7th day in the ER

Things have been standard. Lots of flu, learning how to distinguish it from pneumonia using basic tips such as if they have cough all the time or only upon breathing deep (if it's the latter then they can probably skip the CAT scan). I've been working with a PA of 7 years who was 40 when she graduated. It's sort of odd, because I usually come down on younger folk who have little experience but she had little experience and is really, really impressive (tho she did shadow a bit in the ER before applying). I don't know if it's because she was a mom, or if she just has the perfect personality to be a PA. She forgets nothing, her interactions with the patients are extremely thorough and accurate. I've always been one to notice error, and I'm having trouble find any with her. Anyhow, I'll be with her on two midnight shifts next week and I'm really looking forward to it. For the midnight shift, fast track (which the PAs run) shuts down and it's one Doc and one PA up front all night. They one-off it on the rooms, Doc, PA, Doc, PA, so the likelihood that I'm going to be learning a good deal and working hard is high. Looking forward to it!

So where was I, standards ... flu, back pain, finger lacerations, broken arms, sickle cell crisis, concussion. While I was checking out an eye for corneal abrasion, an alarm went off and about 18 people ran out into the lobby. An older man had sat in the triage chair, slumped over and died. This tiny female tech (she was must have been about 5'2") jumped up with him on the stretcher they got him on and was just seriously pumping away. Sure enough, about 2 minutes later, there was a strong pulse and everyone on the team had done a good job. I've been involved in resuscitation attempts before, but it was still good to stand there and watch the synchronization of the team.

There's been a DPM rotating in the morning with us, he's a Doctor of Podiatry (resident). He's been in school his entire life, I'm sure he's still in his 20s. He and one of the young PAs were looking through my Clinical Atlas of ER Medicine (there's lots of gnarly pictures in it), when I heard him ask her if she had ever seen KS (Karposi's Sarcoma). She said she had not, and I said that I had. I looked up and said that I had worked in AIDS hospice. The Podiatry resident said in a snotty tone with his nose turned up, "why would you do that?" I must have looked as confused as I felt, and responded, "why? to learn." It was a weird moment, where it hit me that not everyone is in it for the 'commonwealth of all peoples and nations', if you catch my drift ... especially not for those who are our nation's 'unmentionables'. Maybe I should have asked why he chose to work with smelly, stinky feet for the rest of his life. Anyhow, I chalk his comment up to reasons of immaturity as well as growing up. If anything, it probably made him think.