Old Country Manners

Mr. Right-Handed had been a carpenter for the last 40 or so years before he had an accident one morning that split his dominant thumb in half lengthwise, cutting several tendons and causing him a lot of pain. He kept apologizing for not speaking English very well, though I understood him perfectly.  His deep blue eyes searched my face and crinkled into a smile. He trusted me to take good care of him.  His daughter sat in the background, distant and businesslike.

A stoic man, Mr. RH, didn't want to admit to pain at first, but as he got to know me through his many hour stay, he began to let me see the grimaces and such. He refused almost all the pain medication, however, and I stopped in many times to grab him another pillow or ice-pack.

When the surgeon finally took the bandages off, I was fascinated. The jagged cut went clear to the bone. It was then that Mr. RH finally agreed to have some morphine as the surgeon cleaned and stitched the wound up for evaluation the next morning. He asked me to stay with him, and I distracted him by making conversation through the bloody procedure, though the numbing medication was wearing off quickly.  We got along really well- he told me about his family and about his love for his profession, making customized handiwork for clients.  Occasionally, he would wince and I would hold his good hand.  My father is the same way about pain- he would never admit having any. I notified his nurse, and Mr. RH received some more morphine, but will eventually need surgery to re-attach the tendon.

10 Hours after I first met him in which he wasn't allowed anything to eat or drink, I sent him off with some juice and a sandwich box.  As he stood up, he thanked me, then remarked with a grin, "it looks like after alcohol" as he left on his daughter's steady arm.

S

On the Wings of Karma

Someone decided to switch me out of Urgent Care for 8 of the 12 hours I was supposed to be there. 8 Hours working as helipad tech isn't so bad though, so I refrained from notifying anyone that such a change had been made without my consent (not that it would even matter).

As I peered through squinted eyes in delight at the gorgeous day, feeling the warm breeze wash over my body, I received several patients and met some really cool medics that fly helicoptors for a living.  There was a crazy trauma where a man got his leg caught in a machine that has a threshing mechanism of action; the whole leg was bound with a tourniquet, and when they opened the cardboard encasing it, it was mangled beyond repair.  There is a middle-aged man out there tonight without a leg that had accompanied him his whole life.  

Meanwhile, Urgent Care got slammed. 8 patients at once is already overwhelming, but there were literally 18-20 patients in that waiting room. Whoever wanted a cake-walk shift was definitely mistaken to take this hellish post from me today. (Thank you!!!)

The balmy breeze on top of the helipad tonight lifted my spirits with the dancing lights of the helicoptor.  I watched the patients and their families in the tower across the way stick their faces up close to their windows, watching us working.  I waved and they waved back.  Being outside in that night air is definitely one of the keener sensory pleasures of being a tech.  

S

I Would Love to Go to England if the People Were All Like Him

26 Hours of interrupted sleep later, I think I've recovered somewhat from the splitting headache and nausea all through yesterday.  Whew.  I rarely get headaches and forgot how hard it is to get rid of them! Just imagining the pounding behind my temples makes me nauseous again. The mixed-up dreams and fitful sleep were the worst part though.

The good part of this experience is that I have refilled my empathy pool for people with headaches.    At work, I can generally tell if a patient is legitimately compromised, so I would turn off the lights and let a nurse know about the state of the patient. Other times, I might receive a surly or hopeful demand for that "drug that begins with a d", in which case, I just backpedal quickly out of the room and alert the nurse about the narcotic request.

The other day, I had the most delightful old man. I walked in to see Mr. Dickens lying on his back, a large bleeding "egg" over his left eye. Ever so polite, he brought out my good humor with his mild British accent and tongue-in-cheek charm.

"So did you get that shiner from a fall or a fight, Mr. Dickens?" I asked.
"Oh, I fell, definitely not a fight," he chortled. "Excuse, me, but if you get a chance, I was wondering, I've been here all day and was hoping to get something to eat."
"You know, I will have to check with your doctor about that- if you have to get a surgery, then you can't be eating."
"Oh yes, miss, I understand that they told me they are reconsidering the need for surgery."

I went out of my way to find a vegetarian option for this LOM, and when I presented him with an egg salad sandwich, he was delighted, using all the cutlery gingerly and politely.  It suddenly hit me how often I've seen patients wolf down their food and appreciated little Mr. Dickens ever the more.

"So what was your profession, Mr. Dickens?"
"Well, back in England many years ago, I was a professional voice recorder for books on tape."
"How wonderful! I used to read a lot of Dickens, Thackeray..."
"Dickens is delightful, isn't he? You sound like you like a lot of the Victorian literature."
"Yes, I do, indeed. What an interesting career you must have had."
"Yes, it definitely was."

I gingerly cleaned all the blood still draining from his eye, which was puffed shut. I had to rub out with peroxide what had dried and settled in his gray hair.  He was patient with my gentle and didn't say he felt any pain when I asked, though his eye was puffy with bleeding.  His accent was charming and conversation nuanced.  It's not every day I could gush over classical literature with someone.

