Syndrome

I did this Sunday, broiling chicken. Iced it immediately, clean and dry since, and it's not really that bad. It has made scrubbing the last two days more fun than usual. Full days, in no small part because of the new residents, and next week, new fellows, who are watched closely, and not fast. Started late yesterday because of an issue in pharmacy that meant our anesthesiologists had no drugs until fifteen minutes after we were scheduled to start first cases. Then the cry went up. "WE HAVE DRUGS!" echoed across the OR, repeated through the hallways.

Ran late with a last case that is a suspected Münchausen syndrome. Everyone who has dealt with this person for the last five years knows the wounds and infections and excessive surgeries for one so young are certainly self inflicted. The organisms cultured out are indicative, not absolute. But it's hard to prove when the family is in denial, and not getting the patient in for a psychiatric evaluation. When they clear out the wound, even I can see it's not a normal wound infection, and some of the tissue is sent for examination for foreign bodies, or fecal contamination. It's a strange, rare condition. The surgeon's frustration is that he knows, but without family or psychiatric support, he's helpless. So he's making jokes about using this bit of tissue to "Let the pathologist play CSI!"

I'm prepared for a long, hard August. Full shifts, no days off, and a long way to Labor Day. I suppose that means full paychecks as well, and I need not mind. Storms this week have brought the heat down to more tolerable levels. To the irritation of Moby who hates thunder, and is not too keen on rain come to that. He's taken to the floor near the bottom of the bed.