Wednesday, April 15, 2009

A Doctor by any other name...

So what do you call your friendly neighborhood doc? I've found that as I spend more time in the field I'm less formal with the healers of higher learning. I always refer to them as sir, ma'am or just plain doctor in front of patients but at the desk all bets are off.

I don know if it's my moderately cheeky nature, my anarchic attitude or my inability to remember names easily but I call every male doc either man, dude, slick, cuz (short for cousin) or by their first name. I always call women docs by their first name because I can't find a generic nickname that doesn't sound condesending. In fact I've only once been corrected by someone who wanted me to call them by her title and surname. The older docs look a little taken aback by my inpertinence but quickly get used to it. The younger docs tend to embrace it.

The people I always seem to have problems with are the older nurses. I have been told more than once that calling a doctor anything but doctor is disrespectful. I personally believe that calling everyone by first or nicknames fosters teamwork and provides a breeding ground for true interdisciplinary practice. At least that's what I'll say next time I get called on the carpet for it.

And a word to the wise, if you find yourself itching to try this in your own practice don't refer to anyone of Indian descent as Hoss (southern for horse, meaning strong guy). I don't know what it translates to, but it will get you a dirty look.

RT

Saturday, April 11, 2009

Hallelujah sons and daughters

Hallelujah sons and daughters.

Big changes and I haven’t felt like blogging. My dad, the reason I got into this business died and left a large hole in my life. My wife lost her job and we had to start traveling to make enough money to keep a house we can’t afford to live in.

Savvy?

I’ve been working at a small surgical hospital that’s part of one of the most prestigious health systems on the east coast. All I have to say is world class medicine, really shitty gloves. I mean really, I understand the importance of having a latex free hospital but do you really have to use the crappiest gloves made. I of course have freakishly large hands, and I’m sure that that increases the failure rate. These gloves are busting like the banking industry.

Too soon?

Anyway, tonight I had to terminally extubate in front of a live studio audience. A woman was brought magically back to life after an indeterminate amount of time down. Unfortunatly she had already walked into the light and we were left with what was left. Instead of grasping to some small glimmer of hope and letting her rot away her family made the very hard decision to let her go. After brain death was determined and we had a family reunion they decided it was time to let go of the flesh that had until recently been their family member. I was kicked back doing as little as possible ( a little charting) the RN called me and asked if I would be so kind as to kill his patient.

Yup.

This has always been the toughest part of the job for me. It hurts to be viewed as the asshole who killed momma/granny/dad/granddad/aunt/uncle/disco/the 1986 Red Sox. Because of the experiences of this past year I have seen it from the other side. Dad and my Granny were both terminally extubated and I didn’t hate the rat bastard who killed them.

I digress.

So I walk onto the unit and find a room overflowing with love, grief and family. I gather my supplies and suit up for action. I walk in and explain who I am and what I’m about to do. None of them move. Not one. Crickets chirp. Someone in the back coughs.

I suggest they may be more comfortable in the waiting room.

Now even the crickets are silent.

I pulled the tube out of someone while 15-20 of her family members stayed in the room. I have to say I was a bit uncomfortable. I offered advanced condolences, offered my services and to answer any questions, and scooted out of the room. I’m really glad there was a lot of family. Many hands make light work and there is no heavier work than grieving. I just wish they wouldn’t pray so loud, it’s making my ears bleed.