Late nights and early mornings

I haven't had to talk to a patient in four months.

Four months ago, I finished my sub-i. And then I started working in the surgical ICU, where patients were on ventilators or recovering from anesthesia and complications, and generally just not really up for having deep long conversations about family history and are you still sexually active type of questions. After that, I went on vacation to do interviews, where I talked a whole bunch about my favorite patients, but again, didn't really see any, except when we peeked in on hospital tours to ooooh and aaaaah over EMRs and private patient rooms. And then I came back and did radiology, where you definitely don't see any patients or have any sort of patient contact.

Aside: true story, there were a couple of times when I presented patient findings to the radiology attending without knowing whether the patient was male or female. Even when the images clearly had the answer. This might be why I didn't go into radiology. That and I think my eyesight got so much worse after all the in-the-dark reading we had to do. And my grades and scores really aren't up to par. End aside.

After radiology, I did physiatry, but I was on the stroke service, and the patients who come to rehab hospitals after strokes, well, they aren't really the type of patients whom you can have understandable conversations with. At least not when they first get there.

Now I'm starting emergency medicine. And I'm a little worried that I've forgotten how to take a history or even what the OLDCARTS mnemonic stands for. I'm a little anxious that I no longer know how to distinguish heart sounds from benign whatevers to holy-crap-get-this-person-to-the-cath-lab-now! And if I can only fudge my way through interpreting EKGs, how am I supposed to read stat CTs and chest xrays?

So I'm a little bit anxious. A little bit apprehensive. And a little bit terrified. But you know what else? I'm kinda excited too. Because it's the emergency department. And if there's one thing I learned from all those years of watching ER - besides that George Clooney and Noah Wyle make for very good-looking doctors - it's that anything that can happen, will.