COVID TRAUMA - 168 Hours On Call - Day in the life: DOCTOR

The patient's hypotensive, not doing well. There's a trauma, COVID test was not back yet. This is what happens when you wear N95 for an hour. We are off to an interesting start this morning. It is now Monday morning. I'm coming off a long vacation week and starting seven days of call. The interesting part about today is I was just taking the bus to work. I'm on the west side this whole week and 57th Street happens to be shut down because there was falling debris off of one of these skyscrapers or whatnot. So we took this huge detour. I'm so far away from the hospital. So I had to get an Uber on the corner now to get there. All right, so I was a little interrupted just then by my Uber, which is good. So basically what I was trying to say is the whole 57th Street is shut down right now, limiting our west side travel, which makes it difficult to get to work in under an hour today because of the detour. So basically there's falling debris from the skyscrapers and the whole main crossroad was shut down. But nonetheless, we are here now. We have a full day planned. I start with two uterine fibroid embolizations back-to-back this morning. So that's honestly my favorite procedure and excited about that. So again, this is another seven-day stretch coming off of a long 10-day vacation week. I guess I'm well rested, but also I feel like I'm still in vacation mode. So we'll see how this week goes. Obviously, I'll bring you along for the ride. And yeah, let's go. All right, so this video is sponsored by Board Vitals. Now you may have heard my prior video on passing the core and what my thoughts were on the core examination last year when I did this video and I discussed how the hands-down best resource for this exam is the Board Vitals Question Bank. The questions are almost identical to that on the actual core exam. The explanations of the questions are second to none. I learned so much from this QBank. I can't even recommend it enough. Even if this video wasn't sponsored, I would still tell you all that this is the best QBank far and away. That's how much I loved it. All of my colleagues who also passed the core exam felt the exact same way about this QBank. So do yourself a favor and use my code Dr. Cellini to get 20% off the entire Board Vitals website with the exception of the CME gift card products. So use my code Dr. Cellini now, get 20% off your Board Vitals Radiology Question Bank and pass the core exam. Now, let's get back to the video. So it is about 3 p.m. currently. I finished work, sort of, because I actually have to go to another hospital later on tonight because we have a very critically ill patient at our current hospital and they are being transferred uptown to the other hospital for a variety of reasons. So we don't really have the appropriate gear to do this procedure at the current hospital. So we have to go up to the higher level of care uptown and get the appropriate tools, per se. And also, we have higher level anesthesia care up there as well. So I don't know when the patient is going to be transferred from our ICU to that ICU. So it could take anywhere from like 3 to 4 to 5, 6 hours. Who knows? But I'm going to guess maybe 7.30 p.m. is when I'll have to go in, which kind of sucks. All right. Well, so what time did I talk to you all? Like 3-ish or 4 or whatever. It's now 6.45. Time to make a little coffee because I assume I'm probably going to be going in here in like the next half hour or so. So we'll see how this goes. So this is the side of medicine you all probably aren't familiar with is the hurry up and wait game. So I knew about this patient since 3 o'clock or 3.30 p.m. and it's been almost now, what time is it? And it's now 7.15 p.m. and I'm still just sitting here on the couch. Even though this is a class 1 emergency, these things still take a lot of time. I know the patient is being transferred in the ambulance currently to the other hospital, but I also know that that patient still has to go to the ICU. So get off the ambulance, be transported to the ICU. The ICU nurses, ICU residents, the ICU attendings all have to lay eyes on the patient and examine the patient. Then, once they deem the patient stable enough, we can then get anesthesia together, coordinate bringing the patient down to the IR suite, etc, etc, and we can finally start our procedure. So even though I know the patient is being transported to the hospital currently, I still probably have like an hour and a half until I even get to bring the patient down to the IR suite. That's why I'm sitting here and enjoying my coffee because I feel like it's going to be a long night. And mark my words, I probably won't start the case till 9 p.m., even though this is an emergency. It's not like Grey's Anatomy where you rush patients off the ambulance into the OR or whatever. Well, that happens sometimes, but it's mostly like this. Even though it's an emergency, still takes some time. Just called the Uber now. It's time to mobilize. Let's go. Hey, what's up, man? All right. And just like that, we are done with our procedure. It is now about 10 30 p.m. And just as I anticipated, we were going to start around 9 p.m. I probably won't start the case till 9 p.m. We did and that procedure went pretty well. It's like an hour and a half ish. So I'm pretty tired right now, but not that tired, but I've been sweating for the past like hour and a half because it's like 95 degrees in that room and I'm wearing lead. So all I want to do is get home and take a shower. So that's what I'm going to do right now. Procedure went well. Shower time when I get home. Get to bed at a reasonable hour and do it all over again tomorrow. All right, so I'm officially here again this morning, but I am at a different hospital. I'm at the hospital I was at last night doing a procedure. Going to go check on my patient right now and then call all the way back downtown to the hospital. I'll be at the rest of the day. All right, so this day ended a little short because I'm going to go back uptown to the hospital. All right, so it is about 3 p.m. So far today I did, well, I'm sucking on this lata. So, so far today I did a unifibrilization followed by a CT-guided biopsy and now we have a patient, very complicated case going uptown. The same hospital that I was at last night and this morning going back up there right now because one of the attendings needs a fellow for some help because it's a complicated case. So headed up there now. We'll see. I don't even know