The Actual Prologue
June 21: Friday
T-minus seven days to go in residency. I work six shifts in these last seven days. After my shift on Thursday night I’ll help with last minute packing, and then the hubby and I will head out early next Friday morning. I feel ready to graduate, ready to start my EMS fellowship, and ready to begin life as an EM attending.
The house is in absolute chaos with the packing. But a happy chaos.
June 23: Sunday
Ok, so I’m getting nervous about starting my fellowship. My nerves are not about being an attending, but rather, about having to start over with new co-workers. Here, right now, I know everyone in my department. After four years, I’m a familiar entity to all the nurses and techs and docs, both in the ED and in other departments. I know who to call when I need help with anything ranging from computer issues to medical supplies. A new hospital, though... yikes. The medicine doesn’t change from place to place, but the culture and atmosphere between different EDs is certainly variable.
June 25: Tuesday
2 shifts left! While I’m dreading saying goodbye to my friends and co-workers, I’m so ready to be done and to leave here. Final Countdown!
So much packing to do. Now that the idea of writing another book has firmly embedded itself in my head, it’s hard to shake. Part of me is surprised that I’m planning another book. But when I think about my lifetime of keeping journals, it’s hard to imagine not doing it. Instead of writing every day, which is how I wrote my first book, perhaps I’ll aim for weekly entries. I’m just too unsure of my schedule. As in the first book, I’ll write as I go. The events that unfold will be as much as surprise to me as to any of my readers. A new city, a new job, a new-ish husband – could be fascinating and life changing. Could be dull and boring. Who knows?
Either way, I’ll end up with a new digital journal. Writing is like hitting the release valve on a pressure cooker. If I didn’t write, I’m fairly certain my head would explode. Maybe I’ll post the entries to my website as I go. Wait, there’s a word for that. A blog. There we go. I’ll start a blog. If you’re reading this, then I actually did it.
June 27: Thursday
To keep track of my patients, I write the age, sex, presenting complaint, and room number on a sheet of paper (the paper then gets shredded at the end of shift).
During my last 6 shifts, some of the chief complaints I recorded on my sheet included:
Knee pain, vaginal bleeding, fall, hypotension, suicidal thoughts, kidney issues, nausea and vomiting, accidental overdose, intentional overdose, motor vehicle accident, tractor/truck accident, weakness, chest pain, headache, fainting, lower leg swelling, bradycardia, altered mental status, wound infection, generalized body aches, ankle pain, electric shock, cardiac arrest, elbow pain, snake bites, abdominal trauma, hand pain, burns, broken bones, abdominal pain, bleeding, back pain, pneumonia, heart failure, urinary tract infection, pregnancy, dissection, rash, fever, hypertension, asthma, palpitations, rib pain, tremors, hypoxia, anxiety, seizures, cellulitis, shortness of breath, facial droop, abscess, gun shot wounds, and stabbings.
Every injury and illness under the sun. It’s what I love about emergency medicine. Every day is different, every person is different. We’re here to see any age, any race, any sexuality, any religion, any socioeconomic status, and with any complaint imaginable.
You never know what will roll through the doors. That is also the reason why many non-EM docs hate the ED. It can appear to the outsider to be complete and utter chaos. But really, it’s a controlled chaos. There’s a flow that exists, with nurses, physicians, techs, and everyone else on the team working together, for the common good of the patient. I love it.
June 27: Thursday night
I did it. My EM residency is complete. No time for sleep (or writing, for that matter). Must pack. We’ll be up at 6 am to drive to Southern California. My husband is trailing his car behind our moving truck, while I’ll be driving my car with our two Rotties, Argo and Foss.
June 28: Friday morning
The truck and cars and dogs are packed. Time to go. Farewell residency, hello fellowship and attendinghood.
Recipe: Smoky pink paloma
In a nod to our new home in San Diego, we’ve been exploring Mezcal, a type of smoky tequila. Here, we’ve created a smoky pink paloma, which a balanced, smoky, sultry twist on the classic pink paloma! And what does the smoky paloma have to do with prepping? Well, in the midst of a zombie apocalypse, who wouldn’t want a nice cocktail?
2 parts Mezcal
1 part rose
4 parts grapefruit soda
Juice from 1/2 lime
2-3 dashes of smokey orange bitters
Rim 2 glasses with a mixture of paprika and smoked sea salt
Put into a shaker with ice, shake, then strain into the rimmed glasses and garnish with lime slices.
Recipe: Prepping the car for the move
There are a few items that I recommend people keep in their cars at all times. Cars should undergo regular inspections and maintenance, in addition to having up-to-date insurance and registration. The first item is the most obvious but often overlooked: a full tank of gas. I rarely get below 1/2 a tank before I fill up again. Moving on. Jumper cables will help if you’re broken down, while sneakers and a warm jacket will allow you to walk to safety if your car is stranded somewhere. This is especially helpful if you tend to wear heels to work or other shoes that are not conducive to walking long distances. Water and snacks are always a good idea. Also, keep a flashlight or two in your car, though a headlamp is even better, as it will allow you to work hands-free. A spare phone charger, hat with a brim, and some paper maps (yes, paper!) should round out the basics you keep in your car. If you live in a colder climate, consider adding a hat, gloves, scarf, and earmuffs.
An in-depth discussion could be had about any individual piece of gear suggested, and I plan to do deeper dives into some of the suggested items, especially water, food, and the first aid kit. There are pre-made kits that you can buy, or you can just gather the items individually and stick them in your trunk (which I what I’ve done).
There are just some bare minimum suggestions, and I keep quite a bit more gear in my own vehicle. But to get started, here’s the list:
Instructions for using the jumper cables
Combo seat belt cutter & glass breaker
Sneakers and socks
Flashlight and/or headlamp
Portable phone charger
Large wool blanket
First Aid kit