Oh, Mr. Dickens, you made my day so much better, though you probably thought you were being fussy and making me busy.  Wishing you well.

S

The Next Time You Stop at the ATM...

The next time you decide to drive up to and stop at the ATM for some cash, please stop completely. Don't try to hang out your window and use the ATM with your car running because as you're hanging out, the car might start to move. You might fall out and get dragged about 20 feet before your car pins you against something, like a wall or telephone pole.  Then, EMT's will have to extricate you and bring you to meet yours truly in the trauma room. While you might be a delightful character I would probably not meet otherwise, this is just not the best circumstance to become friends.

End Public Service Announcement. Have a great day!

S

First Time for Everything

I can log a few firsts tonight:

My first confrontation with a co-worker.
My first instigation of a confrontation ever.
My first time trying to speak French with a patient.
My first time observing a glass eye at close range.
My first time taking a break to let off steam.
My first traumatic code
Working my first traumatic code death without help.
My first time being directly appreciated and recognized by a co-worker.

Which of these should I start with in my next entry?
S

Of Butterflies and Roaches

Every once in a while, I check back into a more comfortable reality, as if the realer-than-real life that I have been living in the ER has been a farce. The darkness of humanity will seem to be only a nightmare that dissipates with the morning light of the waking world.

I was pulled from my section to sit for a college freshman who had ingested 20-60 liquid advil in an attempt to harm herself. Oh boy... I've seen enough disturbing cases of these to be totally on my guard.  Young, "alternative", wearing black lace tights, and thick dark eyeliner, she commanded an adult appearance way beyond her years.  Yet, she surprised me. Polite, meek, apologetic, it was as if she got caught in high school for skipping class and was in detention.  She didn't even object to having a "sitter." She took it as her due.  It made me wonder about all the combative, abusive, spitting, terrible people I have sat with hitherto, and how little effort it took to sit with Ms. Advil.  She did everything we asked and more, even replacing the blood pressure cuff herself when she came back to the bed.

Instinct told me to reach out to her- she was a little overwhelmed and completely new to the hospital environment and asked me what "butterflies" were.  The more I talked to her, the easier it was to look through the smeared make-up at the very young soul in front of me. It became more and more apparent just how young she was, with baby fat still lightly gracing her jowls. She hadn't succumbed yet to the college-girl quest for angular chins and improbable diets.

"So what happened that brought you in here?"
"Well, I was going out with this guy Nick, and I was mean to him, but I didn't think I'd push him away. So when he told me he wanted a break, I got mad and lost my temper."
"Did you want to hurt yourself?"
"Yeah, but not anymore. I just love him so much."

I let her babble on about Nick and she thanked me for listening, for it made her feel better.  She was curious about the charcoal we had her drink to deactivate as much of the drug as we could. She didn't mind when her mother and grandparents came in to sit and stay with her.  I've had young patients fight tooth and nail to avoid their parents, but they were apparently a very loving, supportive family.

They had raised a good girl, albeit a little spoiled and impulsive.  They were also very protective, asking for every little detail, whether this IV should be hurting or if the bag should be changed, or if she could have ice chips and a toothbrush/toothpaste to brush her teeth, etc etc...

Sitting with them made me feel safe- removed somehow from the adult world of lies, manipulations, agendas, gambles, real psychiatric problems.  She was just being a pouty kid.

I heard a scream down the hallway from the PCP-ingestion that was heading my way. In stark contrast, this young girl was a brash young hellion with emotional problems and the will to harm.

My few hours of peaceful counsel with the Advil girl was ended by the arrival of the ugly character of the new patient next door, who brought me swiftly back to my adult reality as she started spitting at us. Sigh, just another day in the life.

S

Patients Say the Darndest Things

I set up a pelvic exam tray for bed 13. She eyed the pelvic light with a wide eye, "what is that black thing?"

"Oh, it's just a light", I switched it on and off for her to see. 

"I just had twins, so I mean, it will fit, but y'all aren't gonna stick that thing up there, are you?"  

"Ms. Colorful Language, have you had a pelvic before?"  

"Yeah."

"Then you know, it will be really quick. This light won't stay up there."

"Ok." She kept eyeing the light.

"Don't worry, honey, either me or the other tech over there will be here with you through the whole thing, ok?"

She nodded, but didn't say anything. I left the room and the very straight-laced, so-academic-as-to-be-a-bit-socially-inexperienced resident soon entered with the other tech.  He came out ashen-faced a few minutes later. "Well, I have never heard that expression before!" He sputtered.  "What did she say?" He wouldn't repeat it to me.  Later, I entered the room with him for something else. 

"Doctor, are you going to **** me with that black thing again?"

"No, we're all done," he said, blushing. I could barely hold my face straight.  "That's what I was referring to," he whispered to me as we left the room and a grin crossed my face as I bolted to find somewhere to laugh.  

S