Playing with Bullets

"Excuse me, I wanna get your number so I could like call you about my care and stuff."

"I'm sure that we'll give you a lot of numbers for followup appointments for your care, Mr. Gunshot-wound."

"Well what I mean to say is can I get your number so we can like hang out and stuff?"

"Haha, aren't you a charmer?" I beamed him a smile and turned to finish stocking the trauma room.

"Wait till I become a doctor. Then maybe you'll talk to me when I'm like the one taking care of you."

I looked at him pointedly. "I'm going to get there first."

He grinned dejectedly, but seriously- I wasn't about to give my number to my young gunshot wound patient who was about to be discharged. The bullet was still lodged in his leg and they were not going to remove it via surgery. I wonder that he had the interest to ask me for my number a few hours after he just got shot.

I had to hand it to him, though, as I thought about him and laughed to myself on my way home. He was pretty smooth and definitely a young player in the making.

S

My Life in the ER: Musical Edition

Scene 1: S is walking to work in the afternoon and feeling great after spending the morning at the gym.

S: Oh, what a bright and lovely afternoon- I could break into song! The air is brisk, the sun is shining, nothing can bring me dowwwn. :musical interlude as she walks into ER:

Scene 2: Crowded ER treatment area

S: Oh my what a busy day it is,
oh my what a busy day.
The patients load is rather high and
The drunks are piled up that-a-way...

That man has a mesh bag on his head,
he must have tried to spit.
(Mesh bag head man: dramatic snore)
Those others also have been restrained,
just beware they also might spit.
(Drunk chorus: growls)

(change of key)
But I cannot complain- I'm not sitting,
and changes afoot are a-plenty.
I've got a pager now, and it rings a bell (riiing)
whenever my nurses need meeeeeeee-----

(change back into key)
Oh my Mr. Mesh bag man just woke,
oh my he just woke up now,
he's screaming that he needs to pee,
but no empty rooms I can see.

Mr Mesh bag head man (solo): I can't wait, I can't wait! I'll kill you all just wait!
Tech chorus: We have no room- just a sec- be patient and you'll go-
Mr. Mesh bag head man: I will wait, but just a sec- you need to take these off--
Tech chorus: You can pee with one hand, we won't release you-
Mr. Mesh bag head man: I can't ****ing take my pants off- you dirty *****sss-
Tech chorus: Then you will wait, Mr. MBHM, security is a-coming-
Mr. Mesh bag head man: I hate *****es!
Security: I'll help you sir, what do you need?
Mr. Mesh bag head man: Thank God!
Security: How can I help?
Mr. Mesh bag head man: I would like to be releaaased- I can't pull my pants dooown.
Security: I can help with the pants, but I won't hold it for you. (wink)

End Scene.

Scene 3: Ambulance bay

Ms. Drunk Pregnant woman (soprano): AAAAIEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE
(scuffle ensues)

Nursing staff chorus (softly)
Oh my is that hot mess coming here,
Oh dear, she's rolling our way.
She's thrashing, yelling, cursing lots,
and a mesh bag is over her head.

Ms. Drunk Pregnant woman looks defiantly around and opens her mouth: AAAAAAAAAAAHHHHHHHHHHHHHHHHHHHHH
AHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH
AIEYYYYYYYYYYYYYYYYYYYYYYYYYYYYAAAAAAAAAAAAAAAAAAa

(she continues)

New resident chorus:
What is that?
What could that be?
It is so hard
to believe THAT is a she.

Yet she must be,
though who would want
to impregnate
somebody like that.

Ms. Drunk Pregnant woman: AIIYEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE
(solo)
Let me out! Let me out!
You *****es let me out!
You are all ****ing retarded
and I want to get out.
 AIIIEEEEEHHHHHHHHHHHHHHHHHHHHHHHHHH

What the ****, let me out!
what you n***** lookin' at?
Just shut the ****ing up
and let me ****out.

Bemused Very Tanned Drunk Guy:
Who you callin' a n****?

Ms. Drunk Pregnant Woman:
What the ****, shut your face,
who do you think you are,
when I get the ****ing out
of these restraints, I'll make you pay!

Mentally retarded patient in room 3: Gyahhhhhhhhhhh?

Doctor solo: Take her out as she so desires! To the ambulance bay she shall wander- until she can control her terrible mouth, she can get her ultrasound yonder. I believe I shall exercise my power, for your pleasure and your thanks, please make haste and open up- the most crude of all drunk tanks.
Nursing staff chorus: And be careful, she spits!

Scene 4: Treatment area
(from afar, synchronized trio
Ms. Drunk Pregnant woman: AYYEEEEEEEEEEEEEEEEEEEEEYAAAAAAAA
Tanned Drunk Man, Mesh Bag man and drunk chorus join in: AAAAAAAAAAHIIIIIIIYAAAAAAAAAAAAAA

repeat x200)

S: Oh my it has been a crazy day,
Oh my, I can't wait to go home-
I've got a candy bar waiting for me-
the sweetness will keep me warm!

Final Song:
When you go to the ER, guest,
be sure to bring ear plugs,
for though the chorus is plenty boist'rous,
you will still want to squash them like slugs.

The tale of the ER drunks must end,
for my morning is swiftly passing,
I must return to work again,
and therefore this passage is ending.

Normal Patient Chorus: Hey nurse, hey nurse, hey nurse! This place might be craaaaaayzeeeee.... But it is better than tvvvvvvvvv
Nursing Staff Chorus: It is, after all, the full moon, full moon, full moon moon.
Manager Solo: And in the eeeeend- patient satisfaction is our frieeend. Can you please stay, my favorite tech, to help patients find their way--- bring them upstairs and sign out laaaate?

