10.9.2016 Emergency, South Bay, CA

Case Count: 21

I still get startled by the intensity of my emotions after a busy emergency shift. I tend to have a predictable physical and emotional pattern on those days. Last night was an example:

I was stressed out by cases coming through the door up until about a half hour before shift-change, when my focus shifted to tying up all my loose ends before transferring care to my overnight colleague. When we finished rounding, I had a surge of energy and positivity, an emotional weightless feeling looking ahead to a few hours of shaking off the responsibility of caring for patients. My mind raced pleasantly, I felt energetic and good. About ten minutes into my commute, I could physically feel my mind and body sliding down to the bottom of a hill as exhaustion pulled the ground out from under me. Within a half hour, I was barely awake and felt irritable and...the only way I can describe it is that I felt like I was in a small dark room that had only annoying things outside the door, though I was too apathetic to get up and confirm. 

It was a twelve-hour shift with another this morning, so I had about an hour to visit with my Love, taste the first batch of cookies she mixed using her new Kitchenaid mixer, stuff some food in me, shower, and get to sleep. Showers are emotionally rejuvenating for me.  Maybe it's something about cleansing myself of the day. In any case, the emotional burnout and need for a quiet mind make me understand why folks reach for chemicals or destructive behavior to switch off. To get to a place of calm RIGHT NOW. 

It's a lot. This job takes a lot out of me. I'm better adjusted than I was even a few months ago, owing to an amazing partner, good mental health choices, and a (finally) dialed-in brain medication regimen.

Favorite Quotes

  • "Okay, Doctor, thank you, I wanted to talk to you because you gave me peace of mind yesterday." 

Cases of the Day

7yo male neutered Cockapoo
Keratoconjunctivitis Sicca (KCS)
     Kerato = cornea = surface of the eye. Conjunctiva = the delicate pink tissue under the eyelids. -itis = inflammation. Sicca = dry. KCS = Dry Eye. Most often, caused by the immune system attacking the tear glands. Without tears, the eye dries out, becomes painful, can become infected, and can lose its clarity. This dog came in with mostly-closed eyes from squinting and lots of gunky material in/around his eyes. Signs present for 7 days...so painful. Luckily, no apparent damage to the cornea, so should heal up with eye drops that suppress the immune response (cyclosporine). Interestingly, the same drug is used in pill form to treat skin allergies in dogs and is given to human transplant patients to lower the risk of immune-rejection of the new organ. To continue the etymology geek-out, the brand name of cyclosporine for skin allergies is "Atopica," because it treats "atopic dermatitis." Atopic = no skin. Derm- = skin. -itis = inflammation. Atopic dermatitis = No skin skin inflammation. It refers to the fact that the skin fails to perform its barrier function, allowing pollen/dust/mold/airborne particles to penetrate and trigger the immune system. Fascinating stuff.