Friday the 13th

"You guys do know today's Friday the 13th, right?" These words were said by my attending during rounds today, but I didn't even know that it was Friday the 13th until he brought it up. And even if it was Friday the 13th, I've never been superstitious and I didn't expect this day to be worse than any other day. I was wrong.

I started the morning with 15 patients on my service (the other heme-onc team had 16 so our teams were both beyond capped), and starting at noon I had to run the whole service alone. My intern had clinic, and my sub-I was attending his brother's wedding on the West Coast. I knew my afternoon would be hellish since I had to be a "resi-tern," but between 11 am and 2 pm everything went to hell. One of my patients who had been admitted with anasarca and was responding well to Lasix and albumin suddenly had grossly bloody stools and a drop in Hgb from 8.4 to 7.2. We transfused her 2 units, but when she had a second equally bloody BM, we knew that was trouble. The poor woman had been doing so well and was crying when she learned we had to put in an NG tube. At the same time, I had a patient whom transport was supposed to pick up at 1:00 pm exactly, and I had to scramble to do his discharge paperwork while the GI fellow was at my heels telling me to throw in an NG tube and start Nexium and octreotide on my GI bleeder. Fortunately my fellow could see I was swamped and put in the NG tube (which yielded bright red blood), and she helped transfer that patient to the unit while I ran around like a madwoman filling out scripts, admitting two direct admissions, answering calls from nurses, etc. There were a few times where I felt like crying, but fortunately that didn't happen. Then a patient on the other team had an unwitnessed fall, the same reason for which she was admitted, and we had to send her down for a head CT. *sigh* Is it Friday 13th, or just a bad day? Who knows. At any rate I didn't leave work until 9 pm (I was on call until 8 pm).

What a day....