme. Morphine'. I showered, got dressed and about to head out the door, realized my wallet was nowhere to be found. After ten minutes of searching, it hit me the last place I had seen it was at my desk the the afternoon before, when I had taken it out of my pocket to fetch my credit card when I purchased the vanilla beans (see previous post).
So, out to the car and off I went, into the morning fog. Traffic was understandably slow given the visibility. Coastal fog this time of year often starts at midnight and lingers until 9:30 or so in the morning. The route into town this morning was an automotive conga line as a result. I was about a third of the way into Santa Rosa, when the call came from L & D. Angelica had gotten very active and was now 7 cm, and moving. I told her nurse I'd be there as soon as I could. There's a rather steep hill that marks the halfway point of between home and office, that often marks the separation between sun and fog on my morning commute. Gratefully, that was the story this morning, given my need to get to labor and delivery as quickly as possible. Once out of the fog traffic began to move at a brisk pace.
I was four blocks from the hospital when I saw a bubble lights in my rear view mirror.
The motorcycle cop came to my window and asked "did you realize you just went right through that stop sign?" I responded, "no, and if you're going to ticket me, can we do this as quickly as possible? I have a patient in labor and delivery that's 8 centimeters and it's her fourth child." He asked for my license. My face fell. I told him it was in my wallet which was still on my desk, but to please give me a second and I would give him my registration from the glove box. Gratefully, my hospital ID tag was hanging from my jacket collar.
"You're a physician?" I nodded.
"You're on your way to the hospital up the hill?" I nodded again.
He started to head to his car, then had a change of mind, turned around and handed me back my registration, smiled and waved me on. "Just be careful."
"Officer, you are a gem!" Off I went.
Angela Beatriz was born just about an hour later. Just shy of 9 pounds, she entered the world after three pushes, with the same doctor, in the same hospital, & in the same room, where her two older sisters were delivered – 19 and 21 years ago. Her father is grateful, her mother relieved, and her doctor honored and delighted to have been able the be there, and to be the first face she saw, after arriving in this life.
With four left in the call group, each of us gets one day during the week and then Friday, Saturday and Sunday, rotate through the four of us. Monday nights are mine.
LJ and I had a potluck to go to last night. We got home shortly before 10. Fifteen minutes after walking into the house, my answering service texted me. Angelica was in labor. When I spoke with her, it didn't sound urgent at least not yet, but it was her fourth delivery. I'd been about to head off to bed, but held off awaiting the verdict from the nurses at labor and delivery. No use getting undressed, only to have to get dressed again.
At 11:30, the word was 2 cm. I told them to have her walk for an hour or so, and if she made no change, I wanted her to have enough morphine she would go to sleep. After 22 years, I know this lady very well; the worst thing for her would be to be awake all night in prodromal labor. I needed her to have some 'oomph' left when it came time to push. At one in the morning, L & D called. She was still 2 cm and wanted to go home. "Great," I thought. "That's the last thing she needs. She'll be awake all night, biting her nails, if I know her." I asked her nurse to put her on the phone. It took me only a moment or two to convince her that she was already in a bed in which she could sleep, if she had a little chemical help. Some morphine sent her right into the arms of Morpheus. She slept straight through till change of shift at 7 AM.
I however, was not so fortunate.
ER physicians seem to have little pity, and certainly little awareness that while they are working the night shift, you as a primary care physician just might be asleep. Now, I can understand if the emergency room is packed and the ER doc must get people out, in order to get people out in the waiting room in, but honestly, at 5 AM is that ER waiting room really packed? I'm a night owl, not an early bird. If I'm awake at 5 AM, generally it's because I haven't gone to bed yet. Perky, and conscious is generally not my MO at a 5:15. Not true for the gentle Dr. Patel. The dulcet tones of her voice remind me somewhat of a TV weather woman. Perky doesn't quite do her justice. She's a solid doc, and I'm glad to know she's awake and making the world safe for those truly in need of medical attention in the middle of the night. One of my call partner's patients, an elderly man in his dying process, who for reasons that I do not understand is not yet on hospice care, had arrived in the ER in respiratory distress. The good Dr. Patel had worked some of her medical magic and the man was now stable for the time being, in need of admission. I inquired if she was desperate for beds, which surprised her; she responded, "um, no actually." I countered, "would it be all right with you, since his primary provider comes back on in an hour and a half, if you simply held him in the ER until then?"
My alarm went off at seven. I called my call partner and gave him the heads up, leaving him his sad gentleman to take care of, but not before asking if he intended to refer the gent for hospice care. Then I called labor and delivery to find out that my laboring mother had gratefully slept through the night, thanks to her visit with 'Mme. Morphine'. I showered, got dressed and about to head out the door, realized my wallet was nowhere to be found. After ten minutes of searching, it hit me the last place I had seen it was at my desk the the afternoon before, when I had taken it out of my pocket to fetch my credit card when I purchased the vanilla beans (see previous post).
So, out to the car and off I went, into the morning fog. Traffic was understandably slow given the visibility. Coastal fog this time of year often starts at midnight and lingers until 9:30 or so in the morning. The route into town this morning was an automotive conga line as a result. I was about a third of the way into Santa Rosa, when the call came from L & D. Angelica had gotten very active and was now 7 cm, and moving. I told her nurse I'd be there as soon as I could. There's a rather steep hill that marks the halfway point of between home and office, that often marks the separation between sun and fog on my morning commute. Gratefully, that was the story this morning, given my need to get to labor and delivery as quickly as possible. Once out of the fog traffic began to move at a brisk pace.
I was four blocks from the hospital when I saw a bubble lights in my rear view mirror.
The motorcycle cop came to my window and asked "did you realize you just went right through that stop sign?" I responded, "no, and if you're going to ticket me, can we do this as quickly as possible? I have a patient in labor and delivery that's 8 centimeters and it's her fourth child." He asked for my license. My face fell. I told him it was in my wallet which was still on my desk, but to please give me a second and I would give him my registration from the glove box. Gratefully, my hospital ID tag was hanging from my jacket collar.
"You're a physician?" I nodded.
"You're on your way to the hospital up the hill?" I nodded again.
He started to head to his car, then had a change of mind, turned around and handed me back my registration, smiled and waved me on. "Just be careful."
"Officer, you are a gem!" Off I went.
Angela Beatriz was born just about an hour later. Just shy of 9 pounds, she entered the world after three pushes, with the same doctor, in the same hospital, & in the same room, where her two older sisters were delivered – 19 and 21 years ago. Her father is grateful, her mother relieved, and her doctor honored and delighted to have been able the be there, and to be the first face she saw, after arriving in this life.
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no subject
Date: 2013-01-23 06:51 am (UTC)no subject
Date: 2013-01-23 01:18 pm (UTC)Wait ... mom and dad have children 20 years old ... someone forgot the condoms ...
no subject
Date: 2013-01-23 03:18 pm (UTC)no subject
Date: 2013-01-24 05:27 am (UTC)no subject
Date: 2013-01-25 03:43 am (UTC)I suddenly felt this wish you could be my doctor, especially if i ever decide to have a baby, but some things just aren't meant to be. :)
no subject
Date: 2013-01-29 09:48 am (UTC)