It's only a heart

Strange few days. I believe I mentioned at the end of my last post that I was waiting on a lung harvest. After my training session Monday night, I went home, showered, and headed straight for bed to try to get a little sleep before the transplant. Good thing. Those 5 hours ended up having to last me for the next two days.

It started with a phone call at 2 am Tuesday morning. Phone calls at 2 am are never good. It was our transplant surgeon calling to tell me that the lung transplant had been cancelled. One would think that was good news, but I knew he wouldn't be calling unless there was a catch, and boy was it a big one. After telling me the lungs weren't going to go, he asked when the last time I had harvested a heart. I thought for a minute and replied at least 2 1/2 years. (We did them at Vanderbilt, but much less often than the lungs, and never without an Attending helping us.) He answered back, but you remember how right? I replied that I thought so, but it had been a while. His answer - it's only a heart, I can talk you through it.

That was how I found myself heading out all alone to harvest an organ that I spent a whole extra year of training in snowy Philadelphia to quit operating on. Best laid plans. Thankfully, it went well and I headed back. Per tradition, I helped sew it in. Near the end of the case, we were informed that there was a lung transplant that would be going Tuesday night. Talk about the wrong place at the wrong time. Naturally the transplant surgeon looked across the table and asked me to help him with the lungs. I have a hard time saying no (REALLY need to work on that one), so I agreed to be present at 2 am Wednesday morning to transplant some lungs. I thought, at least we are back to my comfort organ. It was already 4 o'clock Tuesday afternoon, so I was planning to quickly see my patients and head home for a nap.

While I was rounding, I got a call from my partner. His first operation of the day was bleeding in the recovery room, and he was in the middle of his second case. I quickly headed down and then back to the OR with his patient. We were able to get the bleeding under control and the patient back to the recovery room. It was now 8 o'clock. If I played my cards right I could still get a shower and a couple of hours sleep before the lung transplant. Never have been good at playing cards. I got the shower, but had no sooner closed my eyes when I got a call that my partner's patient was again unstable. I headed in and spent the next few hours at bedside trying to stabilize things. I will admit that I did close my eyes a few times on the couch in the doctor's lounge, but my phone seemed to be able to sense whenever I was approaching sleep and it would be kind enough to ring and wake me.

By the time I had the patient quasi-stable, it was time to start the lung transplant. That brought me up to about noon yesterday and the brink of total exhaustion. It was like a bad flashback to residency, but with a new twist. As a resident, I would have been able to head home to bed. As an attending, I got to see my patients, shower quickly and head to the production studio to shoot my commercial. Yeah you heard me correctly - I had to shoot a television commercial for our cancer center after getting zero sleep for 36 hours. All I can say is a huge thank you to the inventor of concealer and the wonderful make-up lady at the studio. I made it through the commercial - something I NEVER wish to do again and headed home.

By then, it was 5:30. As much as I wanted to go straight to bed, I knew this would just completely screw my sleep schedule, so I headed out. I walked to a local restaurant and had the best macaroni and cheese that I have ever tasted. Not at all on my diet, but I really felt at that point that a little comfort food was in order. After the Nirvana of the mac and cheese, and a walk along the beach, it was almost 8 o'clock - a perfectly respectable bed time I felt. I headed home, put on my PJ's and must have crawled into bed because that is where I woke up at 7:30 this morning, but I honestly have no recollection of physically getting there.

Today was supposed to be a fairly quiet day for me, but have already taken a trauma patient to the operating room to pull glass out of her airway, seen an unexpected patient in clinic, and added to my OR schedule for tomorrow. A rumor has been started about another lung transplant. I hope it is just some one's idea of a bad joke. Nevertheless, I am laying low and out of sight the rest of the day.

Do you believe me now?

The weekend didn't start off the most promising. After a horrible case Friday, I went home and crashed. Unfortunately, the mental exhaustion wore off around 2 am at which time I was awake. I called in and checked on my patient, and then spent the rest of the time till dawn wide awake but physically exhausted, so not wanting to be. I finally gave up trying to sleep around 6 am. I showered and ran into work (on my weekend off). Everything seemed okay so I went to the gym, and then ran to Target before my hair appointment.

