Busy

Today, the doctor I'm working with was covering both the Ob/Gyn service and the Casualty unit, so I spent the day running back and forth between prenatal exams, C-sections, and emergency evaluations.  Most of the day, though, was spent in Casualty, and I loved it.  There was cholecystitis, an upper respiratory tract infection, alcoholic cirrhosis, a femoral head fracture, a labial hematoma, metastatic cancer, seizures, a vertebral compression fracture, a DOA (dead on arrival)...  And a suicide attempt - ingestion of pesticide.  My mind was racing with questions I wanted to ask the patient for a full psychiatric evaluation, but not the time or the place.  He was kind of busy being decontaminated (since the toxic substance can remain on the clothes and skin).  He'll get a gastric lavage and some activated charcoal and then sent on his way.  Even if there were psychiatric services available here, the people here would never go for it.  It's a shame.  All he's learned is that he needs to take more pesticide next time.
The hospital is so short-staffed that I can function as a sort of baby doctor.  I can evaluate patients, write notes, order labs and radiological studies, and make recommendations.  I love the autonomy.  And it's so satisfying to feel that I'm actually being of some help.  The doctors here work 6 days a week, sometimes 7, and they're on call every 3 nights with no post-call day off.  They're perpetually exhausted.  It may be that my being here is just as much help to the doctors as it is the patients. 

As for me, I worked 12 busy hours today, and while that pales in comparison to the doctors' schedules, I'm still tired.  But it's so much fun.