This past weekend was rough.

Again.

Middle of the night cases Saturday and Sunday.

Hard cases.

And I was only able to sleep in 3 hour segments.

It has happened before.

If I work too many call cases at night.

If I stay up too late doing something fun.

And I finally get a chance to sleep more than 3 hours.

My brain will go off at about the 3 hour mark.

Last night, earlier tonight.

I was awakened after 3 hours by my husband to tell me my text alert was going off.

It was “amanda from an email address and she is home alone… wink, nudge…”

block.

delete.

And now my brain is going off.

Telling me that I have a meeting in two hours.

Telling me that maybe I should be getting up.

Telling me that I still needed to get the trash together, before my meeting.

Because it is trash day.

Informing me that I am too hot in the covers.

And now I am too hot in the sheet.

And now I am too hot in the sheet with a leg out.

And now I am too cold in the sheet with a leg out.

And now I am too cold in the sheet completely covered.

And now I am just right in the sheet and the cover.

Until my husband rolls over.

Or takes a too deep breath.

And did I really finish my grad school application?

And don’t you know the trash has to go out.

And, look!

It is now 1 hour and 50 minutes until the morning meeting.

Just get out of bed already.

You can sleep on the couch later.

After the meeting you don’t have ANYTHING for nearly 8 hours.

Go on, get up.

You know you want to.

The post-it reads ‘It’s too hard. It’s too soft. It’s just right. 3 bears and a penis.’

When a urologist said the goal of every man is to work on their penis if they either of the first two problem, this struck me as funny.

If is is too hard, and has been for too long, it needs intervention.

If it is too soft, and has been for what is perceived by the man to be too long, it needs intervention.

If it is just right that is the sweet spot, pun intended.

Yesterday’s post was a stark reminder of the cost of this pandemic.

I wanted to go a lot lighter today.

And the first post-it I pulled out was this one.

It made me giggle.

At the time I was collecting OR fairy tales or OR fables for a different project.

I still am.

This one will be fleshed out (pun still intended) and added to the list.

Spoiler alert, I have no children.

My siblings have 14 among them.

I have 4 great nephews and 3 great nieces.

I was a nanny while in college.

I have also participated in the birth of many, many babies.

At my first hospital, the OR staffed the OB c-section suite.

And then, like now I took a tremendous amount of call.

Any time, any day, any shift there were babies.

And, since I lived across the street from the hospital and they knew it, I was called when the mom or baby was in trouble and the baby had to be born stat.

Last week I got an covid update email from my hospital system that reminded everyone that the CDC recommends that all pregnant people should get the covid vaccination.

No matter how little or how much they are pregnant.

It is a matter of life and death.

The mother.

The baby.

I had read of very premature births happening with pregnant people all over the world.

This is not a good trend.

A quick Google of covid complications and pregnancy brings up a thumbnail that the pregnant people who are infected with covid have an increased risk of pre-term labor and other poor pregnancy outcomes.

Poor pregnancy outcomes.

It bears repeating.

It is scary, I get it.

And heart-breaking.

And frightening.

But so is coming home from the hospital without the baby.

Because the baby is still in intensive care or worse.

Or the mother is still in intensive care or worse.

My friends and I have been talking about this.

In our respective hospitals there have been several fetal demises.

They run the gamut of miscarriages at any time before 20 weeks and all the way up to near term.

It is heart-breaking.

And my heart hurts for all those babies and mothers.

Please get vaccinated.

It hasn’t been just about you this entire time.

I am certain that someone is keeping track but not wishing to alarm the public.

Perhaps it is time to alarm the public.

I applied for a PhD program.

This was off my self-imposed to-do list for dispatches.

I applied for a program in my state.

Save on the in-state tuition.

At the nursing conference I went to (in person!) last week, I found more that I am interested in.

I’ve got a lot of read about and consider.

However, there are two, maybe three more I will be applying to before applications close for them at the end of January 2022.

I have an end goal.

I want to write textbooks.

My husband just wants to be married to Dr. Kate.

The theme for October is going to be spooky.

That can mean a lot of things to a lot of different people.

I think of dark cookies, spiders, ghosts and beasties.

We’ll see what I decide.

But today was inspired by a Pinterest cookie.

The picture showed a dark chocolate cookie with orange M&Ms.

That would have been okay.

But I instantly thought ‘Reese’s Pieces’.

