Alive

Not Reading Journal Watch

I am not even going to tell you how many unread Journal Watch emails I have in my inbox. I really need to read them.

Instead I have been fashioning splints today. Today was Carpal Tunnel Day at my clinic. No folks with Carpal Tunnel Syndrome had any insurance so I made some gigantic bilateral plaster of paris splints with ace wraps for these ladies. I joked to the one lady’s son that we’d make a piñata next. You shouldn’t joke about these things with 5-year-olds.

It was a very hands-on day, in a way some days aren’t. Holding the splint in place, making small talk for 5 minutes. Sitting between the stirrups, talking a woman through an IUD insertion. Chatting to the ultrasound image of a baby’s face, just 3 weeks before she’ll be born. Measuring a penis for a concerned mother. Fundoscopic exam of a 6-year-old. Feeling the rough boundaries of a weird-looking rash. Didn’t read much at all today.

Another weird thing happened. Like 3 other providers asked me my opinion. The OB/GYN asked me a pre-operative question about hypertension and showed me an EKG. The midwife had me come in to check on a kid’s hernia. The PA with 30 years experience that I curbside all the time ran some ideas by me on a sick guy who won’t go to the hospital.

What is this? Do these people have any idea who they’re talking to? I still have to look up how to do certain joint injections. I STILL don’t know how to spell amitriptyline. Yesterday I sent someone home on accident with a recorded heart rate of 35, according to the medical assistant who took the vitals.

Yes, he was still alive. No, I didn’t notice the vitals before he left, because he was totally fine. Yes I noticed it while dictating. Yes I fell off my chair.

We called him yesterday evening and talked him through checking his own pulse. In 30 seconds he counted 13. “I feel great, doc! I don’t know what the big deal is. I’ll come in tomorrow, ok? I don’t have a ride right now.”

And I didn’t send the ambulance to his house because there was no way his heart rate was 26. But my heart rate was 120’s with frequent accels for the next 18 hours.

He sauntered in over lunch break today. I put him in a room myself and put my hands on his right radial artery. Pulse 88. I placed the blood pressure cuff over his upper arm, and inflated it manually. 140/80.

Still alive.