168 Hours as a DOCTOR ON CALL - Holiday in NYC

And look where we've come on this beautiful Sunday. And you pull back on the syringe and it just fills with pus. It's a great feeling. I know it's 4 30 a.m. This is a beautiful day to start my seven day on call week. Love it. Alright, so we are back in the hospital. It is Monday morning at 7 a.m. right now. And we are starting yet another seven day stretch on call. I think this is like the sixth or seventh time I've made this kind of week in my life on call videos. And today is a little different again because it is the week of Thanksgiving, which means we're trying to get all these big cases finished before the holidays. And we have a pretty packed Monday through Wednesday this week, which should be good. Should be good. Doing a lot of high-end cases this week. I have a TIPS procedure this morning. Haven't done that in a few months now. So it's good to get those reps under your belt. And then we have Thursday off and Friday off of normal scheduled cases. So it's actually a little better this week. So technically I get Thursday through Sunday off normal cases. But I'm still on call. I'll still have to come in and do some sort of procedure or something. So as always, I'll bring you along for the ride. And we'll see where this week takes us. All right, so it is 11 a.m. now. Just finished my first case of the morning, which was a biliary intervention. Placed a common bile duct stent, which was pretty cool. Now I'm waiting for my TIPS patient to come into the room. If you don't know what TIPS is, it is a transjegular intraepatic portosystemic shunt. And it's done for cirrhotic patients with portal hypertension to kind of relieve some of the pressure caused by portal hypertension. So that's what we're about to do right now. Still running strong. Day one. Let's go. All right, so just finished my TIPS. Went actually pretty well. We had to admit the patient overnight because sometimes if it takes, you know, a couple sticks, or for those of you who don't know, it takes a couple needle passes through the liver in order to create the TIPS. And sometimes I like to watch the patients overnight to make sure they do okay. And that is exactly what we're doing tonight. So just finished admitting that patient. It is about 5.45 right now. We are done for the day. You know, barring any overnight call or whatnot. But gonna head home right now, relax, and probably answer pages because I am on the main or east side call schedule right now. And every time, you know, I cover three hospitals when I cover the west side call. I cover one hospital when I'm on this call. And I get woken up so often overnight by just random phone calls here. So not looking forward to it, but it is what it is. So now it's time to finish out Monday. Tuesday morning. I got here about 45 minutes ago because I had to see my TIPS patient from yesterday. I had to write all the discharge orders, discharge summary, make sure they are ready to go and queued up for today so they can get out of here on time because it's the holiday week after all. I also had to take care of some odds and ends here and there, get some stuff ready for the patients going today. I have a whole bunch of liver work to do today. So pre-Y90 or pre-tear mapping. And if you don't know what a trans-arterial radialization is, I did a whole huge Instagram post on it last week. I'll try to put it in my highlights. So if you don't follow me on Instagram, you miss out on some good educational opportunities here and there. So we're doing a pre-Y90 mapping followed by another pre-Y90 mapping, followed by a TACE and then a liver biopsies. So it is liver Tuesday and we are about to get started. Oh, I forgot to mention, I did not get called in last night. I did get called at our page at midnight, which woke me up. So obviously wasn't happy about that, but didn't have to come in. So could be worse. All I can say is what a day. It is 10 p.m. I just finished that long iliocaval reconstruction. It was quite a bit harder than we anticipated. So if you remember, I was here from 7 a.m. and it is now 10 p.m. And somehow I'm still here. Of course. So just dropped the patient off and I am literally getting Uber out of here so fast and headed home because I am exhausted and absolutely starving. But luckily, my mother-in-law has some chicken eggplant parmesan waiting for me. So that's the only good thing to come out of this. All right, so it is Wednesday morning. The day before Thanksgiving. And I didn't get bothered too much last night. I had, I think I got like one page, which is fantastic. Even though I got home super late, which, you know, didn't go to bed until like almost midnight and had to wake up at 5 o'clock, 545, the usual. So I'm gonna go see a patient, the same patient I did a procedure on last night. See how they are doing today. See if they can get discharged. And then we are about to start the day. I have a trans jugular liver biopsy to do first. And honestly, that's all I have scheduled today. But I'll probably have some add-ons at some point today. Also, this is how I keep from getting a headache through these long work days is just constantly stay hydrated. This is like a little vitamin C powder in here. Why? It doesn't do anything but add some flavor. And this is how I prevent from getting a headache after working 12-15 hours. All right, check in with you in a little bit. Cheers. And we just finished our first two cases of the morning. The first case was pretty sweet, if I do say so myself. I did a trans jugular liver biopsy, which is honestly a pretty basic procedure. Usually takes around, I don't know, 20-30 minutes max. This one took me about two hours because it was not straightforward. And there's one thing I learned about interventional radiology is simple things can humble you very quickly. And also, nothing ever follows plan A. So almost everything you need, like a plan B, plan C, plan D, plan E, you need all these extra things in your pocket. And I'm pretty sure fellowship is just learning how to get all those skill sets and how to think for plan B, plan C, and prepare and get yourself out of tough situations. Because they inevitably happen in this business. That's just the way it goes. So I'm actually pretty much done for the afternoon. It's three o'clock right now. It's the day before Thanksgiving. Cases have slowed down substantially. So we may do a few inpatient add-ons right now and then see where the day takes us. Check in later. And I know I kind of ended abruptly last night, but it is early in the morning here on none other than Thanksgiving day of all days. So it's about 9 a.m. right now. I got literally zero sleep last night, which is awesome. Let me open this door. Kind of scary. All right. So back at it again. Like I said, I got woken up with pages from at least 12 midnight all the way until about 5 a.m. this morning. There's only one actual emergency, which