Wednesday, November 22, 2006

Change of venue

First of week of new job, which I guess soon will just be "job," is done. So far, it's pretty good. It's still early days, of course, but I think I will like it there.

I used to work at a place I affectionately and bitterly called the "Last Chance Motel." Because it was. People came there for the last-ditch treatment option, after failing several other treatments. They are supposedly aware of the risks of the treatment, but are willing to risk it in order to buy themselves a few months or even years of more time with their loved ones. Or they come because they just can't "give up" or they are incurably optimistic or only believe that complications and side effects happen to other people. Whatever their reasons, they showed up, bald, smiling bravely, with sad worried eyes. Anyway, I always felt a cloud of resignation hanging over my head, over everything we did. It sounds horrible, but when every one of my patients had the same outcome, regardless of what we did, how hard we fought, it's hard not to get resigned to it. When a blood culture came back positive for gram negative rods, we sighed our collective sigh, our shoulders drooped, and we reflexively ordered the appropriate antibiotics. In the back of my head I would think that I wasn't surprised, it was only a matter of time, and wondered if this would be the straw that would help our patient to the inevitable end just a little bit faster. Because it was the Last Chance Motel. We tried really hard, and we kept hoping, believing that sometime, some patient has to be the one who makes it. But really, we were waiting for the families to realize what we all already knew.

At the new job, I think I'm going to call it the Not Fair Club. Not because anyone anywhere ever deserves to get cancer or to get sick, but because kids are supposed to be playing outside and wrestling with their siblings and whining for more candy and laughing, and when you're a kid life is supposed to be simple and easy and most arguments can be countered with a big ol' "But it's not fair!" Because when you're a kid life is supposed to be fair. So lying in a hospital bed with tubes in every orifice and sutures across your belly and almost nearly dying because the tumor they just took out of you weighed almost as much as you really isn't fair. So we aren't resigned to any outcomes here, the only acceptable outcome is getting that kid out of that bed and home again so he can pull his brother's hair and smear peas on his face and make his mom laugh again. So when his blood cultures come back positive for gram negative rods our hearts drop and we stamp our feet and pout, "Damn it! It's not fair!" and we order those antibiotics and we check and double check that they are the best ones possible and we didn't miss anything.

Hrm. It's hard to talk about the old job without sounding heartless and dead inside, but I just can't really phrase it right I think.

Anyway, happy thanksgiving to those of you choosing to celebrate genocide and barbaric empiricism with gluttony and excess. Heh. I like the way that sounds. Don't worry, it's not like I would ever turn down a day off of work or a large tasty feast. I'm going to eat Greek food and see a matinee and hang out with my family in Bellingham.

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