Charleston

So the first weekend of October, I went to Charleston, SC with some friends from work. The weekend went like this... This is a picture I took of Charleston from the top floor of a hotel we stopped at one night.

I was on-call on Thursday. Meaning I work up at 4:30 AM, and work from 5:30AM to 11:30 AM on Friday (30 work hours total). Get home, pack, finish some work from home. Leave for Charleston at 4PM (~36hours awake)... I sleep for the first 2 hours. Arrive at Charleston at 8:00PM on Friday, go out with friends until 3:00AM on Saturday. Get up at 9:00AM Saturday and go to the Beach until 4:00PM. Head downtown for dinner, go on a walking tour of the city. Go out with friends again until 1:00AM, then drive four hours back to NC so that I could go to church and my buddy could be on call. I drove while my friend slept so that he was as rested as possible for call (you have to make sacrifices to have fun.... My youngest brother can tell you all about it... he’d sacrifice ANYTHING for fun).

Story.... We decide to take a walking tour of the city of Charleston, that supposedly details haunted buildings in Charleston. What better way to kick off a night than heading out at 9:00PM and hearing scary stories. Here’s how I envisioned it... a guy looking like Vincent Price would take us around scary buildings in Charleston, as we jumped every time we heard an ominous board creak. However, in reality... our tour-guide (Stew) was more like Matt Damon from the Informant
dressed in khakis shorts, a khaki shirt, and (you guessed it) a khaki hat. The outfit was topped off with copious amounts of sweat, and the tour consisted of walking past (not into) “haunted” buildings, as Stew told us 3 historical stories and 1 anecdotal story (that was originally past on by none other than Stew Jr.).,

Stew’s story telling ability also consisted of the recitation of these stories complete with awkward, forced pauses for dramatic affect. (Note: these pauses were often ill-timed and just long enough to be annoying). Let’s just say, it wasn’t exactly “enthralling.” In fact, it was boring enough at certain points that, believe it or not, my friends and I become... ummm... disruptive?... Literally, I think it took about 2 minutes before my first obnoxious comment. It went something like this...

Stew takes roll of all the people who have paid to be on the tour, and the following exchange occurs (a picture I took during the tour of the renovated basement of a building 2 stories above where a pirate dungeon used to be).

Stew: I would like to welcome you a tour of historic Charleston. Charleston was founded in 1670, and consists of (rattles off statistics about the number of original buildings that exist from the 1700’s, 1800’s and early 1900’s). Do any of your have any guesses about what the most historical city in the U.S. is?
Simultaneous - Everyone in the group with a pulse: Ummm... Charleston?...
Simultaneous - The Lady without a pulse: Ummmm....
Stew: I’d also like to remind everyone of the city of Charleston’s motto, Aedes Mores Juraque Curat (She cares for her temples, customs, and rights), but she does not care for her sidewalks, roads, pavements, alleys or paths. And believe you me, this tour is a lot better vertically, than it is horizontally. So please be careful as you walk this evening, and watch your step so that there aren’t any injuries due to stumbling or falling.... (one of the soon to become patented pauses)....
Me: Wow!... That’s a long motto...
Everyone but Stew: Laughing....
Stew: Still pausing...

Who says you can't enjoy prison?...

Residency is hard... I am currently in the middle of a string of 20 days without a day off. Obviously it’s not ideal... Most of the time, it’s not even all that fun. I mean, I spend the bulk of my time doing paperwork, entering orders in the computer, reading/preparing to get “pimped” about anything from skin cancer to drug interactions to home health arrangements. A lot of times, I feel like the guys in this picture... However, there is a brightside to all of this (and it certainly isn't the money)...

To prove it, I submit the following stories. We’ll mark them Exhibits A and B.

Exhibit A. As an intern I don’t operate much So when I do get to the OR it’s very, very exciting. Last month, I met a patient with an occlusion in the artery to the leg. The patient came in with a lot of leg pain, and the patient's first morning in the hospital I listened closely and changed the patient's pain medicines (super small decision... but ended up making a big difference to the patient). When it became clear that the patient wouldn’t respond to medical therapy we decided to amputate the occluded leg... After talking to the patient about the procedure the patient still seemed unsure of the procedure but said, “I don’t care if that tall blonde guy is the worst surgeon in the hospital... I want him to do it...” I of course responded with, “Ummm, my hair is NOT blonde...” And we took the patient to the operating room.

It’s a simple procedure, we didn’t have any complications and I got to do a lot (which basically means it was the blinding brilliant light from heaven on an otherwise craptastic day). We finish, and as we’re leaving the operating room I had the following exchange with my chief resident:

Chief: Alright I’ll take the patient (PS we don't refer to everyone as the patient... it's just my way of keeping the patient's story private... see there I go again) to recovery, can you go talk to the family?...
Me (never one to allow complete ignorance or lack of skill to stop me from doing something), Sure.... yeah.... ummmm... anything in particular you want me to talk to them about?
Chief (quizzically): Why don’t you start with the surgery and see where that takes you?
Me: Oh... right...

I walked up stairs to the waiting room, and nonchalantly asked the patient's family to step out into the hallway (good or bad news I feel like it should be private)... Because I wasn’t sure where to begin, I started with, “Well we finished the surgery

and everything went well.” Thinking that would be a sufficient explanation of a relatively routine procedure, I opened a huge can of worms with, “Do you have any other question?” They in fact had exactly one million questions about how the procedure was carried out, what exactly we did, and how the patient tolerated the procedure... It only took about 5 minutes, but the calming influence seen on their faces while hearing an explanation of a relatively routine procedure is really why I do this.

Exhibit B. One night on call I was covering the burn unit (usually not a lot of big issues... more just little things throughout the night), but occasionally you have to “admit” someone. Meaning you go see them, get the history and examine them. This can be more or less involved depending on the degree of the injury. While on call an elderly patient was transferred in from an outside hospital following a really bad burn. It became apparent right away that the patient would not live through the night. The doctor in charge spoke with the family over the phone, and they quickly realized that nothing could be done. They said they would be on their way and hoped their relative would make it until they arrived....

The patient’s family arrived, and the patient passed shortly after. In the midst of an insane night on call, I had to go to the intensive care unit and pronounce the patient’s death. The exam itself isn’t hard, but explaining the procedure to the family, asking them to step out of the room, examining her and then speaking with them about the pronouncement was definitely something that makes you pause and think. I won’t get into everything it makes you think about, but it certainly makes you miss the family and friends you have at home. It also makes you grateful that even on those busy nights, when you don’t think you have time to breath, you still get to come into people’s lives at a moment they’ll never forget and be a positive influence. So I guess if I’m going to be stuck somewhere doing something... it might as well be something that gives me opportunities like this every day...