The problem with trying to keep the blog updated is that at the end of a busy day when I have tons to vent and gripe and ask for validation about, I just don’t have the energy to sit down and write about it. I want to come home, get into bed (before or after I have taken off my coat) and fall asleep. Remember how in Broadcast News the holly hunter character puts on such a confident, motivated, hardworking face when she is at work and then the moment she gets home, drops her bag and is by herself she sits on her bed and starts sobbing? That’s pretty much me. And I’m not doing such a good job these days of holding back the tears until I get home. Today, I closed my office door twice in the middle of the day to take a deep breath, hold back tears and tell myself it was going to be ok. My work life sucks. My personal life sucks. And it’s all I can do to hold out until I come home, sit on the couch, put my face in my hands and let go.
I feel like I never see anyone normal at work. In the past two days I saw 1 person who had no problems. And I am realizing now that I should never have blabbed about how excited I was to see teens and pts with multiple social issues. Why did I do that? I feel like the entire day I am listening to people’s shitty lives and have no way to solve their problems. In the past two days I’ve seen a teenager who just realized she was pregnant at 25 weeks and whose mom is so overbearing I want to scream. She has extensive back issues that I have no idea how to evaluate and she just got out of the hospital for pyelo which she didn’t know she had because she is so used to back pain she just shrugged off the ache in her flank for 2 weeks and popped Tylenol. I saw my return OB pt who is also a teenager and who is also 25 weeks and who has already had a total of something like 15 visits either to the hospital or office. Abdominal pain that subsides when she gets to the office, decreased FM that she starts to feel once she gets put on the monitor…she has had Chlamydia this pregnancy and trich twice in 10 weeks but assures me she has not been sexually active since she found out she was pregnant. She had trich in her urine weeks ago and she still has not been treated. The first time it was because she and her mother were “afraid” that the medicine was unsafe in pregnancy so she just didn’t take it. “Why didn’t you call me to ask?” I said. “We were busy.” She responded. I saw her yesterday and she still was untreated. Why? Because they went to the pharmacy and there was no script. “Why didn’t you call me?” We were busy, they said. “It’s really really important for you to treat this infection”, I said. “I understand it’s important” her mom said to me slowly. “I work in a hospital”, she said. “It’s just too much for us to handle right now but I don’t expect you to understand that”. I reordered the rx. Every time I asked the pt a question her mom answers. “So, you feeling the baby move every day?” I say to the pt “Oh, we’re feeling that baby move now. Now we know when that baby’s moving, don’t we? After I had to be in that hospital for hours last week…” she eyes her daughter. I wanted to say who the hell is pregnant here? Are you BOTH pregnant? If you’re pregnant too you really need to schedule something…
And I had a pt who had seen me for irregular periods and alopecia and fatigue and weight gain and terrible PMS whose labs all ca\me back normal and the MD said she thought she should have a more in-depth f/u and potentially an US and the pt basically said she couldn’t pay for any more visits. She’d try to call in February. And meanwhile she is suffering from “extreme moodiness and fatigue” 10 days before her period. And today I had a 39 yo with a history of IV drug use and alcohol addiction and her father killed her mother and himself when she was 13 and who has chronic hep c given to her by her ex husband who is now dead and she has abnormally elevated LFTs and wants OCPs and I am so at a loss for how to even begin to help her. The MD said she should f/u with her and believe me I agree, I just hate having to say to someone…I can’t do anything for you. You have to come back and see someone else who knows more than me. I’m sure she’s thinking, why did I even see you at all?? I should have just seen the doc to begin with. And I can’t say she’s entirely wrong. I feel like all I do is see patients and hold back tears and ask other people what I should do. I just don’t know how it gets better. I learn more? I just become familiar with the feelings of incompetence? I find more ways to distract myself? I fall in love and have that fill the hole in my belly when I come home at night? I just deal with the fact that this is an unbelievably hard job and there is no way around the emotional challenges?
It just seems to continue to get harder.
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