Finished Christiana and the audition rotations

Today was my last shift at Christiana. It was a little short since I took off at 1pm to get errands done before I fly out tomorrow. One memorable case was a guy with a "surgical belly" from, we believe, his second bowel perforation. He had the first repaired last month, but it didn't have nearly as much free air, free fecal matter or perotinitis. These are happening because mets from his stage IV lung cancer are eating holes through his intestines. And he's a young guy.

Over the last week I've had several good cases at Christiana. Good traumas, some acute injuries and some interesting work-ups. Yesterday in Wilmington we had a homeless lady with Pyoderma Gangrenosum. She was a sad case that used alcohol and crack to self medicate on the street. The bandages we took off were at least two weeks old. They were black and the smell of rotting flesh lingered around the ED for hours after she was admitted. The ulcers were easily the worst I've ever seen. Her breasts, back and left hip were craters. If she would try to take care of herself and stay on her medications it wouldn't have gotten nearly this bad.

On Tuesday I had my Christiana interview. It went better than I expected. I really liked the answers to my questions. There's some great new changes like a $5M sim lab and one-on-one teaching rounds. And the EM department is very strong with the hospital organization. I really enjoyed meeting the Assistant Program Director as well. Right now, it feels like it will come down to whether we want a 4-year program with fellowship (i.e. Hopkins) or 3-year program that really takes care of its residents (i.e. Christiana).

Hopefully Becky and I can come back in January for a second look at the programs and areas (homes, schools, job opps for her).

Now though I have to pack. I'm getting up at 2:30am to turn in my rental and catch a shuttle to the Baltimore airport. My flight leaves at 7am and gets me into Phoenix around 2pm. Then we have a late Thanksgiving meal with Tucker and his family at our house. It's going to be a long, tiring day tomorrow.

Luckily I've managed to get 8-9 hours of sleep the last couple of nights. I'm starting to feel like myself again. If I had to use one word to describe the week it would be exhaustion. The lack of days off, numerous interviews, stress of setting up interviews and getting rejections all caught up to me. I've also done a terrible job of keeping shape.

I'm going to have to spend some serious hours in the pool and on the bike to shed a few pounds and get back into shape upon returning to Phoenix. But on the plus side, I'm halfway through my interviews!

Time to pack and try to get a little sleep.