This weekend has been less than ideal. I'm on call (which always puts a damper on the weekend), I'm nursing a second bout of mastitis due, I think, to Bean weaning some night feedings, even when I'm not getting called every couple of hours, I'm not sleeping well. My best sleep seems to be right around 6 am, which is unfortunate because that is when CindyLou has decided to wake up for the last 3 mornings and demand to be fed. The house is a wreck, I don't feel like cleaning, something in the fridge smells bad, I don't want to search it out, the bottles need labeling for the week, and I don't want to do it. I feel fat, but all I want to do is eat bad food like pizza, pasta, and Chinese. I need to organize baby photo albums, not just for Bean, but for CindyLou, too. I need to go shopping, but I don't want to leave the house. Florida State lost (again) to a team they should have beaten. I got a new consult this morning on a patient with an adnexal mass that looks like cancer. Oh, and Mr. Whoo is sleeping in today. (Now, this is partially my fault, since I told him to go ahead and keep sleeping when I took the kids downstairs at 6:30 this morning, but he is taking full advantage, let me tell you!) Bitch, bitch, bitch...ad nauseam.
I feel really short tempered and snappish, but I think it all stems from being bone tired. Yesterday I had to transfer a patient with PROM to the tertiary care center, and I got treated like some kind of second class resident by the accepting physician. Usually I can let these things roll off my back, but they really ticked me off. I got the business about whether or not I had personally examined the patient (I had), whether or not the appropriate antibiotics had been started (they had), and whether or not the patient was in active labor (she wasn't). I realize that I am a community physician, but I'm not stupid. I trained in a residency that was 90% management of high risk patients. I know that tertiary care centers get a lot of "dumps" on the weekends, but I have never shipped a patient that didn't warrant transfer. I don't know why I let that physician get to me that way, but I'm still silently fuming about it.
I also heard about a terrible call that the L&D nurses and pediatrician had to attend. Apparently a woman was being attended in a home birth by a lay doula, (no midwife, no back up physician, just a doula with no medical training) the baby was footling breech and had a cord prolapse...instead of immediately going to the hospital, she continued to labor the mother at home. The baby was dead when it was delivered. A beautiful, perfect term baby that didn't have to die. When the medical team arrived the doula was chanting and lighting incense around the house and the mother was hemorrhaging in the tub. It just makes me physically ill to think of it. Don't get me wrong, I respect the art of midwifery, and I think that having a doula can greatly enhance a mother's birth experience. In this case, the doula overstepped her bounds of expertise with deadly consequences. I wonder if she will be subject to the kind of lawsuits that obstetricians face daily. Sometimes, even in normal births, things go terribly wrong, and ignorance of when to forgo the desired birth "experience" and get to the hospital to save a baby or a mother is catastrophic. So sad for that family.
I'm dreading heading back into the hospital. The only patients in house are OtherDoc's patients, and it is always difficult to manage his patients because our styles are so very different. I tend to be overly cautious, and I write a lot in my progress notes. He tends to be a bit more relaxed, and often will not write notes at all. It can be really frustrating. Oh well, at least I have next weekend for which to look forward. Two whole blissful days off, just 5 short days away. I think I can hold out until then. Hope your collective weekends are going far better than mine! :)