As I was getting my hair trimmed, my stylist was telling everyone that would listen (as she always does) that I am a surgeon. She actually says "La Cirujana de Thorax" as she only speaks Spanish. One of the ladies that she was telling this to responded, "you mean she is going to be a surgeon?". My Spanish, I am proud to say, is finally good enough that I understood what she said and could reassure her myself that I was indeed already a doctora. She didn't believe me in Spanish or English. I actually had to show her my driver's license before she would believe my age.

That was then. This is now. Since that one highlight, I have spent way too many hours in the OR, and the ones not there were spent worrying about needing to go back. I most definitely look my age and a couple of other people's today. After the lung transplant that is slated to start at midnight, I may even be offered a senior citizen discount at IHOP tomorrow.

Lack of Oxygen?

I have started having auditory hallucinations. No boring voices for me - that would be too normal. I hear a ringing phone or a text message chirp - EVEN when I don't have my phone and no one else around me does either!

Yesterday I went for a run - 8 miles and I almost died, but I digress. I live with my phone constantly attached to me. I don't have a pager, which I love, but that means I always have to have my phone so the hospital can reach me. The one exception that I give myself is while I am exercising on days that I am not on call. It's not often, but on those days for one or two hours I get to be completely alone and unreachable. It is FANTASTIC.

Yesterday happened to be one of those days, so I didn't even carry my phone with me to the gym. The fact of it not being there, however, did not stop me from hearing it. I must have looked for it twenty times while I was running because I would have sworn that I heard it. Granted there didn't seem to be a lot of oxygen going to my brain, but this was pathetic. Have I become so co-dependent on my phone that I hear it even when it's not there? Luckily when I went home, it was not to find twenty missed calls or texts - that would have been just too freaky.

Possibly going too far

Okay - I may be taking this Fall thing a little too far. Today I broke out the worsted wool orange jacket, long skirt and boots. Probably a little over the top, but definitely beautiful for Fall - which we technically are in even if the weather isn't cooperating here.

Why am I so into fall this year? Not sure exactly. Partly I think that my blood has actually "thinned", and I now really do find the low 80's a little chilly, but I think mostly I am a little homesick. Wearing Fall clothes and colors almost convinces me that I am back home in Georgia or Tennessee. Some days that helps.

Sad but true

Everyone warned me it would happen. I assured them it would not. I felt confident that I was stronger if not smarter than to allow it. Today it happened.

As I prepared to leave my condo this am, I stepped outside to "test" the weather. I usually do this to decide if I should pack my rain coat and wear my Wellies. However, this morning, it prompted me to put on a jacket. The temperature you ask - a cool 83 degrees.

It's all about adapting

It's very important when traveling abroad to try to fit in with the local customs. One should try to do what the locals do so that they are accepting of the outsider who has moved to their shores.

Here is my attempt at fitting in with the locals. Already have my first sunburn - guess I should keep some sunscreen in the car.

Wrong again

I had honestly hoped that the simple act of moving to the beach would open up this whole new life for me. It would be filled with glitzy parties, cute guys, ladies lunches, and late night strolls on the beach. Okay - I admit that I have a very active imagination. A very active imagination that is very good at ignoring the actual reality of my career choice.

What has it actually been like living on the beach? I must admit not much different. The view is a little nicer, but until VERY recently, I couldn't see it for the boxes. When it is dark, which it is both when I leave for work and when I come home, the ocean is really more of a sound than a sight anyway. I have met a few people in my building, but I seem to have a different schedule than most. I am getting up when most of the people who lead the life of which I dream are just lying down to bed. Even worse, my bedtime these days seems to be even earlier than Grace's and she's 4! I don't regret moving to the beach. I think I will really enjoy it here. I was just hoping for a week or two of seeing how the "other half" live. Guess there is more to it than just the right zip code after all.

On the positive side, things are finally going very well at work which partly explains why I haven't been out more, and I am almost unpacked which explains the rest of why I haven't been out more. However, despite being on call this weekend, I plan to go new car shopping. Convertible here I come - wish me luck!