Hurricane Call

Last week I took overnight call for the first time as Orthopaedic resident and its was…exciting. It was exciting not only because it was my first call, but because Hurricane Irene was also bearing down on the East Coast, ready to bear all sorts of carnage. On the drive in to work, I saw this in my neighborhood:

Of course since I was driving in at night (I took this on my post-call day) I almost hit that tree, not expecting it in the streets of Baltimore. But this was only the continuation of my “exciting” call since when I woke up on my call day I had no power due to the hurricane showing Baltimore Gas & Electric who’s boss.

I finally arrived at the hospital, and at that time I got sign out from all the services, Trauma, Spine, Peds, Hand, and Sports. They all gave me their pagers, and I was left to fend for myself. Okay, just kidding, they also left a PGY-4 from Union Memorial to help me through my first call too, but it didn’t change the terror I felt of having 5 pagers on my waist. At around 5:30 pm all the pagers began to go off. Its a known fact that you get the bulk of your pages about floor patients around the time that nurses are getting ready to switch off. By 10 pm many of the patients started to go to sleep, so the pages that started coming in then were ER consults, because everyone with a fracture decides to wait until Friday night around 11 pm to come in to the ER.

The night was pretty eventful and the one thing I noticed immediately that was different from being a medical student on call was that the option of sleeping just wasn’t there. Often as a medical student when things started to slow down at around 2 a.m. the resident would tell me to get some rest. I wrongly assumed that the resident himself/herself were also heading to their call room for some shut eye. But this just is not possible; when you are not getting paged about floor patients  to come change Mr. X’s IV pain med to PO, or that Mrs. X started to get tachycardic and is complaining of 10/10 pain; and when you are not getting paged by the Adult or Peds ED to see such and such patient who they have been sitting on for like 3 hours before they call you, then you are typing up all the consults that are required to be done before 6 am the next day when the attending comes in to round on the new consults. In addition to that, you also have to present all the consults you saw at “The Board”. The Board is where the resident on call pulls up all the X-rays of the consults they saw in the ER or on the floor and describes the fracture/problem, and shows how they fixed it/splinted it, etc, and what the overall plan is. You are doing this in front of all the residents and a couple of key attendings. Most times this can be a stressful but benign event, however if your splint looks sub-par on X-ray, or you missed something important on X-ray, or you are asked a pertinent question about the fracture classification and don’t know it then the event can get particularly stressful. As a new intern, really just 2 weeks into being in the hospital, on my first call, I had to make sure that I had my presentations for The Board down pact.

So really all this equates to the fact that you just can not sleep at all when you are on call for ortho at Hopkins. There is too much to prepare for even when the ED isn’t harassing you. However this was the aspect of the program that I really liked as a student. I liked the fact that even though its an academic institution, you work very hard. Its better to put in the hard work now than suffer and stumble through things later as an attending.

I’m writing this currently after finishing my second call as an ortho resident and it was even more busy. Although I must say that I did learn a bunch; I learned how to put on a spica cast, I learned how to evaluate a deep laceration of the forearm for tendon and muscle damage; I put on a sugar tong splint and ulnar gutter splint without supervision, which is truly the only way to know that you do or don’t know how to put one on correctly; I learned how to deal with patients calling the on-call pager for pain scripts or cast care, etc. There truly is so much new information to learn in the field of orthopedics and I’m excited to even get the chance to do this. I’ve still be struggling with having devotion during this ortho rotation, but I know that at some point I have to make it a priority over other stuff I do in my limited downtime.

3 Responses to Hurricane Call

  1. Dan says:

    Like the blog. Worked in foreign missions for a few years after college, and am applying to med school now. Keep up the good work!

  2. Dan says:

    Oops, I just read the piece on the Catholic Church. I have Adventist friends, and know we disagree on some things, but I have never come across any vitriole like that except in history class–especially on the occasion of a person’s death and funeral, let alone that of a holy man like JPII. Anyway, stick to surgery, I guess.

    • DoctaJay says:

      Hi Dan, I’m not fully sure if you read the entire post on the Catholic church; in fact I am sure you did not. Regardless, I thought I made it clear there that I have nothing against Catholics. A number of Catholics I have personally met have been the most compassionate and kind people to walk the earth. It is clear that their walk with Christ is strong.

      The post was about the Catholic church as an institution, which as you mentioned in your history classes has done nothing but 1) prevent common people from reading the bible, 2)jailed and killed those who have spoken out again the pope or its doctrines 3) changed the order and structure of the 10 commandments spoken by God himself, etc. I could go on and on, not from conspiracy theories but from history itself.

      It is because of all of these things that Martin Luther started the Protestant movement. It was in “protest” to the catholic churches handling of the Bible and it’s precepts. Does this mean that individual Catholics are inherently bad? Absolutely not. Does this mean that the institution of the church is inherently flawed? I believe YES.

      If you believe JP II to be holy while allowing fellowing priests to molest good natured, God loving children, in order to not bring attention to the church then fine. But realize that no man is perfect, including the pope, including all Adventist pastors, and pastors of every other denomination. The difference is that we don’t consider our church infallible.

      So again. Please prove me wrong from history and from the Bible what is listed in my previous post. I am certainly open to learning new things and am always willing to change my views. Are you?

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