Day 69, So I’ve just finished another marathon weekend on call, 80 hours in a row of being available to be called if I wasn’t at the hospital already. The surprising thing was that it was pretty tolerable. I don’t know whether it was that I’m becoming used to the work here or whether it was simply a quieter weekend but I don’t feel as overwhelmed as I had after my first weekend.
Despite the easier ride it still had its typically Mseleni hairy and surreal moments. The fact that the first night was accompanied by thunderstorms was less than amusing. Trudging around in the dark isn’t fun at the best of times but doing so with the downpour of tropical rain washing mud and rain down the hill I have to walk up was not what I wanted to do at 2 in the morning. But alas there was a caesarean to cut and the lack of sleep meant that the whole weekend felt a bit of a sleepwalk.
The weekends are split up so you alternate whether you’re covering for the OPD, and hence the emergencies or whether you’re covering the wards being responsible for all the inpatients. The latter can be unsettling at night as the nurses have to inform the doctor of any death. Regular readers may have inferred that mortality rates are quite high which means that you can usually expect to be woken up at night to be informed of a death. The nurses don’t really expect you to do anything further and so all it does is provide for slightly disturbing dreams as you struggle to fall back to sleep.
The other call they are particularly fond of is “doctor, the patient is gasping”. To the non medics gasping is a pretty late and pre-terminal sign, basically for most patients it is a point of no return. So the futility of being informed of this is quite frustrating. Especially as even if resuscitation were attempted at this point as most of these dying patients are HIV positive I wouldn’t be able to get them an intensive care bed anywhere. So often it turns out to be a response of “lets try and keep them comfortable”.
This weekend we didn’t have an xray department which added a new depth to the challenge, as medics we use xray as our sixth sense. Much as with the other senses, when you lose one, the rest becomes heightened. I found my clinical skills and diagnostic abilities having to be that much sharper to try and overcome this disability.
Perhaps the best thing about working a weekend is when you complete one you know you don’t have to do another for a month. It’s akin to hitting your head against a brick wall, it feels such a relief when you stop. Added bonus is the weekend is over, the sun is shining again and the rest of week seems a bit of a doddle by comparison.
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