Wednesday, December 6, 2017

These dreams go on when I close my eyes. Every second of the [day] I live another life.

This is probably my next dream just waiting to happen.

My schedule has been unconventional lately.  The attending physician -- a very compassionate man, by the way  -- who is supervising me doesn't want to put undue strain on my still-recovering eyes, so he's trying to match my work schedule with my natural waking cycle, which is incredibly kind of him. It probably helps that I'm in an ophthalmology rotation; an ophthalmologist might be expected to be more concerned with recovery from an ophthalmological condition than might, say for the sake of argument, a gastroenterologist.

The steroids I've had to take have wreaked havoc with my ability to sleep. Initially I would be awake for sixty hours or so straight, and then crash for four or five hours, then repeat the cycle.  Each week I decrease my daily dosage of steroids by ten milligrams. This has improved the quality of sleep slightly, but only slightly. What now happens to me is that I am awake all night. I was reporting for work in the morning, then either turning into a virtual zombie or literally falling asleep standing up by around 2:30 p.m.  It would be ideal for me to simply work a full med student's night shift, which would be from around 8:00 or 9:00 p.m. until somewhere around noon the following day.  Ophthalmologists, however, don't work night shifts. They became ophthalmologists, for the most part,  so that they would not have to work night shifts. I would be working largely unsupervised by those charged with teaching me what I need to know about the field of ophthalmology.  This would , of course, be counter-productive to my medical education.

We've reached a compromise. I report to the hospital at 2:15 a.m. I check on admitted patients who have undergone eye surgeries or are suffering from eye conditions, and I make my own assessments of any patients in the emergency room suffering from eye symptoms.  As a non-MD, there's really nothing I can do for any of these people. I'm there primarily to annoy them. (If anyone is in grave discomfort, a non-specialist MD on staff can at least prescribe pain medications for the patients I've evaluated. I make my recommendations to them.) Meanwhile, I write my own reports as to my findings concerning their conditions or progress. At around 7:00 or 7:30, the attending ophthalmologist directly supervising me makes an uncharacteristically early appearance at the hospital to check my reports and to check on patients himself. By 9:00, we make it to the office.

The lead RN/office manager glares at me for the next three hours, until she goes to lunch, except when I am in exam rooms administering preliminary exams to patients and sitting in on actual physician exams. I man the phones during the lunch break, giving the paid answering service a pointless reprieve from taking the calls from our office. There's little I'm authorized to tell a patient that the anonymous receptionist from central casting could not tell him or her.  It's essentially "Dial 9-1-1," "Go to the ER immediately. Have someone else drive you there. Do NOT drive yourself!,"  "We'll see you later today. I don't have the authority to give you an appointment time; you will need to wait until our actual receptionist returns at 1:15 and returns your call," or "You should be seen tomorrow or in the next few days" and ditto about not having the authority to schedule an appointment, or "You need to speak to a nurse. I will have one return your call ASAP."  "You're fucking crazy" should be one of the optional responses as well, but it's not on the approved list of comments I'm authorized to make to patients.

Then at 1:15 the full crew returns minus the attending physicians and fellow. Doors are unlocked. The intern and resident begin seeing patients. The lead RN/office manager resumes her glare at me. At 1:30 the fellow returns and begins to see patients.  At 1:45, the attending physicians return unless they are performing surgery at the hospital, which they do on a rotating basis.  My supervising physician's surgery day is Friday, so on Fridays I remain at the hospital with him until he has completed his surgeries or until my waking hours have expired, whichever happens first.

At 2:20, I am kicked out of whatever building in which I happen to be. I rush home so that I will still be awake while driving myself there. I jump into the shower to rid myself of the filth of  germy patients, trying hard not to fall asleep in the shower. I have fallen asleep in the shower, which is one reason I shower instead of bathe. It's more difficult to drown in a shower than in a bathtub even partially filled with water. I do not wish to suffer the fate either of the late Whitney Houston or of her daughter,  the late Bobbi Kristina.

