Wednesday, May 16, 2007

Sisyphus...minus the rock

Today, despite the fact that I was post-call and could have taken the day off, I decided to go to work and help with sedations for the MRI suite. It was a interesting and frustrating day, and it left an impression on me (witness the fact that I am posting on here - a rare event! I can guarantee it won't be as interesting or well thought-out as what Aaron has to say, but I have the password to this blog and I'm gonna use it).

One thing you get accustomed to very rapidly as an anesthesia resident is learning to interact with a group of nurses/doctors/techs who have never met you or worked with you before, and therefore tend to view you with a)curiosity b)suspicion c)indifference d)a combination of a,b and c. To make things worse, more often than not the group you are working with is close-knit, has a routine, and the members of said group have worked with each other for say, oh, TEN YEARS, before you interject your little self so innocently and unknowingly. This is hard. It gets easier the more you do it, but it's still hard. It's like climbing a hill every day, and just when you get to the top, you somehow end up starting over at the bottom of an ever-so-slightly different hill the next day.

That being said, I thought the people working in the MRI suite were very nice and patient with me. Cause the thing is, the MRI is a big magnet. I know that. You know that. We learned that in medical school, on tv, or in a magazine. But knowning that in your mind, and the reality of standing next to an extremely powerful magnet while trying to sedate small children are two very different things.

When I got to work this morning, I started off by meeting the MRI staff, meeting my anesthesia staff, and filling out a form to say that I had none of the following: a pacemaker, a metallic foreign body in my eye, a tattoo (I can just hear my mom sighing with relief), previous experience as a metal worker, a bullet lodged somewhere within me, an IUD, and various other things that just don't belong in an MRI (think anything ferromagnetic that could be ripped from your body, or that could heat up inside). I watched the MRI safety video, which was both highly informative and completely terrifying. It had a lot of fancy words in it, many of which I have only a marginal understanding, including: gantry, MRI quenching, gating, and units in Gauss. I looked up the definition of Gauss. It appeared as follows:

a unit of magnetic field strength that is approximately the strength of the earth's magnetic field at its surface (the earth's field is about 0.5 to 1G). The value of 1 gauss is defined as 1 line of flux per cm2. As larger magnetic fields have become commonplace, the unit gauss (G) has been largely replaced by the more practical unit tesla (T), where 1 T = 10,000 G.

Um, yeah, I totally knew that.

So after all that, I was ready to go. We poked some children with some needles (sorry!), pumped in some Propofol and off we went to the scanner. This is where something seemed to go awry for me at various points throughout the day. For one thing, it's quite dark in the MRI suite. It was hard to read the infusion pump and connect all the monitors in the semi-darkness. For another thing, I kept thinking I was going crazy whenever I'd get too close to the magnet and suddenly, my name badge was floating, or my watch was being lifted off my wrist. I almost carried a vial of Propofol into the room before an astute nurse asked me what I had in my hand and did it maybe have a metal top? Oops. That would have made a sweet little projectile...and could have seriously hurt someone.

At one point I leaned over my little patient to adjust his nasal prongs and everything flew out of my pocket: several syringes, my nametag (yet again) and my pen, which landed (thankfully) stuck to the side of the MRI tunnel, and well away from from anyone's face. This, combined with a few difficult IV starts, a fair amount of crying (not by me), and a reduced amount of sleep, made me at times wish that I was somewhere else. And that I was someone else.

I got through the day with the help of some coffee, the kindness of the staff in the MRI suite, the patience of the anesthesiologist I was working with, and a cinnamon bun. And tomorrow I get to do it all over a different room, with a different staff, and a different set of nurses. And no magnet (thank god).


Midwife with a Knife said...

I totally know what you mean about working with different people. L&D nurses are very territorial, and it takes time to earn their respect, so being a new obstetrician can be frustrating from that respect.

By the way, I've tagged you both Dr. J and Dr. H for the 8 random things about me meme. :)

Anonymous said...

That was a great post! And hilarious. I'm sure that it wasn't funny at the time, but the vision of everything flying out of your pocket as you bent over the patient gives me a vision of Lucy (I Love anybody old enough to remember her?) as a Or worse, me.

I don't know how you do it, you're awesome. Keep posting.

And by the way, let's get a tatoo together and freak your mom

Love Mom/Nancy

Your Mother said...

I laughed when I read your blog(?).
Seems we had a similar conversation last night about our respective new settings - new situations are difficult and new people are even more difficult - mind you, I have it easier with the patients, I don't touch them,I just tell them to change their lives!
And I'm soooo happy you don't have a tatoo. So is your father!