Saturday, December 31, 2011

Once a Scientist...

Mr. Curious is a little old man with knobbly knees.  When I first saw him, he was under assault by two nurses pulling his clothes off.  As his little knees knocked against each other in cold, he politely answered the questions shot in rapid sequence.  I grabbed him a blanket and he exclaimed, "what is this blanket made of?"

S: I'm not sure, Mr. C.
Mr. Curious: Speak up, I can't hear you!
S: I am not sure what they're made of.
Mr. Curious: They feel so warm- why is that?
S: Well, Mr. C, I got them for you out of the warmer.
Mr. Curious: No! I mean, what is this material? It's remarkably warm.
S: I think all the little pill-like fibers keep heat in. More surface area, crevices, and insulation.
Mr. Curious: I'm a scientist, see, and I don't know if it would be too much trouble, but can I have a small piece of this blanket?

I told him he could keep it and he was enthralled.
He explained to me that he used to design polymers for industry and had amassed many patents in his 90+ years of life. It was wonderful to see that at such an age, in such a situation, his sense of wonder and intellectual curiosity was intact. Once a scientist, ever a scientist.

Happy New Year!

Friday, December 30, 2011

Basketball Team Loyalty

So I went to a college with a very good basketball team.  On occasion, I discuss college basketball with patients but because another team is the local favorite, I have to be careful what I say. Never did I expect, however, that I would be arguing about college basketball while pulling stitches out of someone's backside.  Apparently he might have been playing on one of the opposing teams of a game I had gone to see my freshman year.

I didn't hurt him too much. I think. : )

Just kidding.  Despite the arguing, he was quiet as a mouse about the stitches.


Monday, December 26, 2011

Holiday Hijinx

My white cloud brought me no traumas Christmas Day (yay!), so I kept myself busy helping in the other sections for the day. First theme of Christmas: there were many, many people who didn't chew their food well enough, coming in with foreign bodies in their throats.  I have to say, pulling steak out of someone's throat wasn't what I was expecting to be doing!

Another theme of the Christmas season has been the dropping off the elderly at the ER because nonnie or poppy "wasn't acting right." Unfortunately, because the holidays are the only time the family visits, the mental changes in their beloved, albeit neglected parents/grandparents/great aunts/great uncles were not necessarily acute.  "Yes, Mr. Dementia is confused sir, yes, he probably wasn't like this the last time you visited, no, actually, this isn't new- we've seen your loved one several times already this year and this has been his/her baseline. Also unfortunately, it is the holidays and their immediate placement in nursing homes is very unlikely until at least the next business day, please don't yell or call your lawyer?"

There were also many, many overdose patients.  One family found their son unconscious in the bathroom because he had taken whatever pills he had found in the medicine drawer in a suicide attempt.  The parents removed and brought the whole drawer to the ER. It was full of empty pill bottles. The only one still half full was the bottle of Vitamin D pills.  Waiting in the family room, the parents kept harassing our resident.  However, the clean-up process was long. The young man was covered in paint-chip-like flakes, which turned out to be half-digested pills. Yours truly also figured out how to work the new "stomach-pumper", but it yielded little, as mostly everything was already expelled or digested. When we finally invited the parents in, I could understand why the resident got so frazzled. If you could picture older hippie Trekkies, they were the disheveled stereotype.  When we transported the young man to the ICU, the father was at the bedside telling his son that they were going on a spaceship and warping to another universe.  Privately, though, he choked to me, "thank you for the best Christmas present ever, for bringing him back." The father then asked me if we shaved him.  "No, we haven't done anything, why?" "Well, you see, he was about five days unshaven the last time I saw him... So I was just wondering." It was probably how his son meant to look at the "end."  Poor family- I hope the best for them.

Another young man had overdosed on narcotics and was intubated when he came in. A nurse and I felt the long track marks on his right arm and looked at each other- "this guy must be left-handed!" Later, a respiratory therapist had undone the restraint on a wrist in order to draw a blood gas.  Alas it was his left hand! He was apparently awake, pushed her hand aside and ripped the endotracheal tube right out of his throat, balloon still intact and puffed up. Ouch!! He then looked at me and asked me for juice!! The doctor said no and he was admitted to the ICU for observation anyway.

Our Christmas Trannie came in to visit wearing a Christmas speedo. We know because she/he/it was smoking funny things and flashed us while in four-point restraints, shaking her booty and grinding toward the sky for all to see while viciously lambasting us at the same time. Talk about mixed  messages.  She/he/it was visually very feminine and attractive, so hearing his voice screaming in the ambulance bay was rather incongruous.  His bright lipstick made her fast-moving lips a hypnotic and mesmerizing point of focus.

