"I'm older than I wish to be.
This town holds no more for me.
All my life, I tried to find another way.
I don't care for your attitude.
You bring me down, I think you're rude
All my life, I try to make a better day...."
Work has really been getting to me. After all this studying, training, and preparation I'm finally out in what I thought was the real world. Is it really? Am I just in a bad situation or am I actually unhappy doing what I thought I wanted to do?
There are moments when I find myself happy and I can recall why I went into medicine and in particular why I went into critical care medicine, but they are outnumbered by the agony of the idiocy and Kafkaesque attitude that permeates the "Center for Clincal Excellence" that I work in. Floors are understaffed. Nurses page for three things: pain, diet, and sleep. The vitals signs, chart, and medication list are all kept in separate folders in three different places in a design to maximize inefficiency and increase frustration. Stat chest x-rays that take an hour to performed. Intubation trays with laryngoscopes that do not have functioning batteries. Tiny trash cans that are always overflowing. Annoying computer phone operators "Oh I'm sorry, I'll work on recognizing that name better. Transfering to the operator" (no you won't you're a stupid machine that is trying to pacify me).
As an intern, resident and fellow everything was exciting and there was the rush of procedures, intubation, central lines, thoracentesis, arterial lines. I was learning. There was teaching, an espirit de corps, a band of brothers mentality among the other residents. Sometime in the last few years that magical feeling, that rush of adrenaline that came with trying to salvage the unsalvagable, well it died. Maybe it was with the 80 hour work week and the new mentality among residents these days. Maybe it's me.
"Backbeat the word on the steet is that the fire in your heart is out.."
I thought things would be different in academic medicine, that I would be the attending guiding the residents and fellows and we would work as a team. Now all I get are notes that are merely data gathering with no thought put into the differential diagnosis or treatment plan. It's merely a note for a note's sake so that they can get out of the hospital by 3 pm.
"Do I still have to follow this patient..'cause I don't think I'm learning much from following Mrs. Jones?"
Tough shit pal. I took care of plenty of uninteresting patients as an intern and resident. Nursing home placement, Loss of caregiver. These admissions sucked and we didn't particularly like them. We did our job, complained in private and didn't whine in front of an attending about having to work too hard. We were told that there was "something to be learned from every patient." I'm sick of hearing residents complain about having to stay past 3 or 4 pm when I have to stay until the work is done.
"Oh life! It's bigger, it's bigger than you and you are not me
The lengths that I will go to, the distance in your eyes
Oh no, I've said too much. I've set it up.
That's me in corner
That's me in the spotlight, losing my religion."
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