I quickly comb though my tangles, throw on pjs, and crawl into bed and almost immediately fall into REM sleep. It's supposed to take more time to reach that phase of sleep than it is currently taking me, but I'm in dreamland within minutes of my wet head hitting the pillow. I wake up roughly three hours later in the middle of whatever dream I'm having that is so amazingly vivid and real to me that I have a hard time convincing myself it isn't real.  Yesterday I dreamed that there was a sandstorm of Desert Storm proportions going on outside that was so severe that no one was allowed to go outside for any reason. I honestly believed I didn't need to go to work tonight until Matthew came home and told me there was no sandstorm. Another afternoon I had some bizarre dream I cannot exactly remember except that someone in it had painted spots all over Ashley Madison, our cat, and that she now had a job at the hospital and had to be taken to work by six p.m. Matthew made noise that woke me up when he got home. I came out of my room and told him that Ashley Madison was late for work, and asked if he was going to drive her thee or if I needed to do so. He looked at me as though I was crazier than the late Charlie Manson on one of Charlie's not particularly lucid days. Another day I had a dream that I found a cockroach infestation in our pantry. I woke up and called our contracted pest control company, which answers calls after hours, to report the infestation and to schedule an emergency spray job. Roughly an hour later I realized there was no cockroach infestation. I had to call the pest control company back and say, "Never mind"  like I was Rosanne Rosannadanna or whoever it was that always went off on faulty tangents on SNL, then, once she figured out she was barking up the wrong tree once again, just said, "Never mind," as though that excused everything. I didn't even bother explaining about my dream. The receptionist wouldn't have believed it. She would just have thought I was a lunatic. Instead, I apologized and totally lied, saying my younger cousin was visiting and had made a prank phone call to her.

These steroids are killing what's left of my sanity. I just have another two weeks of them, though. By then, I'll be on winter break. At least my sleep during winter break shouldn't be disrupted, either in duration or by the deranged dreams I've been having.

My dad's solution to this problem is that once I wake up, he says I need to either go to the loft area upstairs or very carefully walk downstairs and sit in a recliner  and do nothing except turn on the TV. He said not even to flip through the channels with the remote because I might have had a dream that I was supposed to order one hundred pay-per-view movies or buy something like ten- thousand dollars' worth of Marie Osmond's dolls on one of those home shopping network channels. He said I should sit in the chair, vegetate, and look at whatever happens to be on the screen until reality hits me and I realize that whatever I experienced in my most recent dream was just a dream. He said not to leave the condo unless I actually see flames or smell smoke really strongly. He said not to dial 9-1-1 unless I actually see with my own eyes, once I am up and sitting in the recliner, someone I don't know know burst into our house through a door or window. He said not to call anyone other than my mom or him until I've been awake for at least an hour. He told me, above all, not to call or text Judge Alex or, for that matter,  any judge or MD, because they probably have the connections to have me locked away for a mandatory seventy-two-hour evaluation, which at this point I would almost certainly fail.

The terrible thing here is that I can't think of a better solution. There is no joy in Mudville when I am forced to rely on the advice of as big a wack job as my father because I can't come up with anything better on my own.

I do not own this blast-from-the-past video. To whomever owns it, thanks for allowing it to remain here for however long you allow it to remain here.

-sent from work because I didn't have the heart to wake a sleeping post-surgery patient for no good reason at 2:15 a.m.


  1. This reminds me of a sketch I saw a number of years ago on SNL or Kids in the Hall or one of those. The guy was wound up tight and selling "I can't believe it's not 'roids!" while exhibiting the behavior of an abuser. It was hilarious.

  2. The stuff on those shows back in the day was funnier than hell. It doesn't seem all that funny now that I'm living through it, but I assume it will become funny to me in a matter of months.

  3. That's one of my favorite Heart songs... actually sung by Nancy, no less!

    I'm glad your supervisor is at least compassionate. Hope your eyes recover soon and you can get back to some semblance of normal sleep.