Full Speed
By the time I hurriedly finished suturing the jagged facial laceration of my young trauma patient, sweat was pouring off of me. It was a complicated repair, certainly, and it was somewhat difficult for me to find a position of comfort. But the room wasn't hot and I wasn't really concerned about the patient in front of me or the quality of my work. I was thinking of the patient I had sent to the CT scanner some 20 minutes prior, and the full waiting room was weighing heavily on me as well.
The fact that I hadn't been called out of the room by a panicked nurse was reassuring, I hoped, but I honestly wasn't sure that my patient would be alive by the time I returned. And yet, without the scan, I had no more interventions to attempt and nobody to call for help. Sometimes it isn't even clear which organ system is causing a patient such horrible distress. I'd already done three EKGs, afraid it might be his heart. They were mildly suspicious, but not diagnostic of anything. I tried to perform an ultrasound, but the patient's rapid breathing, severe pain, and large girth made the study almost worthless, so I aborted the procedure because I honestly thought the patient was either going to die right in front of me or pretty darn quick if I didn't get some answers fast. So with some hesitation and dread, I sent him off to the CT scanner ("where patients go to die").
But I'd already anesthetized the disfigured face of my young trauma patient prior to the arrival of this trainwreck, and I needed to complete the repair before the sensation returned. Having a few minutes to spare, I charged in and did my best despite the rush of adrenaline that made my hands tremble a bit.
As I sprinted back to the shock room, I was pleasantly surprised to see that my other patient had stabilized, and the CT scan ultimately gave me the answers I needed. It appeared that he was going to be OK, at least for the time being.
To the patient with the stubbed toe, all I can say is this: when you see an agitated ER doc running around the department barking orders, soaked with sweat and fully charged with adrenaline, it might not be the best time to express your displeasure regarding your waiting time. Can you not see that I'm doing the best that I can?
But I am truly sorry for yelling at you. Please come back and see us.
Labels: ER, letters, nightshifts, patients, rants
posted by scalpel at 9:47 AM
9 Comments:
Oh have no fear. He WILL come back to see you.
Glad your CT patient turned out okay.
I remember one night in a trauma center where I chose to go down to CT to painstakingly remove about 15 bobby pins from the hair-do of my patient, an elderly woman who had just come in from an MVA. It irritated the doc that I left to go to CT because he'd cleared her off the backboard and didn't see the need for me to go down there. But I "had that feeling". When they finally CT'd her after I'd carefully gotten the damn bobby pins out without moving her head, sure enough--she'd broken her dang neck. When I ran to tell the doc he cussed to high heaven. And then the patient bitched at me about removing the bobby pins because she'd just been to the hairdresser that day. We ended up transferring her to another hospital. But as the MICU truck drove away, I was finally able to breath my sigh of relief that she still had sensation in all of her extremities, thank GOD.
Keep on truckin'....
Eh, do you really want them to come back?
i feel you brother. i think another thing people wouldn't believe about what we do is that sometimes, on a shift such as you describe, you can go 8-10 hours without eating, drinking, or peeing. it's only after the adrenaline begins to wane that you realize that your bladder is FULL brother!
obtw, scalpel, it took me a bit to understand your avatar... thought it was a bird's head for the longest time.... i'm on the overnight and enjoying your blog.
Interesting post. You all must have a calling, because not everyone could do that on a regular basis. Then when your off - your free-e-e-e - without the demands of a private practice.
Everyone has to conform to the policy and procedures in their profession, but for some reason I see the ER Docs as the mavericks of doctors..I don't know why exactly, I just do. :)
Reminds me of a patient with a sprained ankle who screamed, "If I had a massive bleeding head wound, you would have seen me RIGHT AWAY!!!"
Why yes, yes I would.
Try as I might to explain it to the patients, they still don't understand. In the event of an Emergency you do not want to be seen first. Or even second or third. No you want to be the guy i see AFTER I eat lunch. This means I don't think your going to die.
That's funny Fab! :)
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