My life could best be described as chaotic. I’m the father of 3 small children (2 of whom still wear diapers) and am a full-time emergency physician. My work days are fast paced marathons taking care of critically ill patients, malingerers and everything in between. My only “downtime” is the 3 minute drive between my house and the hospital. I’m not complaining – I’m not good at sitting still.
As I discussed in The curse of job satisfaction, I recently discovered a new side hustle working in a cardiac rehab. The job consists of sitting around in case someone with a fresh stent keels over on a treadmill (something that almost never happens). With the power of Crossing the Streams I’m able to get paid to do two jobs simultaneously as I use all the downtime to do chart reviews.
I thought it might be fun to keep track of 2 days – one in the ED and one at cardiac rehab. Let’s see how these two days compare.
Welcome to Work
ED 8AM I’m greeted on the ambulance ramp with an EMS crew bringing in a CPR in progress. I follow them into trauma bay 1 before even clocking in and set up to intubate. As I’m passing the tube through the cords my coworker walks into the room, not even realizing I was in the building yet. “Beat you to it” I said. We get pulses back but his blood pressure stinks and the nurses can’t find any IV access. While the X-ray tech sets up for the post intubation chest X-ray I log onto the computer, sign up for a few other patients and get workups started before grabbing supplies to put a central line in.
Cardiac rehab 8AM I show up to the cardiac rehab not quite sure where to go. “You must be the new doctor. Thank you so much for your help! We really appreciate you. Let me show you your office. Would you like some coffee or tea?” I pinch myself and look for the hidden camera. I sip my coffee, play some music on my laptop and log on to review some charts.
In the Groove
ED 9am-12pm My resuscitated patient is lined, labbed, and packaged for the ICU team. In between tweaking his vent settings and IV pressors, I see a few vague weak and dizzy nursing home patients, abdominal pains and a shoulder dislocation. The family shows up for the ICU patient and I spend some time answering their questions and updating them on his test results. Next up is a big pilonidal abscess with my name on it. After the I&D the putrid metallic scent fills the air to the point that people in the hallway can taste it. So much for lunch. (I wouldn’t have had time to eat it anyway)
Cardiac rehab 9am-12pm Other than friendly nurses coming to introduce themselves, I go 3 hours without any human interaction. I haven’t had this much peace and quiet in years. My coffee is cold, but the employee kitchen has a bottomless supply of refills. I leisurely review charts (usually about 3/hour) and jot down a few notes for future blog posts.
ED Hahahahahahaha! Lunch break?! I wolf down a granola bar on my way into the trauma bay. I’m greeted by a pedestrian who was struck by a car and can’t help but notice that about 3 inches of his fractured femur is flapping in the breeze and pointed towards the ceiling. Thank god for Dilaudid.
Cardiac rehab The rehab program has a private chef that cooks healthy meals for the patients and gives cooking classes during their lunch break. “I made you some fresh polenta, Doc. I hope you like it. Let me know if you want some more to bring home.” What kind of shangri-la have I stumbled into?
Over the Hump
ED Trauma guy’s femur is reduced but it turns out he’s got a big subdural on his head CT. He’s starting to get more lethargic, so I intubate him too. I call the regional level 1 trauma center to get him shipped out. The patient’s girlfriend is angry that we don’t have neurosurgery coverage at this hospital and spends the rest of her visit complaining. The words ‘thank you’ never passes her lips. I brush it off and reload with a fresh set of patients. Heroin addict here for his 12th visit for toothache. Frequent flyer here for the 35th time this year for abdominal pain. A homeless alcoholic with a history of esophageal varices puking blood and hypotensive. Sweet!
Cardiac rehab The nurse administrator stops by the office. “Thanks again for helping us out this week. Let me know if there’s anything you need.”
I go back to chart reviews. I get up and walk around to stretch my legs. I realize I can’t remember the last time I sat still for this long. For better or worse, when I review charts at home I’m usually up a few times an hour doing chores and playing with my kids. Just part of The good, the bad and the ugly of working from home I suppose. A belly full of polenta starts to ease me into food coma. Time for some more caffeine.
ED By the end of the ED shift I saw 23 patients. I got to do some cool procedures and critical care. The faint scent of pilonidal abscess still wafts in my nostrils and I have at least two people’s blood on my shoes. When you combine my hourly rate and the productivity based pay I wont see for another 4 months I probably made about $2000 today. I go home tired but with a sense of fulfillment and accomplishment. I leave all my filthy clothes in the laundry room and go hug my kids.
Cardiac rehab I was thanked by 5 different people and fed a gourmet lunch despite the fact that I did literally NOTHING to help anyone. I reviewed 25 charts and only made one phone call. I drank 3 cups of coffee which led to 3 pee breaks (3 more than I usually have in the ED)
I made $1000 from the cardiac rehab and another $896 from chart reviews for a grand total of $1896. I left right on time feeling like I had just robbed a bank. I didn’t have that same feeling of accomplishment, but at least there was no one else’s bodily fluids on me – just a faint polenta stain on my shirt.
The Curse of Job Satisfaction is Real
Honestly…..I enjoyed my day in the ED more. What the hell is wrong with me? These cushy side gigs are easy money, but they’re so empty. It’s like getting paid to watch grass grow. Actually, watching grass grow would be better because at least I could go outside.
I made nearly equivalent money doing 1/20th the work with way less liability and way more gratitude from the people around me. Have I developed Stockholm syndrome? This is definitely a sustainable side hustle, but for any of you docs thinking about transitioning to a full time non-clinical career I would strongly advise you try it out part time before fully taking the leap. You may be surprised to find that each job makes you appreciate the other one a little more.