Month: September 2012
Male patient, in his thirties decided it made sense to punch a hole through glass with both hands at the same time……..of course he was drunk at the time.
Lacerations everywhere on both upper extremities. He was ‘angry at his wife for asking him to take out the garbage’.
While suturing his MULTIPLE lacerations, he turns to ask me…….if I thought that he had ‘overreacted’.
Ummmmm……yeah….definitely. And when all that alcohol comes out of his system…he is gonna feel it.
So here we were on another hectic Friday night.
Everyone is out drinking, partying and having a good time.
We the ER staff are being kept busy by several motor vehicular accident victims….they just keep rolling them in.
I was exhausted and had to keep a mental checklist of the patients who were extremely critical to the not so critical.
Then a prisoner came in claiming that he was being treated unfairly in prison and that his lower leg was hurting.
I examined him, found no swelling or tenderness, or even bruises. But, just to be sure, I did an xray, which also showed no bony injuries. When I informed the prisoner that there was nothing wrong, he jumped out of the chair and exclaimed that he was not going back to prison. Something had to be wrong for us the keep him. It was not that kind of night.
During all his antics I saw two more MVA victims come in. And I still had other patients to follow up on.
Apparently, on the prisoner’s way out, he grabbed someone’s soda can and started to chew on it. The prison guards got him to spit out the pieces……I don’t know how they did it, but I was soooo grateful. Then they escorted him out of the ER……
Don’t make an ER doctor’s work more than necessary. Whatever you did in your life to earn you a stay in prison is really on you.
Back when I was in 4th year,medical school, I rented an apartment in NY that was on the third floor of a building which had no elevator.
Doing laundry was a workout in itself. I had
To walk up and down those three flight of stairs with a heavy load of laundry.
Once, I was postcall, but still had to get my laundry done or else I would not have had chance to do it for a week because of my schedule. Tired, exhausted and half-asleep I was going down the stairs, slipped and fell landing on my right foot which twisted badly.
Honestly I thought I had broken it. I just sat there in excruciating pain, and all I could think of was that I had ‘screwed up’.
At the time I was on my surgical rotation and the attending was really hard on the students. However, if I could get an LOR from this guy, I would definitely get into a surgical residency, which is what I was extremely interested in at the time.
I did not even want to go to the hospital, and I didn’t. I dragged myself back up to my apartment. Then I wokeup on the floor of my apartment, just inside the door, about two hours later. I had actually lost consciousness due to the pain.
After being assessed at the hospital, I just had a sprained ankle. I stayed off my feet for two days. Showed up to work bright and early on crutches…….you better believe it.
Also getting around on the subway during peak hour while on crutches is like being roadkill….people will push you and actually tell you to, ‘get out of their way’.
Needless to say, when you are laser-focused on a goal, don’t let anything get in your way once you have a pulse.
When I was in my third year of medical school, the first rotation I did was internal medicine. Somehow, I ended up rotating with a cardiology attending for the first few weeks of the rotation.
She was extremely interesting, to say the least. She was tall, I would say about 6ft 3inches. Also, she wore these heels that not only exemplified her height, but warned everyone that she was approaching.
She took heavy, wide-based steps. Even the other senior doctors looked and acted different when they heard those steps coming. She exuded this aura of confidence. Not only that, she was also brilliant. A member of several boards, both medical and business boards. She was also renowned in the field of cardiology.
So here I was on my first rotation with her as my teacher. She asked me to examine a patient and then come tell her the results.
I did the examination and went to find her. Her first question was, ‘Does the patient have hair on their chest?’ I figured I would guess the answer and I said no.
She walked back with me to the patient’s bedside, bringing along the rest of the medical team with her. She then got the patient to lift their shirt and they had the hairiest chest ever.
She turned to me and started laughing, loudly. Then she said something that I have never forgotten to this day…….DON’T ever lie. It doesn’t matter if you get shouted at for not doing something or for forgetting to examine a patient. Once you lie to your team, you become untrustworthy, and, you become the weak link within the team. Don’t ever lie.
After that, I never gave a false answer even if it meant staying back for a couple hours to do something I should have done hours ago……..Even if it meant I was going to get shouted at by several seniors.
It means I can watch someone in the face and say either ‘yes’ or ‘no’ and they can trust me.
When working on a team, any team, medical or otherwise, trust is intrinsic to its foundation and proper development.
DON’T EVER LIE……
One of the most difficult things for a doctor who has moved to a new hospital setting is gaining the trust of their colleagues and…..nurses. If you don’t have the nurses’s trust, things won’t run as smoothly as you may like them to run.
It took me awhile to do this. Nurses will watch you carefully. Especially those who have been around for a longer period of time and have gained a lot of knowledge.
When I moved to my new location, I knew that first and foremost, I had to be humble and yet strong in any decisions I made for my patients. That was not the time to be making mistakes.
You know you have ‘broken the mold’ ,when ,a nurse ask if you are working the shift with them tonight and then looks disappointed when you give a negative answer.
But whatever happens, don’t ever drop your guard. Like so many things in life, it may take a period of time to build the trust of the team, but only seconds to lose it.
I recall as a medical student in my fourth year doing a sub-internship in trauma surgery. One night, this guy came in unconscious. He had been beaten by a group of people using skateboards. It was difficult examining the patient because he was not responding appropriately. He had also lost most of the teeth in his mouth.
The chief surgical resident was well liked by everyone. He was there when the patient came in and fully assessed the patient. However, he believed that the patient had an abdominal injury which was more life-threatening than any of the other injuries.
A CT scan proved him wrong and that the main injury was to the patient’s brain which was being compressed by blood from a skull fracture.
Neurosurgery assessed to patient, and all was well. However, I noticed afterwards that for sometime, attendings started to show up whenever trauma victims came in and that chief resident was on call.
It took awhile for him to prove himself again to the team.
Trust is such a fickle thing to earn.
I initially bought a pair of Danskos clogs waaaaaaayyy back in medical school for my 3rd year surgical rotation.
That shoes is a TROOPER!!!!
Years later, and now as an ER doctor, I looked down to figure out what is wrong with my shoes. The under sole had broke.
Unfortunately I will now be retiring my favorite pair of shoes. It really served me well.
But I will definitely be getting a replacement.
I love Danskos.
Funniest experience a few nights ago. A patient who had been discharged decided to go on an angry rant, complaining to anyone nearby. The patient’s family decided to take forever to come and retrieve him.
Somehow, we became the ‘scapegoats’ who were keeping the patient trapped at the hospital.
The patient stood in the middle of the ER screaming that he would ‘light us up’ if we didn’t get his family pronto.
Before security could even reach to pacify him, another patient jumped off his bed and screamed at the guy…..’SHUT-UP!!!! Can’t you see I am trying to sleep here. Just SHUT the hell up!!!’
The ‘angry’ patient immediately got quiet and sat on the edge of his bed pouting.
I think we need to hire that other guy as security. He was effective!!!!!!