
So, my first day of work was Tuesday and coincidentally, that was my first call day. It was insane, obscene, and "bloody awful" to use a proper English phrase. I did my two assigned elective cases (nice craniosynostoses cases if you're interested), then two emergent cases until about midnight, then an emergent drain in the ICU around 4 am...about 16 consults, too many admissions to count, and the neverending phone calls, then my regular Wednesday started with clinic, and OR until 8 pm that night. I also found out that registrars are limited to a 40 hour work week...and that was just my first shift!
I think the hardest part was not the fact that I hadn't slept, eaten (nothing is open to buy food at from 7 pm on), or jet lagged...it was the disparity between healthcare in the US and New Zealand. I knew what the right thing to do for the patients in Charlottesville was. The question was what is the right was to treat them in Auckland. The answers? Over 70 with a neurosurgical problem, not a chance. Over 50 with another disease state, nope. A one year old with a open head wound, leaking CSF, visible brain at 3 am? I got asked whether waiting 5 hours until 8 am was really going to make a difference. Then I was told no. The kid went on a waiting list and wasn't done until 10 pm that night. WOW!
There aren't pagers here which is rather nice. Instead you get a hospital cell phone. I was gifted the pediatric neurosurgery call phone for my duration here...24/7. Ummm...yeah... Endless phone calls and text messages...It's swell.
One of the really interesting things is also the free staff cafeteria. Anything you want is free...off of the three entree options. However, only sugar free beverages are available, throughout the hospital. In other words, we trust you to make live altering decisions on patients, but not to make appropriate dietary choices. Let us make them for you. No more coke :-( (And trust me, I need it).
Speaking of missing items... There is no Benedryl here! No, seriously, none whatsoever. Do you know how many patients can complain about itching in a single night? What is the treatment here? Phenergan! Drug reaction? Phenergan! Can't sleep? Phenergan! Maybe next call night I will take my own bottle in and dispense it...
But that sounds like a lot of negativity, and I really don't want it to be that way. I really should see it in a more positive light...it's an introduction to Obamacare! I'm way ahead of the curve back home in the US!
Have to sleep now...more cases tomorrow!