Dayshift I have been working on the night shift for about 15 months now. Last month the guy who does our work schedule said he had some extra day shifts to fill because of people taking time off for vacations. Anyone working an extra shift would get paid extra. I agreed to do one not so much for the money but just because it had been so long since I had done one. Today was the day. First off I now remember how much I don't like getting up so early in the morning. I ended up doing 4 cases today. They were all ENT cases including a tonsillectomy on an adult and the removal of a small mass from inside the cheek of a 56 year old lady. The cases were all pretty straight forward and easy. The strange thing was how crowded the OR seemed. On night shift we usually only run 2 rooms at a time with about 10 staff people. On day shift there are 17 rooms going with about 150-200 staff. Needless to say things seemed much more hectic and noisy on the dayshift. I am doing one more dayshift next month. The dayshift is a nice place to visit but I think I will stay on nights.

Good Ride This morning Thumper and I decided to go for a motorcycle ride before it got hot out. So we geared up and hit the road. We rode around for a couple of hours and stopped at KFC for lunch. We went home after lunch because the temp was climbing towards the mid 90s. About 4 in the afternoon the wind picked up a little and the temp actually dropped back down into the 80s so we geared up and went for another ride. All together we went almost 65 miles today. It was a good ride.

Students The hospital where I work in addition to being a trauma center is also a teaching facility. We have surgical residents learning to be surgeons and anesthesiology residents. We also get nurse anesthetist residents who come from other hospitals to learn with us. Normally the nurse anesthetist residents are on day shift. This is because they get more cases and therefore more experience during the day. The night shift is different in that there are no scheduled cases only emergency cases. Some nights are very busy while others are not. This month we are trying something different. We have a group of Air Force Residents who will be graduating in December. These residents are very good and can easily handle routine, daytime type cases. Now they will be joining me on the nightshift to learn to do emergency, trauma cases. From now until they graduate I will have a resident with me for several weekends in a row. Hopefully this will get them some good experience doing trauma cases. Many of these military anesthetists will get deployed to the war zone in the next few years where they will be facing trauma. I hope the time they spend with me will help them be prepared for that. Last night we did a case on a 27 year old man who hit his head while surf boarding. He had a bleed in his brain. We worked on him for about 4 hours to stop the bleeding and remove a large blood clot that was putting pressure on his brain. That was it for the night.

Here it is! Well I bought my new motorcycle. It is a Honda Shadow VLX. Thumper drove me to the dealer this morning and then followed me home. She then got on her Rebel and we went for a ride together. Unfortunately the temp this afternoon was 100+ degrees so we couldn't ride. We plan to go out again first thing tomorrow for another ride.

I GOT IT!!!! I got it! I got it! I got it! I got it! I got it! I got it!I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! I got it! Did I mention I got It!!! I pick it up tomorrow!!!!

I Be a Biker! For the last three days I have been taking The Motorcycle Safety Foundation Basic Rider Course. It consists of 5 hours in the classroom and 10 hours out learning to ride a motorcycle. Just about everything was provided by the course including the motorcycle. The classroom portion went from 5 to 1030 Friday night. To be honest Friday night was painful. The instructor was an older man who said he had been riding for over 30 years. He was very knowlegable but he was also unorganized and not the best of speakers. Fortunately the two instructors we had for the two riding days were excellent. There were twelve students for the riding portion. We were assigned motorcycles on the first day. I was assigned a Honda CR125 which is an older bike that is not street legal (no turn signals or headlight) that was specifically designed for rider courses. I had trouble with my bike right from the start. Everytime I tried to get going it would die on me several times. To get it going I would have to give it lots of throttle and then try to ease off the clutch without lurching into motion. I was getting very frustrated thinking I was doing things wrong. About an hour into the morning one of the instructors called me over to the storage shed where the bikes were kept. Her exact words to me were "as an instructor I am not supposed to do this but why don't you get off that "piece of shit" bike and try this one. She pointed me to an almost brand new Honda Nighthawk. What a difference! Suddenly everything worked right! The bike didn't stall and I could smoothly go into motion. The rest off the first day and all of the second were lots of fun. We went from putting along in 1st gear to riding along in 3rd. We learned to corner, brake, swerve, ride over obstacles, emergency stop, do hairpin turns and many other things. I had a blast. At the end of day two we were tested in all our new skills and everyone passed. The really great thing is that by passing this test I do not have to take the driving exam to get my motorcycle license. Just show the DMV my course certificate, and since I have passed my DMV written exam already I get my license. Now I have to decide what kind of bike to buy myself. Once I have one then Thumper and I can go riding together. I am still undecided about what kind of bike to get. I really liked the Nighthawk I rode during the course. It is a 250cc bike like the Honda Rebel we bought Thumper. I have been told by several riders that I would be happier in the long run with a 500-650cc bike. For the next few weeks I will share Thumper's rebel while I decide what to get myself. Anyone out there with an opinion I would love to hear it.

Long Third Night Just got home from my third night in a row. Friday night was quiet. I finished a case involving a young man who got hit by a motorcycle. It was his own fault as he was trying to walk across the freeway when he was hit! His leg was badly broken but he should recover in time. Last night was much busier. I started out with a young man who is in training to be a California Highway Patrolman. He was suffering from a bulging vertebral disk in his lower back. The disk was causing him a lot of pain as well as weakness in his legs. I put the man to sleep and then he was rolled onto his stomach for the surgery. It went really well and he should recover nicely. My second case of last night was very sad. A 28 year old man was at work as part of a road crew. Somehow he got his right hand caught under an asphalt roller. I'm told this is a small steam roller used to flatten newly laid road asphalt. The mans hand was crushed. The surgeons had to amputate the middle and ring fingers. Only time will tell whether or not he will be able to use his hand in the future. My last case of the night was on a 17 year old boy with a ruptured appendix. He was brought over from a juvenile detention center. His leg was shackled to the gurney. I don't know what crime he committed but the guard was waiting for him in the recovery room after the surgery. One more night to go.

Not a Bad First Night Last night was the first of four in a row. I ended up doing two cases both of which were fairly easy. The first involved a 50 year old man who needed his gall bladder removed. The anesthetic was fairly routine. The surgeons started out trying to remove his gallbladder laprascopically. Unfortunately they were unsuccessful and had to convert to an open cholecystectomy. This means the patient got a 4 inch diagonal incision in the abdomen to remove the gallbladder. On average about 10% of laprascopic gallbladder cases have to convert to open. Unfortunately for the patient an open gallbladder is more painful and usually requires 3 to 5 days in the hospital. My second case involved a 22 year old man with a very "fishy" story. He said that "while mopping the floor I fell onto an exacto knife". He had a single puncture wound in the abdomen near his belly button. The young man was on several medications for depression and his story changed several times during his time in the ER. Fortunately he did no internal damage and his case only lasted about 30 minutes. 3 more nights to go.