ER Ups and Downs

So, what's working in the ER like, Christian? What's the use of working there if you're not getting any good experiences? Well, just so you know, there has been a number of fascinating stories unfolding in the emergency room with me as an assistant and observer, and you are now getting the front row seats to the action (as long as you are able to picture what I'm telling you, seeing as you probably don't have a hospital security card).

Today was the culmination of bittersweet shifts. The first 2 hours or so were pretty quiet, mostly people coming in with finger cuts, head aches, abdominal pain, or a sudden onset of a heavy period. But, then the traumas (not walk-ins, but ambulance cases) began to arrive. This is the cool stuff, so I had my gloves on before the paramedics pulled into the ER garage, moving swiftly to foresee any obstacles or needs of the EMTs. The first case was a woman in her 70s, diabetic and with hypoglycemia (low blood sugar). Her BP (blood pressure) was shooting through the roof, many times over 195/95 (normal is 120/80). No matter what the nurses did, they could not get her to either become alert or respond vocally to questions. The family was there, and told us everything we needed to know, and they ordered a battery of blood tests and CT scans. Eerily for her, the nurses could not get the BP down to an acceptable level. This was still the case when I left 4 hours later.

The second trauma, a male in is late 70s, confused and scared, apparently senile, was placed in the neighboring room. He was complaining of back pains, and had previously received pretty intrusive surgery. He was a fragile, thin and small man, with round, questioning eyes, and every time the doctors or nurses spoke about him, by his bedside, they talked directly to the family and not him. This caused the elderly man to look even more confused, and I remember thinking to myself that he probably would have liked to be included in his own plans for care. The doctor, in a serious manner, asked the family if they wanted to have anything done to examine the origin of the back pain, like a CT scan or to figure out if the same medical problem as before might have returned, hinting at that he didn't think it worth while. The family, after hearing the doctors reasons why not, and including the cost of the procedure in their decision, decided to decline the explorative treatment. I will never know how much of this the man understood, but as they were talking he kept looking confused back on forth on the doctor and family, and looked at all lost and bewildered. I got pretty sad, thinking of the fact that so many people end their lives not knowing their own names, and left the room to see if other traumas were interesting.

This is the jackpot of my day, this trauma. In through the double doors came a naked man on a gurney, lying face down, accompanied by paramedics and police officers. The placed him in on of the rooms, and covered him with a blanket after he turned around. Just past 20, much like me, and truly one for the psychiatry books. All we knew was that this man had set fire to his own house, and that he was in the ER for a checkup and treatment of possible smoke inhalation. Oh, fascinating case. He started out proclaiming to the room that "Jesus Christ will come in three years". Okay, fascinating, but not something you wouldn't hear from just any weird Christian. But it gets better. "I have complete records of what I've done from the moment of my birth until now, and it has all been thoughtfully planned out. I have progressed off the charts intellectually the past weeks, and have developed complete audio and visual photographic memories, as well as memorizing 99% of the Bible." He went on to telling the officers and us how he set fire to the house, apparently just to check the response time of the emergency services in the area, and how he sat down after lighting the fire, inside the house, carefully recounting every incident in his life, including the time he threw his cat into the wall as hard as he could. He broke two windows, to fuel the fire, and got out of there on the exact 30 minutes after lighting it, just to not pass out (and yes, he was naked when walking around lighting the fire). They called a psych consult, officially arrested him, and after a while sent him up to the 4th floor, where he apparently flooded his room and was sent to prison.

Last time a man in his fifties arrived from a car wreck, and he was in a pretty bad shape. Blood everywhere, legs broken so badly they were protruding the skin and poking out, and a very low BP. The surgeon took out a scalpel and made an incision right on his rib cage, and then shoved his fingers hard and quick into the wound to the lungs to make sure the passage was clear. Then they placed a tube in there, to drain off any blood in the lungs, before they intubated him and sent him off to the brand new 64-slice CT-scanner, that I also got to witness. After this I assisted in the cleanup, mainly mopping pools of blood and removing all the stuff the people had thrown everywhere in the moment, and then the ER was ready for whatever fate had to throw at it.

Next weekend I'll be back there, and the ER never disappoints.

Labels: Episode Accounts, Medical, Pictures

posted by CK @ 23:57