Okay, we’re really picking ourselves up by our bootstraps here. Getting obsessed with the numbers (or at least feigning obsession). What’s the calculation for ostomy output? Weight divided by stool volume.... Some shit like that.... It is of supreme importance to calculate everything else as well. Urine output, for example.

The baby had too much coming out of the ostomy, evidently (how much of this is just intuition about numbers?), and the feeds were decreased by a pretty significant amount, proportionally. Now the nurse says the baby can't settle down (too hungry), so we should increase the feeds again.

It’s almost like.... Shit, dude.

This baby has an ostomy in the first place because she was born with some defects inside of her that got surgically corrected against her will, and now she has to shit through a hole in her torso. Big picture, i’m wondering if like… is she just gonna have to do this forever, or what? Part of what we needed to do in order to send the baby home was educate their parents on how to take care of the ostomy, which is just obviously going to create a new kind of living hell for those people... and according to the chart, the other thing keeping this baby in the hospital is that the ostomy supplies haven’t been delivered to their house.... Interesting, then, that we should still be micromanaging feeds and prescribing sodium supplementation and shit like that.... Like, wait, if they're ready to go home, why are we concerning ourselves with these other things? Why aren't the feeds stable right now? It’s weird, man, it’s really weird what can happen when you’re doing things just to do them and not for the patient.

And right here we are reaffirmed in our belief that it’s not really about the patient. It’s really not, it seems, is it? Really not.... So it seems. But i could be wrong.

Anyway, right now i’m still in the on-call room with B--- who is honestly really nice and really stressed. Again, it would be nice to be able to actually talk to her, but we’ll see if that is going to ever happen. I’ll just wait on it. Would love to help her somehow, also, but it seems there’s no way for me to.

Either way, (one of) the hard part(s) is done. That part being "pre-rounding." It wasn’t that crazy. It really wasn’t. Especially when the patient is a baby and you don’t have to worry as much about waking them up and obviously don’t have to talk to them or anything.

But i remember saying to myself earlier that the hard part is showing up. That’s also still true. It’s still hard to just show up, granted. It’s also hard to just like... get pre-rounded. But it’s ultimately not that hard. This is a job about people skills at the end of the day—and snapping yourself out of dissociative tendencies. Pick yourself up by the literal bootstraps, my guy. You got it. That’s what makes it all feel easier: just picking yourself up.

We’ll see how the presentation goes on rounds and whether i can look on with B--- on her handoff sheet. We’ll also see if i ever end up getting access to the electronic health record. Maybe i can call IT now to see if i have it, or i can be less insane and just trust the process and hope i get it tomorrow.