thursday again

I'm not exactly sure how it's Thursday again already. Time has been flying by, and the hours have been filling up without much effort at all. All week I've been thinking, "I have plenty to write about - maybe I can sit down and do it tonight!" And here we are... at Thursday. A sunny late afternoon Thursday, to be precise, and the fact that I'm at home because I ran out of things to do at the hospital is pretty impressive. Time to catch up on the rest of life.

View from the hospital courtyard this week.

After a relatively quiet Saturday on call, Sunday was actually quite busy. Or at least it felt that way, as I found myself up at the hospital for the bulk of the afternoon trying to fix a toddler with supraventricular tachycardia (really high heart rate). Thankfully he was stable, because I floundered for several hours before finding out about the secret stash of cardiac drugs in theater, which included the adenosine I'd been wishing for all day. Quite naturally, he managed to lose his IV once I'd found the drugs, so we spent another half an hour securing an IV line. We had just taped it in place when I heard the nurse behind me say, "Excuse me, doctor... doctor? The patient... she has stopped." Around here, that's code for "arrested", so my syringe of adenosine fell to the bed, and my little SVT guy had to wait while we attempted to resuscitate the patient in the next bedspace over, a very sad teenage girl with end-stage heart failure who had been admitted only a few hours earlier. In spite of a transient return of circulation, she ultimately didn't survive; my toddler, however, got his adenosine and promptly went back into a sinus rhythm with a much more normal heart rate. Miraculously, the rest of the night was calm.

Zucchini bat.

Monday was Mashujaa Day, or Heroes' Day, in Kenya, so those of us not on call had the day free. As so often happens on a rare day off, I didn't manage to sleep any later than normal, but I did spend the morning in my pajamas, which always feels like a luxury. Perhaps not surprisingly, I donned an apron and went a little crazy in the kitchen: apple cinnamon scones, zucchini muffins (to use up a ridiculous zucchini bat I bought last week), soda bread, and a new soup from The New England Soup Factory Cookbook, which is my favorite soup cookbook of all time. Oh, and cocoa brownies. Which I really ought to make back home sometime, too, because they are delicious. I also did some laundry and made a trip up to the new grocery store just outside the hospital gates, so I felt pretty domestic by the time all was said and done. We had friends over for dinner and stayed up late (or at least late-ish, by my circadian clock) playing Waterworks, the 1970's-era Parker Brothers game that I really am going to buy this time.

Deep cleaning the peds ward.

The rest of the week has been a bit of a blur since then. Though the ward census and nursery acuity have both continued to be relatively low, there's always plenty to be done in the late afternoon: X-rays to chase down, consults to follow up, patients to see in casualty, lab results to chase. (It's always unnerving to check a baby's bilirubin drawn six hours before and discover it's critically high and no one else has realized...) And yesterday, I got to represent pediatrics (paediatrics) at the Kranium meeting, which was illuminating, if nothing else. The electronic medical record is set to go fully live in the nursery next Monday, and it will be an exercise in creativity and patience to figure out how to navigate the computers on wheels through the maze of babies in boxes and breastfeeding mothers. Pictures to come, I promise. In the meantime, it's been nice to feel a little breathing room this evening to relax and have a little downtime. I think we're planning to watch a movie, if we don't all fall asleep first!

And because this picture has made me giggle every time I've pulled it up, I'm going to leave you with it. A little context: when we see babies in the nursery, we're asked to take off our white coats and put on gowns. (Infection control, I guess.) Usually they come in the form of shapeless, pinafore-type garments, but apparently yesterday Vincent and Kenneth found these jackets and decided they were preferable. I'm not so sure. But they do look adorable in pastel.

Two very masculine pediatric interns.