sleep drug

Met my older son coming in this morning as I was going out to work. He is on a mid-year break, staying up all night online, gaming and chatting, going to bed as I am getting up. We hugged and discussed a new social network then I had to leave for clinic.

Discussing care of children with a patient I have known for years. She has a history of attention deficit disorder as a teenager and possible schizoaffective disorder. She has had treatment for anxiety for a long time but says she doesn't need it now because she never gets enough sleep. I know what she means. The tiredness is like a sedative or the effects of mild inebriation.

I went to sleep after four again last night and now I am removed enough from reality to cope with my existence, like taking off your glasses so that the world looks softer, out of focus. I expect there are side effects. The immune system is probably suppressed. Some would say that judgement may be compromised but I disagree. If I had any good judgement to compromise then I wouldn't be doing this work in the first place.

Running from clinic to labour ward and back. Two inductions for fulminating pre-eclampsia, both on hydralazine infusions, one on magnesium as well. One foetal heart rate plummeted, with the head in posterior position. Epidural enough to weaken pushing but not good enough pain relief for rotational forceps. However no rotation or effective descent from vacuum cup, heart rate very slow, so applied forceps and pulled out the baby still facing forwards. Sewed up the tear, wrote up the notes and returned to clinic only an hour behind, apologising to each patient like a recorded message. For saving a life; or at least saving a lot of brain cells from hypoxic death........
..too tired...