oh, where has the time gone?!

So its the darndest thing, you keep telling yourself, oh, well I'll get to it tomorrow, and then tomorrow comes, and you do the same thing again. Well, that's exactly what happened with my blog. I let myself come up with excuses, some valid, some not so valid, and I would sleep, eat, write (essays), run, or do a lot of other things rather than blog. However, now that I've really forced myself to do this, I remember why I do it in the first place. It keeps me grounded, it keeps me sane, and helps me to go back on the days experiences, and as I see that it hasn't been since mid-october since I've done this, i realize just how fast the time is flying by me. Today at work, and this week at work, have been difficult. I've been pushed in ways that I didn't expect. I've recently dealt with my first emergency situation: one of our patients (a new one) began seizing and vomiting in the lobby. Before I knew what was going on, I was assisting our MD with putting on a non-rebreather mask to get some O2 flowing, reading his O2 saturation, and moving the patient to a position of comfort. It reminded me a lot of my time as an EMT in college and while it frightened me a bit, I also somehow felt calm through the whole experience. The patient was able to get transported to the hospital, with what appeared to be severe alcohol withdrawal symptoms (vomiting, shaking, SOB). Other than that, this week i've seen a man's foot reduced to bone, covered in yellow, green, and red stained curlex padding. This patient had been to a local hospital, was treated for a severe infection of his foot, and had a sizable chunk of his foot removed including the heel and upper area. Skin grafts were applied and held in place with stitches. The surgery was so extensive that the surgeon did three separate surgeries to take care of the extensive damage that had occurred to his foot. However, something caused the hospital to rescind on their goodwill and discharge the patient, telling him to find a clinic to take care of his foot. When he came to our clinic, he had been turned away from over 3 other clinics as he did not have insurance. He came to us with the same gauze on his foot that the hospital had left. It was my job to remove that gauze, and that itself was a process as (don't read on if you're squeemish) the skin had oozed pus and discharge that had dried and caked onto the gauze, forming an area which made it hard to distinguish what was flesh and what was not. We had no saline at the clinic so we tried to loosen the bandages with distilled water, maintaining a sterile environment. As we peeled layer after layer off, we encountered the funky colors, and finally revealed a disfigured foot, with stitches still visible and the graft still appearing like flesh. This was not a case that clinics deal with, it should have been a job for a wound-care center. The pt had not been given any follow up appointments with that hospital to have the stitches removed. We all at the clinic could not believe how a hospital could do such a half-assed job. To leave a man who had already been through so much, like this, hardly able to walk and without insurance. They easily could have enrolled him in the city plan, could have assisted him in getting insurance for himself that would have allowed him to heal, and maybe have a chance at walking again. Instead, his future looks bleak. He was sent back to that same hospital, where he will rack up again more debt, more costs, and deplete more dollars out of the health care system. A system that is so broken, so ridiculous in its costs, that I feel, at the root, is caused by a feeling of entitlement that doctors feel to money, and that everyone in the healthcare field feels entitled to. It is not cheap to go through medical school, it costs hundreds of thousands of dollars. That money must be payed off. Well, at this point I feel like I am rambling and that it is getting late, again, my apologies for the long period of silence, I hope that it does not continue. Keep in touch