Nearing the Finish Line

At precisely 6:00 pm tonight, I walked out of the ER for the last time this month. I had admitted the last patient of the shift, and our call was officially over. And thus call ends for this resident for yet another month. Tomorrow and Wednesday are mop up days for the team and then Wednesday afternoon is sweet release.

Only 4 patients admitted today, which was a nice light load on the last call day when some of the other residents and I had already “mentally checked out” in terms of working hard.

I have a few more moving tasks to do and then Wednesday there will be some beer pong and barbeque at Pete’s house followed by a little Spider-Man 2 (E. Boogaloo). I can’t wait. After that, I have a 4 day weekend in Seattle coming up – it will be all about splitting the days between working on my new place and then hitting the town hard. Pumped!

It’s been kind of a long month, will nearly all my time spent working, moving, or doing move-related tasks. For you non-medicine types, here are some the things I did in the hospital this month:

-Looked a man with newly discovered pancreatic cancer right in the eyes and somberly told him he was going to die from it (and sooner rather than later). This was at 2 am in the morning.

-Tapped 4 Liters of peritoneal fluid out of a lady today. I.e, her liver was congested (from metastatic breast cancer), the blood going through the liver is clogged, the osmotic pressure backs up and excess fluid spills into her abdomen. Cue me, with sharp needle and Paracentesis Kit ™ - I stick her with the needle and pull off 4 liters of golden body fluid – right out of her abdomen. She actually feels better after all this is done. Mmm.

-There was a week or so this month when just about all my patients, among their other problems, were alarmingly constipated. I transformed into an enema fairy, ordering stool softeners and enemas like candy. There’s a difficult-to-describe joy surrounding walking into a patient’s room in the morning (the day after you’ve ordered all the stool medicines) and before you even ask them if they had a bowel movement, you simply look at them and know they did. (you can see it in their grateful eyes…)

-There were a couple of crazy “codes”. (A “code” is a “cardiac arrest”, or “everyone-stop-what-you’re-doing-and-run-like-hell-to-this patient’s-room-and-help-resuscitate-him”). One code I had was straight out of the show ER. A man went into cardiac arrest on the floor. When I got there, a nurse was sitting on his chest doing CPR and some other docs were hooking up the defibrillator. A moment later, “CLEAR!” was yelled and we shocked his heart back into an appropriate rhythm. We intubated him without sedation. As me and 3 other docs were rushing him to the ICU, he suddenly came alert (probably from his heart being back in a proper rhythm) and he went nuts. He had this tube down his throat (to breathe for him) and he had no idea what was going on. He was also withdrawing from alcohol (being an alcoholic). He was a huge guy, and he starting going ballistic, winging his arms around everywhere. His IV’s all got yanked with blood beginning to seep out. He reached for the tube in his throat (to pull it out). We tried to stop his arm, but this moose of a man was too strong. With me and a nurse using all our force to hold him back, he slowly inched his hand, muscles bulging, toward the tube in his mouth. It was like a slow motion movie scene. We couldn’t stop him. When he got there, he gripped down hard and yanked that thing straight out and spit up blood everywhere. (the tube, when in position, has an air cuff at the end which inflates, thus holding it in place – when someone pulls it out like that, they pull it out with the cuff inflated and thus drag a big plastic, air-inflated bulb, from inside their lungs and outside their trachea – the bulb is bigger than the pathway – i.e. not good). It took a whole team of docs and nurses to subdue this guy before we could get him properly sedated. The most hilarious thing of all, was that after it was done, I realized that all his tube yanking and blood gushing had occurred in the hallway (between the floor and the ICU) and we had actually stopped the bed to wrestle this bear-man right in front of the family waiting area for the ICU.

(Therefore, picture this: You’re a distraught family member of an ICU patient. You sit in the lonely room, thinking about your sick mother and the world in general. All of a sudden, a rush of people appear outside the window. A team of nurses and docs and a huge, psychotic, delirious patient are absolutely brawling. Docs are being flung around like rag dolls, IV’s are pulled out and blood is spilling. Then this behemoth of a man, in crazy hulk fashion, against all force, pulls out his own endotracheal tube and spits blood everywhere while he tries to sit up as more nurses and docs arrive to try and subdue this beast. And this is the hospital your relative is at….)

I can’t even imagine. Good stuff – we were laughing about that for awhile.

-I took care of a 20-year-old soldier who fell 9 stories in Bangkok Thailand while drunk and lived. His legs and back were fractured all over. We were seeing him for fevers he developed in the hospital. 9 stories. Damn.

-And many more

But I’m tired of typing. I guess some of the mundane stuff I do these days would still be exciting or crazy to people not in “the biz”. I’ll try and keep coming with the stories – it seems people enjoy them.

2 more days of wards. Then sweet parole. And Seattle.