Call at the Valley

Overnight call at the Valley is quite different than call at Stanford. Santa Clara Valley sees a lot more trauma, and so I expect to be up all night. It's an educational experience providing anesthesia without knowing a patient's past medical history, medications, or substance use and being unable to interview a patient. Now that I'm finishing my second year of anesthesia, the range of cases is less intimidating; whether a craniotomy for a person who fell and crushed their skull or a child who broke her elbow or a combative patient high on methamphetamines with an open fracture, I know what to expect in the anesthetic.

We also cover obstetrics (at Stanford, the dedicated OB anesthesia resident does) and that is a continual deterrent to getting any sleep on call. Every time things seem to slow down, I get paged for a labor epidural. But my last call, I had a pretty adrenaline-stimulating case. I was paged stat to the obstetric operating room for a patient who was admitted for preterm labor but the fetus started having bradycardia. An obstetric emergency, the surgeons were prepping the belly as I got my monitors on. In situations like these, training kicks in; although I haven't seen too many stat C-sections, I could hear my professors' voices sounding in my head: place a bump for uterine displacement, give bicitra if there's time, anticipate a difficult rapid sequence airway. Within a couple minutes, I had the patient asleep, the airway secure, the antibiotics going, and the pitocin prepared. I did learn a lot from that experience, especially in crisis resource management; I had to utilize the nurses in the room so I don't become task saturated, and I had to maintain an awareness of everything else that's going on - not just what I'm doing. Cases like this make Valley an exhaustingly fun place to take call.