In the midst of the hustle, one of our drunk/psych patients came in and latched onto me in triage while I was taking vital signs. She wouldn't let me go and bawled her sorry eyes out while pretending to be someone else. We knew her from her many visits by name, though, and called her out on it, making her sob even harder.  Meanwhile, our Christmas Trannie was tranquilized, and in the moment she/he/it rolled by, Ms. Hot Mess was distracted and I extricated my hands. The evening thus became considerably calmer.

This weekend has been at moments uplifting, hilarious, and poignantly sad.  All in all, though, I am just very tired... Managers had scheduled me on Christmas Eve Eve (1530-midnight), Christmas Eve (1100-2330), Christmas Day (0730-2000)... I am feeling the most burnt out I have felt since June, the month I was stuck in the drunk tank almost every day.

However, I am thankful to have today off. Post-holiday Manic Monday doubly busy- the day when everyone who said "I'll wait till after the holiday" or "We'll see if it gets better by Monday" decide to come in.  Looking forward to an early bedtime tonight. : )


Sunday, December 25, 2011

Merry Christmas and Don't Drink Too Much

If I were over 100 years old and adorable, I'd want to drink whiskey shots too.  As many as I would like. However, I'd avoid falling out of the chair and hitting my head so I can continue to spend Christmas Eve with my family, instead charming all the nurses in the Emergency Room. : )

He kept crossing and uncrossing his legs to "get comfortable."  At first, he denied the alcohol, but then mused, well, I might have forgotten if I did have any. Luckily, he went home after his scans came back negative.

Monday, December 19, 2011

The Thin Line Between Tragedy and Comedy

At sixteen years old, Mr. Athlete was already a man.  He was tall; his waist was wiry and muscular in the way that only youth can sculpt.  His arms and legs were sinewy and had obviously been very active and athletic.  However, as he was wheeling into my trauma room, Mr. Athlete was not moving.

A trauma to his curly head had left only a little blood, but his Glasgow Coma Score ( was between 5 and 6.  His eyes were half-open and not moving.  He made no sign of recognition to his name and rubbing hard on his chest only produced a spasm.  I pulled his neon sneakers off his callous-less feet.  The perfect body lay in front of me and it lay terrifyingly still.

There is something so terrible about a scene like the one before me. The potential strength of the body before me was meted by the delicacy and specificity of biology. Everything must be "just so" for us to function as we do; there are uncountable details that must be heeded to form the elegance of a merely functional being, let alone the highly sophisticated and elegant people we are and encounter every day.  I realized I was scared for him. In that moment, I wished fervently- nay, prayed- that he would come back and instinctively grabbed his hand.  It was ice-cold as he had been laying out in the cold until the ambulance brought him to us. His neurological state qualified him to be intubated, but the doctors fortunately stayed their hands as we called out to him one last time and his lips moved almost imperceptibly.  He could hear us.

His friends, still dressed in full gear, came in to keep him company.  They were cut from the same cloth- tall, slim, athletic, but with all the long-lashed, clear-skinned visage of children.  They were horrified to see their comrade thus. It was worse when his parents arrived, however, seeing their son with his eyes unmoving.

Hour by hour, however, he began to move a little more and his voice began to come back- words incomprehensible at first.  His remarkable transformation in the hours under our care was heartening. His scans showed no bleeding. He became fully awake when a nurse tried to give him a urinary catheter.

By the time he left, ten hours later, he made a remarkable transformation.  Because we cut off his clothes, I fetched him some paper scrubs and mesh underwear.  His friends laughed uncontrollably at the mesh underwear.  He grinned sheepishly and made a crass joke about feminine hygiene products. His tragedy suddenly turned into a comedy.

All was well and they- parents, child athlete and friends- walked together into the night.


Worst Boyfriend Ever

If your girlfriend is pregnant and decides against an abortion, please don't take it into your own hands help her change her mind.  It's a life-changing choice to drive the car into headlong traffic, sending her into the operating room- and in many more ways than one.  But of course, being the lucky **#%(* you are, you'll get off with only a misdemeanor because she doesn't want to press charges!!!

Luckily, the nursing staff sees what kind of *(#%)%)(#@* you are when you try to threaten/control/thrash/scream at us, and you got knocked out pretty quickly.  How dare you.

This is what I want to do to you!!

Friday, December 16, 2011

Holiday Plans

Holidays are great times to work... On Halloween, I apprehended a bunch of frat guys wearing superhero costumes, on Thanksgiving, I told patients that we had a "Thanksgiving Day Turkey Sandwich Special", and this ChanuChristmas, I will be working, but as a side project, I am organizing a caroling group to go around the hospital wards. I figured it will be fun to do something together with my co-workers and volunteer program.

