Smack Talk in the ER

Smack talking is not just for athletes and sports fans.

The other night this patient in respiratory distress rolled into the ER around 11pm. This is during the three glorious hours when my 9p-7a shift overlaps with the 2p-12 midnight doctor and there is actually double coverage with two docs in the ER. I grabbed the chart and went into his room listen to his lungs and find the paperwork sent form the nursing home to try to figure out which meds he needed acutely to fix his breathing. I decided he was probably a mixed clinical picture with both CHF (congestive heart failure) and COPD (chronic obstructive pulmonary disease) contributing to his breathing problem, and I barked out a slew of orders to treat both.

I walked out of the room to chart all of my orders, and I saw my newest colleague and Gill the charge nurse standing there smirking.

"What?"

Dr. H was egging me on. "I was just telling Gill that I've never seen you intubate," he said with excited anticipation regarding what he thought was about to happen to my patient.

Gill was quick to get my back. "Oh she's good. She's good."

I just sat there and charted and said "No sweat."

I went and checked on the patient's breathing again, and Dr. H was still watching with baited breath. I couldn't resist... "Intubating's easy. You haven't seen me intubate because a good doctor can save a patient from intubation by fixing him."

"Oooooh. Touche." He feigned a slap across his cheek. The nurses laughed.

Nothing like a verbal bitch-slap to relieve a little tension. And damned if the patient didn't get better, and, yes, avoid a tube down his throat, shortly thereafter. Maybe I should talk a little smack more often.

'Tis the Season

December Already!!

It's that time of year again! I'm so excited because this is the first year Cole has any real understanding of who Santa Claus is. Between all the Christmas episodes of his favorite shows, all the Christmas books, and a lot of talking about how Santa will be coming to "White House," Cole seems to really get it.

As we prepare for Cole's 3rd and Graham's 2nd Christmas, we've already had some priceless memories:

Cole knows exactly what he wants Santa to bring him. It warmed my heart to hear his answer the first time I asked him the most popular question posed to little kids this time of year "What do you want Santa to bring you?"

Cole thought for a second and got a big smile on his face and excitedly proclaimed, "A SUPER BOUNCY BALL!!!" And he has consistently responded the same way every subsequent time he's been asked.

The child is going to end up with hundreds, maybe thousands of dollars worth of toys, and all he really needs to be happy is a $0.50 rubber ball. Nothing like the simple joys of childhood. I could have killed the Santa at the mall when he heard Cole tell him he wanted a super bouncy ball and, looking at him in disbelief, said "What else?"

"That's it," I quickly cut in. "He wants a super bouncy ball and that's what Santa is going to bring him." Santa probably thought I was a cheap bitch. The reality is that he'll get dozens of super bouncy balls plus the boat-load of gifts you'd expect me to spoil my little baby with, but if all he expects is one rubber ball, he'll be that much more astounded by Santa's generosity. I can't wait!

Graham is also appreciating Santa. He's a little young to grasp the concept of Christmas presents, but he loves to "Ho-ho-ho." I read him a few Christmas books and did the characteristic deep and bellowing "Ho-ho-ho," and he instantly picked it up. Imagine the sweet little 18-month-old "G" rounding his little mouth and making his deepest "Ho-ho-ho" whenever he sees any picture of Santa. It is priceless. He does it for Santa pictures in books, Santa characters on TV, and the real life Santas we've encountered at the mall and the Christmas tree farm. Apparently one day while out with Dan he saw a man in plain clothes who happened to have a big white beard and gave him a "H0-ho-ho" too. It's his new favorite word and it really gets us in the Christmas spirit.

A lot of joy this time of year definitely comes from anticipation. With Cole and Graham, the magic of childhood will make December very special.