Whew.
Work was a whirlwind this weekend. One of the most complicated cases was a chronically ill young woman who had received an organ transplant (I'm not identifying the organ to protect her privacy) and was in chronic rejection. I was at the end of my rope in trying to keep her adequately ventilated early on Monday morning and it looked as if she would die when word came that another compatible organ had been identified and the transplant team would be there at 7:30AM. Lots of ethical questions and moral issues with this patient (is it ethical to get a THIRD chance at life when so many others never even get a second?) and I am exhausted from having walked the tightrope with the rest of the medical team that kept her alive all weekend. When she got back from the OR last night, she got into trouble almost right away: she was bleeding too much and we couldn't stop the bleeding and her pulmonary artery pressure was dangerously high. When I left this morning, she was relatively stable: the senior fellow had found a drug to stop the bleeding and we had given nitric oxide through the ventilator to decrease the pressure on the pulmonary blood vessels. Now we'll see what happens....
Work
I've wanted to write about my new job and the problems that I'm having and I haven't. So, here it is:
I left the rehab hospital where I worked before to come to Children's because I like critical care better; I like the pediatric population; Children's is, academically, one of the very best places to work in the US; and, finally, I see a career path here where, when Jack is in school full-time, I can work in development or in marketing for the hospital, since it's an independent institution and not one of the medical behemoths that dominate health care.
I am not disappointed in the work: the level of clinical challenge is very high; the resources are fantastic. I like the energy and the pace. I like the academic institution and participating in rounds and teaching. I like the working with kids and babies.
So what could be wrong?
My co-workers are jerks.
OK, that's harsh. Some of them are very kind. The doctors, most of them residents, have been especially kind, since they're in the same boat, as "new kids on the block." However, most of the staff at Children's don't want to hear from me until I've worked there for, oh, 5 years or so. Any of my education, my experience, doesn't matter, because the education wasn't at Harvard and the experience wasn't at Children's. I've been pretty miserable since completing my orientation and going to full-time night shift. I don't feel as if I have any friends and I'm getting more and more defensive (although pushing back a little has worked in some instances.)
I told Kevin that I'm giving it 3 months and then I will consider a different option within Children's. The problem is, since I am the person in our family responsible for getting the benefits, I am not willing to make a switch to another institution again in the near future. I also don't want to change anymore; I just want to go to work, work my 3 nights and then go home and be with Jack.
I am trying so hard to make this work and it is so frustrating and exhausting when it doesn't work.
Doocing
No, I am not worried about being "dooced" because of my marketability. For better or worse, I can go to any hospital in the city (or outside of the city) and get a job and a sign-on bonus and maybe even more money (not many people out there want to work every weekend and permanent night shift.) The problem is that I am at the hospital where I want to work. Now I just have to figure out how to make it work for me.
9:18:29 PM 
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