And that made me think of E.T. the extraterrestrial.

And Drew Barrymore’s character Gertie trying to coax ET from hiding.

It took a minute to find Reese’s Pieces.

The last thing I saw them in was Reese’s Peanut Butter cups.

But a CRNA at the hospital said to try a gas station.

I finally found small boxes of them at a pharmacy.

These cookies were definitely a hit.

A friend of mine said that the group in the lounge voted and they were voted the best ever.

I will definitely be making these again.

Yes, another self indulgent post.

This time is about gravity.

You know, the thing that keeps us all grounded.

Facebook reminded me that it has been 2 years since I fell in the OR, during induction on a peds case.

I tripped over the c-arm on the way to the phone to call x-ray.

The irony just avalanches some days.

My left knee and tibia bones finally stopped hurting about 6 months ago and I can kneel without pain.

The newly formed dimple in my left cheek is here to stay.

I have not gone back to employee health.

They have their hands full right now.

And told me the dimple was in my head anyway.

Sure, Jan.

It still pulls when I smile too broadly.

The horrible TMJ pain is gone.

Small victories, I know.

What I remember most of that day is:

1. the anesthesiologist getting me an ice pack
2. the surgeon getting me a bandaid
3. the surprise on the team’s faces when I would not call anyone else in, um, this is a ten minute case, there is no one to call, and you’ll be done before they get here
4. the black bruising to my collar bone the next day

The OR is a dangerous place.

Sometimes for the workers there.

Last night was rough.

Again.

I know, I sound like a broken record.

I went home at my normal time.

Puttered around.

Played a little computer.

Killed a few thousand undead.

Headed to bed at a not unreasonable hour.

I have meetings on Tuesday mornings, after all.

And at 0130 I get a call from an MD.

Who wants to put a case on at 0500.

Okay.

Case for 0500.

Have to be at the hospital at 0400 to prep the room and prep the patient.

Called the surgeon at 0430 at their request as a wake up call.

Start the case.

Help the patient.

Finish case in time for the day shift to start.

Drive home.

I want a bagel but it is too late to get a bagel and make my meeting.

I was in my zoom meeting 2 minutes early.

Finish meeting.

Off to bed I go.

4.5 hours is an okay night of sleep, right?

I followed a surgeon to the door after a case.

Three of the biggest anti-vaxxers in the department had been speaking over him and the other surgeon.

They were talking about all the people who lost their jobs.

They were talking about all the people who no longer could get religious exemptions.

And places not giving out exemptions at all.

They were talking about all the places around the country who were lightening mask mandates.

They were talking about where they were going to be going on vacation next.

And hoped there would be no masks required.

One of them mentioned alternative treatments for covid that their cousin’s uncle’s wife had.

And lived.

They were not taking about vaccinating their kids.

They were not talking about vaccinating other kids.

They were not talking about the stupendous loss of life.

These conversations were being had in the open.

In front of two of the biggest vaccine proponents on staff.

The two vaccine proponents who had been told to modulate their tones while talking to anti-vaxxers.

I was telling the truth when I followed the MD to the door.

I admire their restraint.

The post-it reads ‘to the new to evenings CRNA, you’re in the endgame now.’

We have had a crop of new CRNAs who work until 1900 or are the call CRNA.

It is always interesting when a new CRNA looks around and sees how busy we are.

It is as if they don’t understand why we are still doing cases in the nighttime.

The OR takes all cases and does them at all times.

Whatever the patient needs, we do.

I am a huge Marvel fan.

Have been since I was a child.

I have many boxes full of comic books.

This is an Infinity War part 2 reference.

Dr. Strange tells Iron Man that they are in the endgame now.

Meaning it is the one chance to defeat Thanos.

Evening shift is not at war with anyone.

But I love this quote.

Because to me it means that there is work still left to do and we have patients to take care.

Until the shift ends, or the call team comes in.

Whichever happens first.

P.S. my favorite Avenger is Hawkeye, who fights even when he is hopelessly outnumbered with his skill.

Kind of like the OR.

Except we take them on one case at a time.

700,248 dead since the beginning of the pandemic.

18 months.

The US hit 676,000 on 9/21/21.

9 days to add 24,000 deaths.

Are there words?

I am not sure there are words.

Take a shot.

Any shot.

Please.

Healthcare workers are begging you.

This nurse is begging you.