The ER is festively decorated with shiny baubles and there are wreaths and garlands hanging around.
The most wonderful time of the year, indeed.


Thursday, December 15, 2011

Perils of ER Dating Predators

NQ Honest is a co-worker from a different department who I see often at work.  He is a friendly young man with more than a hint of exaggerated machismo. NQ took to winking at me every time he saw me. I would return a curt nod.  Although he seemed nice, I maintained my strong ideas against dating anyone from the workplace.  There are stories (not mine) out there that can curl your hair!

NQ seemed to be encouraged by my lukewarm acknowledgment, however, and escalated his advances so far as to ask for my number.  I declined every day for a week until he told me it was his birthday. I can safely say, I will never be guilted by the birthday excuse again.

Strike one: After a barrage of "y havnt u been txting me lol" messages, he exchanged numbers the same week with RN McSlutty in the back hallway.  Oops.... Sloppy game, man. Subsequent pretenses to be infatuated with me were that much more alarming in the next few days.

Strike two: I was introduced to his mom 3 days after the strike one incident.  But this isn't going where you think it is. Working in critical care early in the morning, he rolled in as my patient, tachycardic at 160.  I was shocked to see him so pale, but ever the gentleman, he first introduced me to his mother. Although he told me he was there because he had worked overnight and was overtired, his chart told me that he had tried Cialis for the first time and took too much.  That would explain his extreme difficulty urinating and need to be catheterized after he downed 8+ glasses of water.

Strike three: Asking me out for drinks because his mom was so taken with me. My polite decline caused him to loudly proclaim in front of my co-workers, "you should be nicer to me after all those drinks I bought for you."


Mr. Not Quite Honest has since been a strong reminder of the perils of dating in general.  It's a scary world out there, but apparently not as scary as taking a dip in the company cookie jar.


Don't look behind the curtain...

Mr. Saucisson didn't fit in the post-mortem bag.  We had to push his rotund belly around to stretch the heavy plastic so the zipper would reach.  And then we broke the zipper.  When the other tech went to find another bag, I looked at him.  It was eerie; the pallor of his face wasn't terribly noticeable and his eyes were slightly open, all-seeing, like the Mona Lisa.  I put my warm hand over his forehead and covered his eyes lightly. They stayed shut.

He had already passed by the beginning of my shift.  I never got to know him.  He was put into a room where crying family filed in and out all afternoon.  When they had all left, we pushed him into a far-away corridor room to clean him, then zip up the bag for the autopsy technicians to pick up.

I looked at him once more and closed the curtain.

An hour later, I was passing the staff bathroom when I heard nurses tell someone where to find the body. As one of them led the visitor down the hallway, I froze, realizing what they were going to see. Goodness forbid that this was a family member!! I raced down the hall, trying to hint to the nurse. "Um, are you going to see Mr. Saucisson? You see, he might have been moved." "Um, well, we just *changed the *linens (hard look)", "You know, we didn't expect any more family to come..." to no avail- the nurse looked at me weirdly and led him to the curtained room.  Suddenly, realization dawns on her face and she rushed out of the room to find out about the patient.  Meanwhile, the visitor tried to peek and I stopped him.

"Sir, what relation are you to Mr. Saucisson?"
"I'm his primary care attending, his doctor."
I sighed in relief. "Oh, I see."
"I heard he was very sick."
"Yes, that's definitely true."
"I also heard he recovered, but I wasn't sure if I would find him... alive."
"I'm sorry, but he had passed a few hours ago and the family has been here to see him."
The doctor looked struck. "Oh, oh I see. I had hoped to see him one last time. I only spoke with him yesterday..."
I took a step back. He was mentally prepared now.
"May I?" He took a step forward.
"Go right ahead."

I stood at a distance, to give them some time.  He came back out presently- and thanked me for preparing him to see Mr. Saucisson as he was.  He had thought there was a recovery...Ugh.   Crisis averted for the day!

Tuesday, December 13, 2011

The worse insult

PA: How could you not tell me this patient had an O2 sat of 87?!
S: I thought telling the nurse would have sufficed (considering pt x was on a bedpan, patients y,z,a, and b needed vital signs, crazy patient c was puking all over the floor, patients d and e both needed labs drawn asap, poor patient f needed to be wheeled to the bathroom, then home, and we got new patients g and h.)
PA: Well, I just would have expected that someone that just got into PA school would actually care about letting someone know, that's all.

The biggest insult in her remark? It wasn't that it was in full view of doctors, nurses, and patients. Nor that I was yelled at, nor that she snidely thought I didn't care, considering how many people told me the opposite during the course of the day. It was probably that she assumed I got into PA school. At this point, I would probably be very happy. Unfortunately, medical schools haven't given me much of an indication of anything yet. Sigh.