An Anxious Morning

My mom started spiking fevers on Saturday night, after she had been in the hospital for over a week. She was due to go home on Friday, but couldn't because of "Winter Storm Nemo" -- the visiting nurse wouldn't have been able to bring the supplies needed for home IV antibiotics since a state of emergency had been declared, and all cars were ordered off the road.

A lucky break for my mom, it turns out.

Her fever was up to nearly 103 last night, which is very high for an adult who has been on IV antibiotics for more than a week already. I was getting very, very nervous that this meant the doctors haven't been able to get her bloodstream MRSA infection under control.

However, it seems that since she had two negative blood cultures (ie they didn't show any sign of bacteria in her blood) since she started the antibiotics, this is unlikely. Her chest x-ray was negative for pneumonia. Her blood and urine cultures are still pending, but it appears that this may be a somewhat unusual allergic reaction to her antibiotic, called Red Man Syndrome, because she's also become quite flushed.

Fingers crossed that's what it is, and nothing more serious.

In addition to worrying about that this morning, and wondering (agonizing) if I needed to drive to MA, and if it could wait for the weekend (when I will have four days off), and how I would manage the trip with Calliope, I was also juggling a hopping day at the clinic plus managing three pediatric residents. I'm not their attending physician (ie the one that evaluates them, and is officially responsible for them... but I'm still responsible for the patients they see), and they are only with me 3-4 partial days a month, and I never have any idea how much they really know, so I have to try to balance not offending their experience while simultaneously protecting my patients by not assuming they know too much. I really don't have enough time to get to know their knowledge base very well.

I've stopped feeling like an insensitive jerk for not learning their names.  I don't have the energy to care. They always seem to be from far off lands -- but it's not like they are all from the same far off land; this month one is from Indonesia, one's from India, and one is from, darn, somewhere in Southeast Asia -- so their names are always unfamiliar and these young doctors get flung into my orbit, invariably, while I'm in the middle of seeing a patient.

So I try to just avoid using their names.

So I was juggling the three of them, between my office and my one extra exam room, and trying to follow what they were doing with three different patients, when my nanny called. It was hard to hear her over Calliope's screaming in the background.

The gist of the conversation was that the nanny had left the room briefly, to warm Eleanor's milk in the kitchen, and came back to find Calliope in hysterics. The nanny thought maybe Calliope had hurt her hand, because she was refusing to use it, but the nanny couldn't find any swelling or sign of injury.

Over the hearbreaking sounds of my baby wailing in unmistakable pain, I instructed the nanny to strip Calliope down, paying special attention to her elbows -- no sign of nursemaid's elbow -- and toes -- no sign of a hair wrapped around a digit and cutting off circulation. She wasn't constipated -- she screamed like this, in abject terror, once when a poop got stuck (sorry for TMI) after her one and only exposure to Gerber puffs.

The residents, meanwhile, had stopped their chatter and were listening to my end of the conversation attentively.

I told Nastya I had to think for a moment, and would call her back. And hung up the phone.

I put my face in my hands and almost cried -- I couldn't leave the residents to go home, and the worry about my mother, and oh, insecurity with my job, and now my baby -- but instead I started to snort in a sort of hysterical almost laughter.

The residents murmured sympathetically and urged me to go home.

I called Nastya back and she was just experimenting with putting Calliope into the crib... where she rubbed her eyes -- with the "injured" hand -- and lay down.

We got off the phone and then Nastya called back a few minutes later. Calliope went right to sleep, almost 90 minutes before her regular nap time.

And slept almost two hours, and woke up cheerful.

I still don't know what happened. She has seemed slightly off since her cold almost two weeks ago... sleeping a lot (16 hours on both Saturday and Sunday) but generally fine in most other respects. She has a check up with the doctor next week, and I can't see taking a day off from work before then to "complain" about how my child has been sleeping more than thirteen hours at night but still taking long naps during the day as well.

It looks like she may be getting the infamous canine teeth at long last... but they don't appear to be close to the surface, so maybe not. Just touching her gums, though, made her hysterical -- I do hope it's normal for a child in rage to have purple lips. This happens when she gets so upset it's hard for her to catch her breath, and I always find it unnerving.

Tomorrow we have a staff meeting to discuss all the changes with the proposed hospital closure. It seems our program is enough merged with the other hospital that our jobs should be safe... but our union status and benefits may not be. And that's pretty terrifying. I can't pay my mortgage and my childcare bill with anything less than I am making now. I'm trying very, very hard to just stay present and wait and see what happens.