My vicious brain.

Yesterday was exciting. At 9am, I sat down in our teaching simulation centre. Every Thursday during the Summer, we are given a topic to research, then locked in a room with a bleeding mannequin and told to "fix it".

Yesterday's topic was Procedural Sedation; that is, giving people drugs in ER to make them drowsy so you can hurt them with minimal distress. I had not done the reading. I stayed up late watching a documentary on Netflix called "Babies", instead.

"Sam, you be the team leader." said my friend/senior Jen.
"This is a 200kg woman who has popped her prosthetic hip out of alignment. It's the third time this happened and she is in a lot of pain. The orthopaedics team is here to do the relocation, what drugs would you like to give?"

I could feel the stress flush creeping up my neck. I couldn't remember any drug names, doses, side effects, nothing... The mannequin started moaning and crying. My team looked at me expectantly. My peers, watching on the other side of the 2-way mirror, tunneled through the glass with their eyes. My armpits steamed up.

I gave propofol and ketamine. Not enough initially, too much eventually. The woman, once her hip was back in place, stopped breathing on her own due to my drugs. We had to help her breathe until they wore off. And my peers, while supportive, judged me with their eyes.

After this intense humiliation, I walked across the street and began my 8 hour ER shift. During this shift, 2 traumas rolled in. A young guy having some sort of seizure and a man who had been pinned under his tractor for many hours. I successfully intubated the young guy, giving the right drugs at the right dose. I scanned the tractor guy's belly using our portable ultrasound and identified some internal bleeding, teeing him up for surgical exploration. I also poked 3 year old with broken clavicles, old men with tummy pain and young women with bleeding in early pregnancy.

It was a good day. I happened to also be on call for the Trauma Team last night, so my pager was by my bedside, waiting to go off all night. When I turned it off at 8am this morning, I fell into a deep sleep.

A woman named Laura (I don't know any Lauras!) with dark hair and an acerbic attitude, was walking with me through the snow. She had talked to all my ex-boyfriends, and took me through all the stupid and humiliating things I've done in previous relationships. "You shouldn't have bothered with the surprise birthday, I'm just saying..." She told me that my enjoyment of my work was a sign that there was something wrong with me. "Sadistic, though?". Mentioned that most people thought I was a loser and breaking up with me was the best thing they ever did. I woke up shaking.

I don't know if my brain was just waiting to remind me of my Sim Lab failures, or if 20 hours of work/stimulation/emotion is too much. I do know I am never going to sleep again.