I hate Queen ICU calls...

So after a whole 2 months (almost) doing calls in SMC (mostly ICU calls), i have returned to Queen ICU...i started my 1st out of 3 consecutive every other day calls yesterday...and i've decided that i hate Queen ICU calls...arrghh!!! i don't hate my boss...he's a nice guy...albeit a little odd...i just can't stand the fact that every time i'm on call in Queen i'll have practically sleepless nights...i mean, the patient turnover rate in Queen ICU is definitely much slower than in SMC ICU...and yet, it seems like the turnover happen mostly during my calls..

I had 2 admissions yesterday...when there hasn't been any for the last 2 days before yesterday..which meant that we had to transfer out 2 patients to admit these 2 new patients...one was an idiot who decided to drink pesticide in front of his fiancee to threaten her to marry him..at the marriage registry...would have loved to see the drama...but since he only drank a bit so he didn't manage to die of malathion poisoning...but he needed ventilation and observation and so was admitted to my ICU....he came during the day...and it was a good thing he didn't give me much problem over the night...

The 2nd admission was a young lady with metastatic adenocarcinoma of the lung..mets to vertebra...she went for a pericardial window and chemoport insertion the day before yesterday...and she developed worsening shortness of breath yesterday...great...boss wasn't too keen to take her in...i mean...what exactly was our end point here? to save her today so she can die of her cancer in maybe another 3 months?..Pang pointed this out this morning during passover round and my respond in a jest was, "I dunno...give her a chance to get married before she dies?"...kind of got me thinking...if i were in her shoes, would i be lucky enough to have a man that i want to marry who would still marry me despite my condition....and what if the tables were turned around and i had to see the man i love dies in that way...i don't know if i can bear the pain...i don't think my heart is strong enough to suffer such kind of pain...but i digress...so boss took her in anyway...boss wanted to put her on non-invasive ventilation..to avoid intubation...but the patient couldn't tolerate the NIV...so i just kept her on high flow mask 10L/min....but she was so tachypnoeic that she was bound to get tired sooner or later..

I was reading a book i borrowed from Kean Khang while things seemed a little settled just around midnight...it's a very interesting dark humour kind of book called "The Graveyard Book"...i finished it about 2am...and after checking that everyone of my patients were comfortable, i went to sleep hoping to only be awaken by my alarm at 7.30am...but it was not meant to be...coz the nurse called me about 3.45am informing that the cancer lady was complaining of difficulty in breathing...so i tried her on NIV again but she became more restless although her saturation was good...so i told her that i'd have to intubate her and she said ok....couldn't even bloody get her to lie flat...had to induce her while she was sitting upright...and she was trashing all over until the scoline set in...thank God it wasn't a difficult intubation...but her lungs were so bad...i needed to put her on high ventilator settings..and when she woke up she was so bloody restless, she was trying to extubate herself...so had to properly sedate her....

After settling her about 5am...thought maybe i'd get some sleep...but again, it was not meant to be...coz one of the uncle in ICU who had multiple problems decided to vomit out blood at 5.30am..and he desaturated coz he probably aspirated the blood...and became bradydardic...had to start CPR..and intubate him...this would be his 4th time getting reintubated..thank God he came back after 15 mins...and although this uncle was a difficult intubation, thank God i managed to get the tube in the right place....so that was it...by the time i settled him...it was almost 7am...hardly any sleep at all...

Anyway, will tell you a bit about "The Graveyard Book"....since that was the only good thing that happened yesterday...the story revolves around this boy called Nobody Owens who was raised up in a graveyard by a ghost couple and a vampire guardian...his whole family was killed while he was still a toddler...but he managed to find his way to a graveyard and was protected by the ghosts and his guardian from the man who wanted to kill him...so Bod grew up among ghosts and was given the Freedom of the Graveyard....where he can Fade, Dreamwalk and Haunt...so after his many adventures while he was growing up, eventually the man who wanted to kill him found him...and the reason why he was supposed to be killed was....hmmm i guess i shouldn't spill the beans...go read the book and find out yourself...it's a light read actually...very entertaining...

Ok, now i shall crawl into my chamber and sleep until the moon comes out...then i shall roam the night world to look for food...