Tuesday, January 23, 2007

ICU, psychosis*

I have a job!

Well, I had a job anyhow, but now I have a job about which I can feel more joy (and yet more terror) than either full time drug and alcohol work or nine to five, wall to wall, day in day out sexually transmissible diseases stuff. Starting (hopefully) in about a month I will be working at the ICU at Florey, doing that half time and the drug and alcohol stuff half time, and maybe after half a year changing to full time hospital work.

I am getting ahead of myself here.

The situation at the moment is I am not working. This is on the advice - and advice seems much too weak a word - of Dr Tesla. He says I am not to work at all for a fortnight post discharge, and then only to return gradually - first part time addiction stuff, then full time, then maybe only then look at taking on anything new (i.e.: part time addiction stuff, part time hospital work).

And, as stated, while I lay intubated in the ICU (that's intensive care unit) at the Royal, or possibly later, as I watched the spots on the floor crawl around, or gazed at the flocks of multi-coloured budgerigars that had for some reason taken up residence in my room on the general ward, my previously half-arranged job in Florey ED was given to someone else not currently detained under the mental health act.

Typical of the discrimination we sufferers face.

Anyhow, there is a process for mentally ill doctors returning to work, and we are working through it. By the way, if ever given a choice, go for being the crazy doctor rather than the drug dependent doctor. The crazy doctor, if s/he has insight, gets to go back to work with far fewer restrictions than does the drug dependent doctor. The crazy doctor without insight, however, who does not comply with the medication, doesn't have the blood tests done, doesn't attend followup, that's the most dangerous and thus the worst of all. That person gets the medical board as a second skin.

You know, the above was a rather humiliating paragraph to have to write. Been a bitch of a year.
Anyway, I am following the plan, and part of the plan was actually getting a job I enjoyed. So I asked around and half an hour later I sat in Dr Claudius' office (him rotund, bearded, a nest of ginger hair surmounting vigorous blue eyes), and said I'd heard he was looking for workers.

He said the first thing is he wanted to know that I would be able to work, to fulfill my committments. The department was understaffed (Dr Pradesh being pregnant, Dr Constantine being unwell, Dr Vijay having to return to India), and the normal level of support would not be there.

He knew I had had a difficult year - and he expressly did not want to know details - but he wanted to know if I could be counted on to operate with minimal support. By support, he stressed, he did not mean techincal support. There would be technical support, but not a lot of the other.

And there was a pause, while I looked at him, and he looked back at me.

I said it had been my experience, working in Emergency Departments, that they were fairly porous, that news of anything of note that happened in one fairly quickly reached the others - often in a fairly distorted form. I asked if this was the case in the ICUs.

He said it was worse in Intensive Care because there was only five departments in the city, one in each major hospital. Rumour mills, he said.

And superimposed on all this, like a ghost, was the image of me intubated, heart-rate elevated, tubes everywhere.

Well, I said, with rumours it's best to believe half of what you see, and none of what you hear**.

Part of me was amazed at my speaking to a consultant like this. But I was strengthened by having heard the rumour about me and noting how markedly it differed from the facts - they had got several key things wrong, doses and so forth, confounding my story with Dr Greene's and that of the psychiatry consultant who had leapt from the sixth floor of Sabin Public around about the same time.

I had been ill, I said, as he had heard. But for the previous five years I had not been significantly ill. And I said I had never made a bad clinical decision on the basis of my... illness, and that assertion could be confirmed by speaking to any of the consultants in the ED. I had a good support network, a medication regimen with which I was aggressively compliant, and I would be relying on him for technical support only. And I did not anticipate any further episodes of illness.

Okay, he said. And then he said could I start pretty much now, like Wednesday, pretty much full time, and I said that wasn't really possible, what with the medical board and so on, and we moved on.

All in all the interview went well. I feel the ICU has its own problems - I know every other ICU in the state has. Maybe in a month's time I will be writing in saying that this is the single stupidest decision I have made in my life. But considering my record over the last year or so, that's unlikely.

