Once Humpty Dumpty was put back together again, time was no longer frozen. The next and probably the biggest part of my recovery would put the remnants of my brain to their biggest test. Could I return to work as a Nurse Practitioner? Could I handle a schedule of patients, juggling multiple tasks at once? Could I safely manage patients and treatment plans? Could I adapt to the unexpected which was a common place at work? My final exam would throw me in at the deep end with my only options being swim or drown.
The beginning of May, I became the permanent on-call provider at work. A way to "ease" me into interacting with patients again. Test the ability of my problem solving skills. It allowed me to get use to our computer system at a slower pace than a full office schedule. Before my first shift, I went into the office to address the last minute details. Get all my computer access back online, go over the expectations with my Medical Director. As I browsed the electronic medical record at my leisure that day, I had my first official task. A patient needed a prescription, so it was decided to send it to me. To make sure my account allowed me to send prescriptions which would be an integral part of being on-call. I opened up the prescription, went through the steps necessary to send it electronically to the pharmacy. APPROVED flashed on my screen. I proudly exclaimed to the office it worked and "It's like riding a bike!" I had completed my first official duty as a Nurse Practitioner successfully. Now that I was back on my bike, I would attempt the Tour de France.
Weekdays were slow, with one or two calls coming in after offices closed. I developed a rhythm and system. I had our office at home set up with my work computer, note pads full of non-sensical scribbles as calls came in. Weekends were when my limits were challenged. Call, after call came for hours at a time Friday nights, Saturday mornings continuously into the afternoon. Patients screaming at me, or crying desperate for help, pharmacists needing prescription clarifications, coordinating with hospitals when our patients were admitted. I soon started to flinch every time my phone rang. But despite the chaos, I managed to keep my head above water. My brain rose to the occasion. Each week that passed, I could feel more of myself return. My neurons fired faster, I could be on the phone solving one problem while I worked on other cases on the computer. The training wheels were officially off the bike and I was cruising.
I did this every day, for 2 months. By the time I reached the end of the race, I was fatigued. Essentially, I was working round the clock for 70 days. The hardest of these days came when there was a weekend in June when suddenly almost the entire state of Massachusetts was out of Suboxone. This is the medication we utilize primarily at work. And that Saturday, I fielded 28 calls in less than 8 hours. Patients panicked that their pharmacy was out of this medication. As I talked to a patient on the phone, my phone was constantly beeping with incoming calls. I spent most of my day calling numerous pharmacies around the state, trying to find even the smallest amounts to get to people. This was the first time my brain started to get overloaded and I developed a headache. I eventually called my Medical Director for backup, stating bluntly "I'm drowning here." It was an extenuating circumstance, but despite the overwhelming pressure, the bike didn't fly off the track and crash.
It was a difficult 2 months, but I finished with the confidence that my brain was ok. I could work as a Nurse Practitioner. I wasn't totally damaged beyond repair. The damage my neurosurgeon feared that day in December had not been as extensive as was expected.