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Yes I have had it (see my old post in burnout & stress forum), and here is my take: I can tell from the tone of your post that you are defensive about linking psychological factors to the variant angina. Set that aside for a moment and look at it this way: IF you are in an existing anxiety state (which you may not know btw) you may be prone to vaso spasm due to increased release of stress hormones. Stay with me here..... If you are secreting higher than normal stress hormones, simply adding a little more stress, whether it be psychological, smoking a cigarette, or physical exertion, may trigger an angina attack. Now this may not be what is occurring, but as a diagnostician you should do a thorough job of ruling out whatever you can. My suggestion to you is to entertain the idea that perhaps without knowing it you may be in an "anxious state" and secreting extra catecholamine's that is putting you on the verge of vasospasm, and take some action. You may be surprised what a massage, meditation, or even a cleanout of your psychological closet can reward you with physically. If you find my old post about longevity in EMS you will see the steps I took. I am happy to report I am 6mos without angina, horrible nightmares, and have a lower resting heart rate. No drugs, no exercise change, just a change in mentality. I'm not saying it's all in your head....... I'm just saying some of it may be buried deep within your brain.

You might be a firefighter if you... ... do CPR without gloves... ... get mad at, and verbally attack and blame, the medic for not having an extra pair of gloves for you for doing CPR... ... have a pair of gloves in your back pocket but can't be bothered to take off your turnout gear to get them in order to do CPR... ... show up in the ER complaining about an exposure because you did CPR without gloves... ... cannot document or describe what kind of exposure might have happened while doing compressions without gloves... ... cannot document or describe what kind of bodily fluids you might have been exposed to while doing compressions without gloves... ... cannot demonstrate any open wound or broken skin that may have proven to be an exposure risk while doing CPR without gloves... ... belittle the attending ER physician while screaming obscenities because he won't do immediate BBP testing after doing CPR without gloves... ... fail to understand that despite the blatant stupidity demonstrated by doing CPR without gloves there was no exposure and therefore no exposure risk... ... document on your workers comp/exposure paperwork "I did CPR without gloves and was exposed." with no further description and turn it in to your boss... ... have any combination, or all, of the above happen to you. The above is all true. He was not my patient.

Call the helicopter and clear the scene (sorry, couldn't resist).

Wow, just wow. Putting aside insulting several of our more prominent members and a colleague of yours (no wonder nurses are stereotyped as eating their young), you are wrong. No attending should be blasting any resident, especially in front of others. That is a disgusting lack of professionalism. As for the ego of the ER doc deciding to call the NICU, who else is he going to call? It's hard to care for a baby for days in the ER. Remember though, not every hospital is an ivory tower with a NICU team and every specialist you could want. The closest NICU team for me, when I work at my rural hospital, is over an hour away. If I'm lucky, the hospitalist who is on will be med/peds but not likely. Until the NICU teams arrives in their golden chariot, guess who manages that baby. Yup, that egotistical ER doc And unlike the NICU team, he has to manage the mother also (hopefully she's not hemorrhaging from undiagnosed placenta previa due to a lack of prenatal care. yeah, that was a lot of fun). Luckily I work with a bunch of awesome nurses who don't have huge egos and feel the need to berate and belittle someone to feel better about themselves.

