12 Hours

I'm tired.

We had two codes in two days. One Saturday and the other on Sunday. We have an almost entirely new staff and no one, apparently, can think very well.

I am normally a pretty scattered, ditsy person. I can never find my keys. My house is a mess, and I always seem to be a day late and a dollar short, but at work, I am weirdly competent. Maybe it's the fact that the environment is so controlled? And when things get really hairy and bad, I hate to say this about myself, because it sounds like bragging (I think it's okay because I'm so miserable about so many other aspects of myself--my hair I can't seem to do anything about, my unfulfilled potential, my flat violin playing. my sloppy mothering), but when things get really hairy and bad, I'm a fucking machine. I am really good at thinking very clearly and taking action when everyone else is freaking out. It's like my competency is inversely proportional to that of the people around me.

Maybe that's how ADD is an adaptation?

But normal situations--like grocery shopping--take me 5 times as long as anyone else.

Well, that's enought about me.

Both patients lived. And one's survival was kind of funny. We had coded this guy for 25 minutes. No pulse. Nothing. We'd gone through three drug boxes. The wife had been in the room during the code, crying, but not interfering.

Mac, who was the code physician, turned to her. "I don't know what else to do." He told her, helplessly. She stood by the bedside, sobbing, stroking her husband's hands.

The little medical students in the room continued to practice chest compressions on the guy, rotating through, so they could get their check-off.

Mac turned to us--"Can you guys think of anything else to do? Is there anything we haven't done?"

I was the recording nurse. In a code, everyone is assigned a role. There's a drug nurse, a code nurse, a recording nurse, and a code physician. Then there are 37 other people who just show up, criticize and generally get in the way.

I looked down at my form, which has a list of all the meds you can give during a code.

"The only thing we haven't given is bicarb."

"He's not acidotic." Mac says.

"You asked."

"Okay. Give him some bicarb. What the hell."

2 meQ of bicarb.

"It's in," says Kim. Kim's one of our new disasters. Here's a sample: Last week she was a no call, no show for her shift. She called in at 10am and blithely explained, "I'm so sorry--I went out drinking the night before and was still too drunk at 6:30 to come to work!" Laughing. Like we would all laugh with her and think this was just fun little shenanigans. Why she's still on our staff is beyond me. That's the nursing shortage, folks.

"Stop compressions. Check pulse."

We wait. Then: beep beep beep beep. P...qrs...t...p...qrs...t. Regular rate and rhythm.

Giovanni, our new fellow--I've talked about him before, right?--"and that, my lovelies is a pulse."

After these, though, I can't do anything. All my meds are late, I seem to move through jello. Two days of this. No wonder I have now been diagnosed with adrenal insufficiency. I have a dim suspicion this is connnected to Adderall.

Oh, well. You gotta have something. Didn't JFK have Addison's?

It's amazing how much the world outside does in 12 hours. Last Thursday, I was on the river.
Jay's organization, River Rescue, held a formal party on one of the sand bars. It was wonderful. 120 people, the environmental aristrocracy of the state, were transported by boat to the island, which had been transformed into paradise--sort of a hippy paradise--but paradise nonetheless. We ate jambalaya and caramel cake on white tablecloths. We wrote our dreams for the river and hung them on a tree constructed out of driftwood on the edge of the island. We sat by the fire afterwards singing John Prine songs and launching fouchees (these are fire balloons made of ingeniously folded newspaper--they look like willow-the-wisps). A generator had been lugged out to the island and the tables and tents were strung with tiny blue lights. Made silent, silent laughing love in the tent. Got miraculously called off the next morning, so I was able to wake up and see the mist coming up off the river in the sunrise.

Good times.

That's my 1/2 hour.