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.