The first rule is to take your own pulse

Tachycardic and panicky. Graduated nearly 17 years ago and it still sometimes floors me that I’m entrusted to keep people alive.

It’s the bizarre way we monitor an airway and jam in adrenaline and jot down the worsening biphasic wheeze while hoping for the ambulance. Any minute now. Drawing up adrenaline while trying to remember the algorithm – handily printed on the laminated sheet attached to the trolley. Handover. Wtf is SBAR. No I didn’t do that because it’s just me and no one else til you got here.

20 minutes later a new person is prone on the table and I’m slowly sliding 12.7 cm of surgical steel through their flesh while chatting animatedly about whether their sciatic symptoms go to the ankle or sole of the foot. Have a great day. Hope you feel better soon. Breast cancer. Renal cancer. Ingrown hair. Constipation… No wait diverticulitis.

I meant to call that other doctor about the thing. Scattered. Refocus. Another long thin needle wending its way between bone and vessel and nerve. Same spiel. Tailored spiel. Weird cardiac variants.

3 hours later remember I’m supposed to take my own pulse but I need to go talk to this anxious lady please, if you have time.

Fuck.

Rusty with a sphygmomanometer but still good with a stethoscope. Not sure anyone cares about the split S2. Only 86 patients today and I know I need to leave but also feel guilty. Because 86. I never leave after 86.

Never remember to take my own pulse and just breathe until it’s hours later and I can’t eat and don’t have the executive function to put my washing away. Because stuff needs to be separated and I can’t work out where it goes. So I don’t. And I stare at the one star I can see from my bedroom window and brush my teeth because I used to get so sick and everything is so much easier when your mouth feels clean.

HR 94.