what we're getting into. We'll see what happens when we get up there. All right, so the case went surprisingly really well given how sick the patient was. It is almost 6 o'clock right now. I'm going to go home, wait for Andrea to come home. I still have to answer all the pages, of course, because I'm on call, but let's just hope it's a nice night. We can relax and have a nice dinner and do this all over again tomorrow. You all may remember this hallway. Seems to be becoming a common trend lately. So it is 1 a.m. now. I'm back at this hospital for the fourth time in less than 48 hours. Four cases. I have another semi-urgent case to do on a patient that we did a procedure on earlier today. So we're about to go to the OR. The patient had to rush to the OR. We're going to do a procedure with the cardiothoracic surgery team and help this patient out a little bit. So can't complain too much, you know. This is what we signed up for, but usually you don't have back-to-back nights on call being called in. So I'm a little upset about that, but what can you do, as I always say? All right, so I got to sleep in a little bit this morning. I didn't get home till about maybe 3.30 in the morning. Basically what happened is we got there. The patient was already in the operating room, but the surgery took longer than anticipated. So we were stuck waiting around for a little bit. Finished about 3.30, got home, set my alarm for 5.30, which was a bit ambitious because that's the normal time I wake up, but I was dying. So I texted one of my residents, who's a senior resident here, who also takes fellow on call, told him I'd be a little late this morning, so if he could cover the first two cases. So now it's about 8.30, just got in, and starting the day. Let's just hope that we can finish on time today and not continue this whole getting called in every single night so far. I need a break. All right, it is 4.30. Pretty light day today, I think. God, I was dying about halfway through. I had an enormous cup of coffee. Got me through till about 2 p.m. Had another procedure just now finished, and now I'm starting to hit a wall, and I'm headed home. And I'm literally probably just going to collapse on the couch and relax. It's kind of weird right now because the sun's going down, and it's 4.30 p.m., but, you know, what can you do? Pretty sure a siren interrupts every vlog I ever make. So anyways, where was I? So I'm headed home now, going to sit on the couch. It is now Wednesday, by the way. I don't think I've even said that, but the last 48 hours plus have been absolutely crazy, and I pretty much have enough content to end the video right here, but I don't want to leave you all hanging, and we'll finish out the week strong and go from there. So let's hopefully check in in the morning. I mean, look at this trash pile right here. This is insanity. It's taller than me. Isn't New York City beautiful? And it is Thursday morning. Back at work. Only a few pages last night that kept me up, and now I'm here. Let's go ahead and get this crazy busy day off to a good start. Here I am. It is now midnight on Sunday. I've actually had a pretty laid-back weekend, and by laid-back, I mean I've literally probably gotten like three or four pages on Saturday, maybe three today. It's now Sunday, by the way. Sunday at midnight, which is day seven, by the way, of my call week. So it's day seven of seven, which makes this hurt just a tad bit more, seeing as I only have to make it until 7 a.m. Monday morning for my call week to be over, but I couldn't do that because we have an emergency. We actually have a trauma patient who is in pretty bad shape going to the OR right now because the injuries they sustained were pretty severe. The patient's hypotensive, not doing well. So they're going to the OR real quick, and then coming straight down to us because the patient's likely bleeding. We don't know where, but we got to figure that out, and we have to stop the bleeding and make sure the patient is no longer hypotensive. And what I mean by hypotensive is when the blood pressure gets really low, like in the case when they're bleeding, the volume is low, which means the organs are not getting perfused well enough. So the brain, the heart, the kidneys, the liver, all that kind of stuff. Those organs aren't getting perfused well enough, and the blood pressure and the blood volume is not high enough to sustain perfusion to those organs, as you all know what happens when you can't maintain a blood pressure, organs start shutting down if you can't find a source of bleeding or prevent hypotension. So that's what we're here for. Like I always say, this is nothing like Grey's Anatomy. It's hurry up and wait. The patient's in the OR right now. We're just waiting for the patient to come straight here emergently, and we'll get down to business and hopefully save another life tonight. That's the only thing I will say. Yes, I'm dead tired. I'm glad I didn't have to do anything this weekend, but the only thing I don't feel bad about getting out of bed for is saving a life because that's what we're here for, and that's what hopefully happens today. So I'll wait here a little longer, wait for my attendant to get here, and we'll get to it. I'll let you know how it goes whenever I get out of here. I imagine it'll probably be around 3 a.m., hopefully sooner. We'll see. All right, as you can see, there's a trauma. COVID test was not back yet. We had to do it as a PUI, and which is why I had to wear N95 face shield and all that stuff, and as you can see, this is what happens when you wear N95 for an hour and a face shield. I've seen better days. It is, and it's also the air conditioner is like broken in that room. It's like 85 degrees with the light on, full PPE. It's not fun, but luckily, my attendant's a boss. We did that case in like 45 minutes, and now I am going home. I said 3 a.m., but I was completely wrong. It is 140... 145 a.m., so I was way ahead of schedule. Going home right now. Going to take a shower, because I am drenched in sweat. This officially concludes this week on call. I'm glad you guys joined me for this one. If you don't want me to do more videos like this, I will anyways, because it's kind of fun making them, and I don't really mind going in as much when I know I get to like show everybody else and film it. I don't know. That probably doesn't make sense, but anyways, make sure you smash the like and subscribe button. Follow me on Instagram if you don't already. Otherwise, I'll see you all on the next video.