Chaos Theory

Today I am seriously considering a career change.

I think it's time to get me a job flipping burgers at McDonalds.

I remember my glory days working in Pizza Hut. When I was on the 'make' table nothing could get in my way. I had each pizza's toppings memorised and I could literally make any pizza with my eyes shut in 20 seconds.

When my mate "Ratboy" ( seriously, that was his name... we even had a secret society of "dodgy brothers" and would make tapes of "pizza-making-music" to listen to) and I were on shift, we had the store under control.

Things would admittedly get busy, but we always knew how to handle it. We could get thru the busy rush periods knowing how to keep things from escalating into chaos.

Not so with medicine.

Somewhere today on the ward I lost the plot completely.

It looked to be another ordinary day until at midday 4 patients simultaneously all got really sick at once.

Now if it's just one or two sick patients and everyone else behaves themselves I can deal with it.

But when I have 4 of them all crashing at once I cannot deal with it*. I tried to focus on them one at a time but the nurses kept hassling me about the other ones each time I sat down to sort out one of them properly.

It really messes with your mind as you are trying to go through your med school teaching on APO as a nurse badgers you about hypovolaemia and it starts to confuse your thinking.

"Does this patient have too much fluid or not enough?"

"WHICH patient's notes am I even writing in?"

At this point I received a page from one of my reg's... and I did the only thing I knew how to... I asked for help.

I dunno if it's a sign of 'weakness' in the tough surgical world to admit defeat, but I was stuffed.

I thought it more important to get these patients better than to worry about looking 'competent' in front of the regs.

So Dr C came down and brought her calming influence to the ward. Patient's had tests promptly ordered and management was swift in its arrival.

Why can't I be like that? Why is it so hard for me amidst the chaos to stand back and be objective about the whole situation?

On overtime I seem to manage much better at assessing theings detachedly. But somehow on the chaos fo the ward I cannot segregate these things.

Someone suggested it was cos I was being too nice to the nurses and so they will keep paging me for stupid things and wont leave me alone... I'm sure there's some truth in that!

But eventually I escaped the ward and made it into the peacefull bliss of overtime. Where my pager does not go off and my wards are all calm. I am back in my vibe once more and exert my 'pax romana' across my empire.

Or at least until tomorrow...

*Especially when one of them is a patient refusing to talk (stupid psych issues I think!) about his shortness of breath, one is my renal donor whose daughter just rejected her donated kindey (very sad!) and the other is a 16 yr old boy with a renal infarct of 'unknown origin' who is septic and being seen by 4 different medical teams (I don't even know why we surgeons are seeing him!)