I'm purposely trying to phase myself out of the picture these next two weeks as I don't want people to get dependent on me always being around to do things. You know, put central lines, "cover OPD clinic", cover for another team, look at patients that aren't on my team, see random consults. but everytime I get caught in another project. It's not that i'm complaining, but i'm just only one person-theres only a limit to the amount of work I can do. As you may have guessed today was one of those days I literally wanted to bang my head against the wall a million times. It all started today when the malawian physician stated to me this morning that I would be the captain of the ship for the next 6 days. Wait, what does that mean. Apparently physicians from 2 teams were leaving to cape town (second time this has happened in the two months), so there are only 2 doctors- me and someone else and he wants me to be the leader. Yikes! Not that i'm afraid of the work, but i really want to start winding things to a close.
Today i was the only person rounding on my team. The students finally arrived- and oh my god i cant believe for 2 montsh i had been working without students. One of the other doctors commented on how well i handled myself without any guidance or supervision but wow, things were soo much easier. They really took the initiative to track down labs, do things-- ordinarily i would be bogged down with such things.
One of my patients isn't doing so hot. I feel horrible. He's the guy who had the chest tube placed for the pneumothorax. It was draining out pus, so the other day we decided to remove the chest tube and have the surgeons place another one as we suspected that the first incision was infected? good lord, he is so lethargic and delirous today. not eating. I had to put a central line in today and run fluids wide open. I dno't think he is going to make it. The family firmly believes that the patient was doing fine until the chest tube was placed--- they know nothing about the pneumothoraxes or empyema but convinced that the patient's problems started with the tube. who knows. they may be right it may have been infected?
I was on call today-shortstay which was well short stay. busy as can be. One guy had a perforated cecum and i saw air under the diaphragm and i literally had the throw the x-ray in front of the surgeon's face for them to even see the patient today. I made him NPO, started antibiotics, NG. he needs surgery.
Well we'll see how things go. everyone cmes back on wednesday next week. after wednesday i'm definately going to take off for an entire week. i'm going to need a breather i feel.