Sleep over!

Let this video play in the background while you read today's post. I shouldn't be the only one with The Commodores stuck in my head.



I was in the mood to try something new this week, so I asked my boss to schedule me for a night shift. And it was completely worth the sleep deprivation!
I showed up for work at 5pm, fresh off of the radio broadcast and a little nap. When I got to the hospital, I unpacked my food (enough for a small village), and changed into my pajama scrubs. The day doc went over the patients that were already in the ER, and officially passed the torch on to us. From that point on, it was just the doctor, two nurses, an intake receptionist, and myself covering the entire hospital.
Our first few patients were pretty benign. The 5pm to 7pm rush is generally people with non life-threatening emergencies that can't take off of work to come to the regular clinic. We had a few mysterious rashes, a sprained knee, and a pretty nasty case of diaper rash. (But I feel much better now.)
I took advantage of a quick lull around 7:30 to sneak out for some sunset photos.

On the reservation, even the view from the back door of a hospital is dramatic.
Around 8pm, things started to get a bit more interesting. A mother in her mid-twenties brought in her toddler son to have his diarrhea checked out (always the job of a med student). The diarrhea turned out to be from a mild stomach bug, and we weren't too concerned about it. What did get our attention was his swollen knee. His mom said that it had just started that day, and he began to complain about it after a nap. Since it wasn't likely that he injured the knee in his sleep, we suspected that there was an infection in his joint cavity. They're not that uncommon in children, and can be very harmful if left untreated. We drew some blood to send to the lab (he wasn't crazy about that), and sent the family home with some antibiotics. That should do the trick, but we scheduled him for a follow up appointment next week, just to be safe.
The next patient had a chronic seizure condition that seemed to be getting worse (or at least different, which is still something to be concerned about, when it comes to neurological conditions). We ran a few tests, and gave her a few medications. The drugs seemed to help, but there was a lot of underlying anxiety and family issues that we couldn't address appropriately in the ER. We called the on-call neurologist in Flagstaff (who seemed less than thrilled to be woken up at midnight), and he gave us some advice for her follow-up care. Seizures are a difficult condition to treat. We don't fully understand all of their causes, and the episodes can range from harmless to fatal. This patient seemed to be a very mild, but frequent seizer, so she will probably do much better after a neurologist reevaluates her and adjusts her meds.
Midnight in the clinic is a unique experience. The location feels familiar, but the aura is way different. Of course, I was probably starting to get a little loopy by that point.

After midnight, the patients only got more interesting. The next person to come into the ER had damaged his eyes when the sparks from his welder started flying before his mask was fully down. I don't think that I need to point out how painful that is. And apparently, it's not all that uncommon. The damage caused by welder sparks is rarely from the metal flying out. It's actually caused by the intense amount of UV light given off during the process. So people that are far away from the flying metal have a false sense of safety, and don't protect their eyes as well as they should. Four to six hours later, they're in the ER, writhing in pain. The good news is that--as painful as it is--"welder's flash" is fully treatable, and most people recover completely.
Around 3am, we got the grand finale of ER trauma. A couple of brothers had been drinking too much, and got into a vicious fight. When the cops were called to break it up, one of the brothers charged an officer, and found himself at the receiving end of 50,000 volts. And probably crapped his pants on the spot. By the time we saw him, he had calmed down considerably, but still had a couple of taser prongs sticking out of his chest. Our job was to remove the prongs, and to treat his other injuries. However, the doctor that I was working with had never taken out the prongs before. She asked the police officer how she should remove them, since they're barbed, and they don't come out nearly as easily as they go in. The cop just smiled, and said, "pull."
The other brother was soon to follow. He was brought in by the paramedics, since he was bit during all of the rolling around. Human bites are one of the most likely types to get infected (way worse than dogs or cats), so standard protocol is to bring them in for treatment. By the time both of the brothers were in the ER, they had moved past whatever skirmish had started the fight. They were actually very nice to us, and to each other. The fight was almost undoubtedly caused more by the alcohol than by any animosity between them. However, even though he had calmed down a lot, the brother that charged the officer would still be spending the night in jail.
By the time that we had finished treating the brothers, I had actually grown to like them both, and I felt bad that one of them would be going to jail. 
After we treated the injuries (most were very superficial) and discharged the patients, things got very quiet. The doctor and I both went to go take a nap; she in the doctor's sleeping lounge, and me in the staff conference room.

Surprisingly, I actually slept pretty well! That is, until I was woken up an hour later by an overhead page. I didn't actually hear who it was for, but since the doctor and I were the only people wandering around the hospital, I figured that it was for us. So I stumbled my way down the hospital corridor, and I asked the nurses who the patient was. They looked very surprised to see me, and before they could respond, I remembered that the overnight janitor gets pages, too.
"Grumble, grumble, grumble...this sucks...grumble, grumble, grumble...night shift is stupid."
However, all was forgiven when I realized that the page had woken me up at the perfect time to see the sunrise over the mesa.

That worth at least seven of the eight hours that I didn't sleep last night.

At 8am, today's ER doctor showed up to take us off the clock. It was glorious. I spent the rest of the day making up for lost time, and took about a dozen naps--even before lunch. 

And speaking of lunch, the staff nurses put together an incredible pot luck of traditional Hopi dishes as a send-off before I leave tomorrow.

I sure am going to miss this place.

-M