S: I suppose... I ... caaaaaaannnnn.
(squeaky stretcher wheels fade into distance)
End Scene.

Family Problems

An 18 year old man was rushed into my trauma room- a bullet had gone into his back. As the physicians were crowded around, arguing with each other about the best course of action, he said quietly to me at his side, I feel it right here. There was no exit wound- there was a bullet still inside.

I put a hand over his and felt the sharp point of the bullet barely protruding from his right chest/abdomen.  "Hey, he says he feels it right over here." The doctors looked up and started moving the ultrasound probe near the bullet.

"Hey, I'm really uncomfortable, can I lie on my side?" Absolutely not, the doctors replied. And the young boy laid sulkily in the chaos, feeling unheard.  "It's because the bullet went so close to your spine. If you move, you might be paralyzed," I whispered in his ear. He nodded. He understood.

"Where were you when this happened?"
"At my grandmother's funeral."
Shot at a funeral... Really??
I had seen the new tattoo on his young neck- RIP Grandma- "Is that the tattoo on your neck?"
"No, it's the other one. And I don't want to talk about it."

Things were moving so quickly because he had to be transferred to the operating room immediately, but I couldn't help but feel for the young man- so young, with so many family problems, a bullet in his chest and nobody able to answer his basic questions.

S

Dumb Idea

"Why did you do it, sir?"
"Well, when you get a little bit drunk, have you ever thought maybe I'll just jump out of a window?"
"Actually, no, sir, I have never thought that."

My patient had jumped out of a second story window "just to scare (his) brothers".  Still intoxicated, he babbled happily about the party and what had gone on before he jumped.

"Oh, by the way, I can't feel or move my right leg- can you help me fix that?"

Sure, Mr. Jumper, will do. Just know that your actions have warranted that you can have no visitors, a sitter, and a lot of pain/surgery in the days to come.

S

In Which I Lose My Temper

I'm not proud of it, but I showed my temper last night.  Thinking of it still makes my blood boil.

The attending physician asked me to take vital signs on a woman in room 13, a section that I was not working in.  I agreed to do it, however, as it was the attending and came to the room just as the OB-GYN residents exited the room.  I knocked the partially open door and the young and obese drama queen told me to stay out as she got dressed. The doctors outside were discussing her impending ultrasound and such, so I knew that she was not supposed to get dressed.  I paused at the door and told her to wait a second before getting dressed.  When I peeked inside that they had left her lying back, exposed, and still in the stirrups.  So sloppy. It was understandable why she was upset.

"Din't I tell you not to stay out, miss?" 
"You look so uncomfortable and the head doctor is worried about you. He wanted me to get your blood pressure right away. Can I help you with getting up?"
"No, you can get out. I don't need your help."

The OB-GYNS then barged in without knocking and she ordered them around.  For whatever reason, I was the target of her ire. I'm not sure what kind of hold she had over the doctors, perhaps she had something seriously wrong with her, but they did her bidding as she imperiously commanded them around the room.  Silly, as the clumsy new residents had no idea where we kept anything. I watched silently as she flexed her ugly attitude.

"Get me a pad," she turned to me, "and you can get the **** out while I get changed."
Obviously, she was not going to cooperate with getting vital signs.

Wordlessly, I left and shut the door without responding. I didn't think I could muster anything polite at that point. This perceived insult incurred bellowing on the other side of the door as vicious curses and rejoinders that I should never enter that room again.

Honestly, how does she expect hand-to-foot waiting service when her manner is so horrible? Boggles the mind...

S

Why We Keep Our Legs Crossed

In an epic battle between pit-bull and testicle the other day, the pit-bull most decidedly had the upper hand.

Frolicking in the snow, it waited until the human in question looked away into the distance, smoking a cigarette outside in his underwear.  Sensing preoccupation, the stray little dog grabbed the opportunity, so to speak, and the hapless gentleman made a visit to my trauma room.

Usually, rabies shots are administered 0, 3, 7, and 14 days after the bite. The first is an immunoglobulin shot, then a series of shots in the arm.  Usually, the first shot is given to the bite-area, but as this case was in a sensitive spot, the shot was administered to the patient's backside.  Interestingly enough, this was the most frightening part for the patient, who is lucky to still be, for all intents and purposes, an intact human male.

His animated re-telling and subsequent musing that at the sight of any dog, he will run inside or jump headlong into a motor vehicle was amusing, to say the least.

Moral: Keeping one's legs crossed isn't just polite, it's potentially life(/genital)-saving.

S

Eulogy

Dr. Devoted was a very quiet patient, despite or maybe because of his local celebrity.  I had seen him myriad times on TV and sometimes in the community. I had even known him as a young child singing in a choir at an annual benefit concert where he made opening remarks about his successful career and long fight with cancer. He was winning then.  

Last night, I had seen him for the last time of many times in my ER, a shell of the man he was. He had definitely taking a trouncing from his disease, but regardless was always polite. He was also honest. He never pretended to not have pain nor to have more than he did.  He would meekly ask for a pillow, but never without that hint of need.  Last night, he was too weak to open his eyes. His frame was thinned from what I had known, his neck curved into an uncomfortable dive into the awaiting pillow.  Pale, weak, with his wheelchair heavily protected by his beloved wife, he lay in quiet slumber as he awaited his room upstairs.

I did not realize his time would come so soon.  Recognizing Death standing over someone's shoulder is yet a skill I have to develop. I can foresee struggle, even grave danger, but not Death himself with any regularity.  Dr. Devoted was a scholar, public servant, and kindred spirit. Rest in peace, sir, for you have touched uncountable lives with your passion and wonderful use of your role as a public figure.  

Rest in Peace.

S