6.05.2009

CYA (or as LB likes to call it, "CAY")

I'm reading this book called "Intern" by Dr. [aside, whenever I write "Dr." I always hear "It's Dr. Evil, I didn't spend six years in Evil Medical School to be called "mister," thank you very much." in my head] Sandeep Jauhar. It focuses on the traumas and tribulations he faced on his medical career path and features the inner workings of the process and procedures of hospital life. Some parts are stomach-clenching, like when his forgetfulness led to a tube of HIV-infected fluids to spray everywhere and on everything in the room. Some parts are secret-revealing, like when he explains that when he checks the blood pressure of a patient, he counts the pulses in the wrist and then keeps pretending to do so while he counts the breaths so as not to make the patient self-concious and thus change breathing patterns. Some parts are disheartening and particular to the medical field but this part struck me as fitting for just about every job, including mine:

"There were set times on call when you could expect a flurry of pages, like when the nurses checked vital signs at 4:00 a.m. That was when they called about fevers. Your response was always the same: blood and urine cultures and a portable chest X-ray to rule out pneumonia—but sometimes you discovered that a patient was already on antibiotics or that blood cultures had been drawn every night for the past week, every single one negative, and then you had to decide whether you really needed to stick him again, but most of the time you did so anyway, not for the patient’s sake but for your own, lest someone fault you in the morning for not doing it. That was the sad reality of residency: much of the time you were ordering tests to protect yourself. “The endgame of life is so depressing,” I wrote in my diary. “Look at Mr. Fisher. Successful lawyer, Goldberg patient. Now look at him? Sick, febrile, dying of who-knows-what: cancer, TB, sarcoidosis? If you think about it, it could make all of life seem unworthwhile if, in the end, we end up dying in the hospital, awakened at 4:00 a.m. by a stupid intern trying to draw another set of blood cultures.”



Can you relate? Does your job have a CYA culture too?

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