You know you're a Firefighter if… You can tell what type of fire it is by the smell of smoke 10 miles away. You have ever had a heated debate over the color of firetrucks. You have ever spent 10 min trying to force open a door only to have someone come along and open it by turning the handle. You have ever taken 10 or more showers in 1 day. You lay out your cloths from that day so if there is a call at night you can find them quickly. You take great joy in smashing the windows of a car parked in a fire zone or in front of a hydrant. 7. You have ever been airborne without an aircraft and water was your thrust. You always wear red suspenders. You have ever slept in a hosebed. You carry a ton of specially modified tools in your pocket. You ever cursed out someone for armor-alling the seats to make them look nice. You've ever clung to the air horn chord for dear life because the driver is insane. You have ever played jingle bells at Xmas time on the air horns to clear traffic. You double your weight every time you go on a job a building. You have ever said, "she's hot tonight" and not been talking about a girl. You have ever had "yoda ears" You have ever called a person found after a fire a "crispy critter" You have ever smoked and there wasn't a cigarette in sight. You have ever stomped out a fire with your boots because you couldn't wait for water. You have ever walked 3 miles into the woods in 100 degree heat in full turnout gear and a 5 gal or more water can strapped on your back just to put out a fire. your kids are afraid to get into water fights with you. "climbing the corporate ladder" has nothing to do with career advancement. your work gear makes you sound like Darth Vader. You roll around in anything that just burned to make your new gear look old. You take pride in the fact that you haven't washed your gear in years. You carry enough in your pockets to give the Swiss army knives competition. You carry enough in your car to extinguish a minor blaze. You have ever juggled hot coals with your gloves. Your Own vehicle has more lights than a Christmas tree (Volunteers Only) All the shirts you own say you are a firefighter (Volunteers Only) You find yourself living at the fire department 365 days a year! When you go to rent a movie, and they insist on getting Backdraft EVERY TIME! You are caught on the back of a truck with your girlfriend or wife in the middle of something and the page goes out for a call. if you have more pagers than than money in your wallet. if the smell of a fire excites you more than sex does. if a great stop has nothing do with a moving vehicle. if assembling a mile and a half of hose to catch fire in running up hill is a good day. The microwave goes off and you run out of the house thinking it was your pager. you ever tried to patent a 911 blocker with the phone company if you can hear that the siren will go off even before your dog notices it. If you have ever woken up thinking your pager went off and as you look at it, it goes off if you have ever tested your gloves by putting a fuzzie out on your hand. If you have ever been awakened with a CO2 extinguisher If you have ever dried your gloves on the trucks exhaust You know you're a firefighter when you really think that rusty old hydrant looks good in the garden. All your friends give you t-shirts from their departments for your birthday, Christmas, anniversary, etc. if your wife voluntarily chooses the lumpy side of the bed to avoid being trampled in route to a call! your wife/girlfriend has learned to duck and cover when she hears the pager go off for fear of being run down. if you had to extricate someone by cutting the car doors off on one side and realized there was nothing wrong with the doors on the other side. If youhave more toy fire trucks than your kids do. When you have ever made a jacuzzi out of a 2100 gallon dump tank and a rescue boat motor (15 horse Merc). ..It was hot!.............Watch yer toes! When you take all of your improtant stuff (like wallets and pagers) out of your pockets before going to a training involving a portable tank. you walk into the station with you belt on and someone yells here comes batman You eat till you're sleep, then sleep till you eat. You can blame the 10 lbs that you've gained on the food cooked at the station. You take your other half out on a date to the fire house/hall. You spend more time on a holiday with you're fellow firefighter than you do with you're family. (although its a good excuse to get out of going over to your inlaws house) You know you're a firefighter if you want to keep the fire truck at your house just so that you can be the one to drive it! you are a ff if you refer to yourself as Satan and the fire as your house if your house is on fire and you still respond to the station You talk about alcohol foams and you are not refering to the head of your beer. when you wish some Fragrance manufacturer would bottle the burnt smell after a fire and used as a mens spray cologne. Your idea of ventilation is done with a chainsaw and not a bag-valve-mask. You have ever dressed from head to foot in rubber and it was not a sexual experience. You run towards a dangerous situation instead of away if you ever said that real fire trucks/engines are RED DAMMIT!!!! you have a wreck with the fire chief on the way to the fire trying to beat him there (Volunteers) All of your calenders have every third day circled. You've been called a nozzle hog. If you collect fire helmets and hang them on your bedroom wall and so far have one of each color. You respond to the fire station during a thunder storm - in case there's a fire started by lightening. You stay in town during the 4th of July - in case there's a fire started by fireworks. If you are running in the opposite direction of everyone else you refer to a room at 1300 F as "Toasty". you respond to sound better than Pavlov's Dog. the term "Hard Suction" doesn't make you chuckle when you are the mother of the bride and you tell everyone in the wedding party, nobody moves when the pagers went off during the ceremony. you have more lights on your personal vehicle than your dept's trucks (Volunteers Mainly) If nine out of the ten toys your child receives for Christmas are fire trucks If you play with the fire toys more than your child does. You know you're a firefighter if your idea of a water fight includes a 100ft. tower with dual monitors, and several shots of 2.5 inch lines If you wash your Fire Truck more than your personal vehicle. If "humping hose" doesn't excite you. When you call ur friend in Maryland, you live in Nevada, and get jealous and turned on at the same time when he gets toned out you've ever felt like a ghost-buster while operating a water-vac you've ever stood on a street corner holding a bunker boot asking for donations you monitor other city's fire dispatch and miss a call for your own. you get excited over the color red and the smell of diesel Your idea of a good time involves soaking the new probies. if someone starts reciting movie lines from "Backdraft" at a fire.