The weird thing is after getting the job I slept better that night, and for the first time in over a year I was able to go to sleep without those morbid, self-lacerating thoughts, those imaginings wherein terrible things happen to those I love, grave-faced police officers coming to tell me the terrible news, or regrets for lives not lived, choices not made. I lay there and worried, of course, thought about how I have to learn and relearn how to read an ECG, an ABG, manage ARF and SSS and half a hundred other things. But that's worry of a different kind, worry about things I can change, things I can fix.

So. Tomorrow I continue my recovery - chookwatching, holidaying, spending time doing nothing, but I will also buy the anaesthesia textbook and start tatooing it on the inside of my eyelids.

More news as it comes to hand. Thanks for listening,

*Actual name for what I got. Occurs in two forms, with or without budgerigars.
**Who are we to argue with Marvin Gaye?


Blogger Camilla said...

Huge congrats on the future new job, and I'm really glad to hear doable things are now occupying your brainspace in the night.

Enjoy your chickenwatching! I hear the Turkens are flocking splendidly this year. (See here for identification notes: http://www.cacklehatchery.com/turken.html )


6:13 PM  
Blogger Benedict 16th said...

So your were with or without budgerigars?

Would you like an anaesthesia text book or 5 downloaded from usenet? - Oh yes I have already given you several copies....

Well ... you have gone all Blue Tooth next you might even read PDF textbooks?


PS Sorry everyone else - in joke

11:20 PM  
Blogger Juanita J. Sanchez said...

ICU, ugh! Give me STDs anyday, (um, that'd be STD clinic, just to be perfectly clear.) But to each his own. You sound happy, congratulations to you!

2:28 PM  
Blogger Foilwoman said...

Congratulations on the job (although I'm with Juanita, I'd vote for the STDs, too -- maybe we could get people to pronounce syphilis correctly too?) and I'm glad you're home. Medications are our friends; let's just keep saying that, okay? The Former Mr. Foilwoman did not have insight, and did not regularly medicate. So medicate. Hogs, bacon, sausages, a few steers, and so on.

3:38 PM  
Blogger Bronze John said...

Hail Milly,
Thanks. However, Sarah informs me I have misled you about the turkens. The term I suspect you are using refers to a real species of chicken, the Transylvanian naked neck (I am not making this up).

I can't remember why I called our lot turkens, maybe it was because they looked like a cross between a turkey and a chicken. Or maybe a turkey and a gherkin, I don't know.

As with all these hybrid animals, (ligon, shoat, etc.) the name of the male parent is first. Hence turkens would have to arise from male turkeys and female gherkins. The reverse, which would be a ghurkey, has never been observed.

Hope that clears things up.

7:06 PM  
Blogger Bronze John said...

I was with budgerigars. Flocks of hundreds of them, of all colours of the rainbow, sitting on long branches.

I have the anaesthesia textbook, it's reading the bugger I can't do. Like the old joke - what do anaesthesiologists use for contraceptives? Their personality.

Note, by the way, the origin of the term Blue Tooth. History is still good for something.


7:08 PM  
Blogger Bronze John said...

Hail Juanita,
The STD clinic didn't win out in the end, as you know. But the ICU has made me feel happy, so that must mean something.


7:10 PM  
Blogger Camilla said...

BJ, my mention of turkens (just typed "turnkeys" by mistake, ha ha) was purely coincidental! I was just looking for a rare or unusual chicken to include with my comment, and happened to find turkens :D

There are a lot of chickens around here. And some peacocks too. Presumably the cross would result in peakens. Or Chic-... never mind!


7:43 PM  
Blogger Bronze John said...

Hail FW,
Well, the way I see it, the medications make me fat. The unmedicated condition makes me stupid, miserable, dangerous to my self and maybe one day others, and, because I eat more when depressed, fat.

No contest. And many thanks for the kind words.


10:25 PM  

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