First Day Blues

I think the frustrating thing about this or any job is the feeling that no matter how hard you've worked up to this point, no matter how well you thought you trained, most all of it is for shit. Try drawing blood on the four year old who offers you his arm. Then f' it up and try three more times until he's kicking and screaming and you have a dirty needle flying through the air. Then repeat that a couple more times. Little things like that used to be a piece of cake, but today, on the first day, it's bound to be inches from impossible. After that, get reassigned to the "treatment room," where the really sick come to hang out because its better than the local hospital. There they spend hours bartering time, trying to get well enough so that they can prove to us that they'll make it through the night. Guess we'll find out tomorrow. And then there's the 4 month old girl with a rare skin condition called epidermolysis bullosa which you, oh yes lucky you, saw three years ago when you were living the first day to end all first days as an intern. Only then, your patient with said skin condition ended up on hospice because her fragile skin would peel away at the slightest trauma, the slightest touch. Her IVs would fall out, and within days, her skin had been stripped to nothing so that she was a gob of gelatinous, bleeding, pussy, pile of bandages and agony. And on the first day, you, yes lucky you, get to see her in the Treatment room. And you sir, are tasked with peeling away her old dressings, and inevitably a majority of the most supperficial layer of her skin, so that by the end of it, you really wonder if maybe she looked better when she first came in than she does now.

Oh first days. First weeks. First months. Nowhere to go but up.

But thankfully, first days offer redemption. Like when you pick up the four year old boy and his eight year old sister who you think might have tuberculosis. Go ahead, pull the trigger. Start the workup, order the films, start the meds which may finally end the year-long cough. It's a start. It's something to build on. And while there weren't any big wins today, I think I'll start with this little one. Because truth be told, I think that I'm in over my head. I worry that I'm in over my head. I know that I'm in over my head. So I'll start treading water, and if anything, use this as motivation to be more and do more than I had previously thought would be good enough.

Because truth be told, I am literally in another world. And I'm starting to remember that in this world it'll never be good enough.