Waving the White Flag

After a particularly frosty walk to work this morning, my wards partner and I arrived to find our crazy day had transitioned easily into an insane night. There were multiple deliveries (one a particularly ill preeclamptic that was now on my hands), and some new sick people to boot.

My newest worry is a 21 year old woman who is 21 weeks pregnant. I got the RMT call on this patient right as I was being called to delivery yesterday afternoon. I had to cut off the health aide, and when I was done with the delivery I couldn't get a hold of him again. My wards partner luckily had completed the call in my absence. This 21 year old woman was complaining of fatigue and tachycardia. That was all the story I got from the health aide (and my quick question "How does she look? Does she look very sick?" to which he replied, "ummm, not too sick"). So the patient arrived on the last commercial flight in last evening (which actually can sometimes be faster than the medevac anyways). She descended on our night float doctor tachycardic, hypotensive, and hypoxic, clearly septic. Oops. She is extremely anemic (hemoglobin of 6) and her kidneys weren't doing so hot (creatinine of 2.4 on admission). The source of her infection is pyelonephritis, and after a transfusion this morning she was looking much better. But I was definitely on the edge of my comfort zone when I took over care of her this morning. The night doc said "Well, she's fine here. She doesn't need to go to Anchorage." And I was thinking, "Yeah... she's fine until she's not fine, and at that point it might be too late." But that's the thing about young people - resilience.

After taking over her care this morning, I had a new patient to worry about - me. I've been fighting terrible sinus infection type symptoms that morphed into a deep, nasty sounding cough yesterday (so common here it has it's own moniker: The Bethel Crud). About 1 hour into my morning I started having shaking chills and sweats with a pounding headache on the side. I trudged over to the OB floor and had the nurses take my vital signs. My fears were realized: febrile and tachycardic. I'd been motoring through for the week trying to somehow make it to Monday without succumbing, but with a confirmed fever and drenched clothing, I couldn't ignore it any further.

So I was sent home to shiver and sweat it out, alone in my guest house, with only the flannel snowmen on my sheets as my company. Boy is it rotten to be sick away from home. And even more rotten to be unable to work while being here. I definitely did not take vacation days from my Seattle clinic and fly thousands of miles north to rest in bed.

I am feeling a little better tonight, and am planning to make my reappearance on wards tomorrow. But I do think I will wave the white flag as far as walking to work. It's time to cab it, no doubt. I am mulling over the age old question "To take antibiotics or not to take?" I'm trying to fight it, seeing as though I spend a good portion of my days in clinic discussing the merits of not taking antibiotics. I will reevaluate in the morning. For now, my white flag and I are packing it in for the night.