is the reason I'm here right now. But the other pages were complete nonsense. And a lot of them weren't even for me. They were just asking the number to something or thought it was me who was covering neuro interventional IR, which I don't do. And they bothered me all night for it. So in turn, I only had one actual really sick patient and got woken up at least seven or eight times. So I got no sleep. We were going to come in the middle of the night to do this patient that we're about to do, but ended up kind of stabilized. So we were able to just wait off until the morning where our true call team and everybody in the daytime shift to come in and do it. We're going to do the first thing, but we didn't have an anesthesia spot because anesthesia was taking care of an emergency in the OR. They now officially have a team available for us, and we are going to go grab the patient and do this procedure on Thanksgiving morning, and we'll see how that goes. So I was really excited because I thought I was going to have an easy night, going to go over to my wife's family's house today for Thanksgiving, but I had no sleep last night. I'm exhausted to begin with, and I still have to do this procedure, and who the heck knows what's going to happen throughout today. So I know it sounds like I'm complaining, but I'm not complaining because at the end of the day, this is what I signed up for, but nobody wants to get called in on a holiday. I don't care who you are. All right, let's get to work. Okay, now it is like 11 a.m. Didn't end up doing the case because we got bumped. There are only two anesthesia teams available. One of them is doing an emergency case in the OR, and there's another surgery case that has to go right now. So we unfortunately are third on the list, even though our patient is pretty ill, but now we have to wait for them. So I'm gonna go home for like two hours and come back. All right, so I just finished the first case of the afternoon, which again, I've been waiting for since like 1 a.m. now, so that's cool. Got the two, did that procedure. Patient's doing A+, fantastic. And now we're headed home. I literally got 10 pages while I was in that procedure, which lasted like 45 minutes. I don't know why, but going to look up some patients now, do some other work, and then hopefully head home and maybe even get a Thanksgiving dinner. We'll see. What's going on? It's been a while. I think the last video you saw was of me going to Queens after I did a procedure on Thanksgiving Day. The second procedure that day got canceled, so I went to just drive out to Queens, met my wife. She was at her family's house, and I went there, and we had a beautiful Thanksgiving dinner. I only got paged like one time, and that was it. I enjoyed the dinner. We had a great time. I ended up coming home around 10 p.m., and then yesterday was Friday. It's currently Saturday, by the way. Yesterday was Friday. I actually didn't get called in once yesterday, which is mind-blowing how that didn't happen, and I didn't. So here I am today. It is now Saturday afternoon at about 1 p.m. The weather is terrible outside, but I've been fielding calls in my pajamas all day long and getting paged nonstop. A lot of them are just consults, which I'll have to see later today or tomorrow morning, but nothing emergent so far. I'm still waiting on it because, I mean, I know it's gonna happen. I'll have to come in sometime, so we'll see what happens. If I make it to Monday without getting called in, this will be like a golden week, which is crazy. I don't even believe that's gonna happen, and I feel like I just jinxed myself, but oh well. What can you do? I don't mind. So gonna continue getting some more pages, probably go to the hospital a little bit, and check in later. And look where we've come on this beautiful Sunday. So we're about to do a CT guided drain placement. Hope we finish this. I have to basically tie up some loose ends around here, get an email together for the start of next week because at the end of the week, after being on call for seven days, you can imagine that we get completely bombarded with pages and consults, and I have to sign out to the next team that comes on Monday morning, and let's just say it's not fun to be that team because you get like 10 or 12 consults thrown at you at 7 a.m. in the morning, but I'm gonna try to see if I can take care of a few right now to kind of lessen the burden on my teammates come Monday morning. So after this procedure, do those consults and go from there. All right, so that procedure's done, went well. Placed that little abdominal drain in, got some good fluid back, nothing better than when you put a drain in. This one's pretty big, like probably like the size of this. Pretty big drain going into the abdomen. And there's nothing better than when you put a drain in and you pull back on the syringe and it just fills with pus. It's a great feeling. I mean, it's so satisfying. I wish I could post all this stuff because it would be like the deep version of like Dr. Pimple Pumper or something. I wonder if you all would like to see that. Let me know in the comments below if you would like me to post videos after I do a drain and when I first do the initial aspiration and all of the fluid comes out. It's actually pretty fun because a lot of these patients are really sick and when you get into the abscess and suck out all the fluid, they feel better so quickly afterwards. You just have to release that pressure and that inflammation. It's great. It's basically like a giant pimple in your abdomen or chest or arm or wherever. We do it all. And also sometimes we try to guess what color the fluid is that we're about to get out of the drain and that's always fun too. So never a dull moment, even though I'm here on a Sunday afternoon. But we're all done for now. Cleaning up some loose ends, gonna head home and wait until tomorrow, Monday at 7am because that is when I finish my call officially. So I'm going to end the vlog here even though every time I do this, I always get called in Sunday night for something. But you know what? I don't even care at this point because tomorrow is a post-call day. So if I get called in, I get called in. Whatever. It's been seven days. Why not add a little more time onto the clock? So as always, make sure you smash the like, subscribe button, follow me on Instagram if you don't already. Follow me on TikTok. I started to post some new cool videos over there pretty frequently now. So you should probably go check that out. Otherwise, if you have a question, leave it in the comments below and I'll see you all on the next video. So it's 4.30am, Monday morning. Just got called about a bleed. So going to log in to my system from home and see if it's worth it, me coming in. I almost made it. All right. I don't see anything. So I'm going to call back the team and tell them an action for us to do. And I'm going back to bed.