September 18, 2007

  • Ups and Downs

    So as I prepare to embark on my final shift in ER, here are two more stories to throw your way.

    Saw my first fetus this evening. As in, mother came in complaining of vaginal bleeding, during the bimanual exam the attending was unable to appreciate the cervix due to the placental sac hanging out. This means that amniotic fluid was outside the uterus, but baby was still inside. In medical terms this is called oligohydramnios. In layman terms this is called not good. Left the room and less than 5 minutes later the husband called us back in…and there lying on the bed curled up in (pardon the phrase) the fetal position was the 18 week old fetus. A not-quite person that less than 5 minutes previously had had a beating heart on ultrasound. In real life, the arms were like tiny little toothbrushes with finger bristles on the end, the legs not quite formed and therefore still joined into a tail, the head recognizable with little eyes, nose and open mouth that almost seemed to be asking, “why me?”

    The resident and I clamped the umbilical cord and cut the dead life from the live one, placing the baby into a bedpan for the mother to see herself, say goodbye to, and begin the grieving process. I then transferred it to the baby bucket that would later be sent to pathology. It felt limp and jellylike in my hands, like one of those tubes that is difficult to hold on too, but one i dared not drop. I did the majority of the handling because the resident simply did not feel comfortable with it. I dont know why it didnt bother me…perhaps the macabre sense of humor i have, perhaps i have learned to accept death as an equal part of life, but picking up and manipulating the fetus and placenta was not an onerous task. And while I felt compassion and sadness for the mother, I could not bring up any real emotion about the almost-human who came out of her. Sorry, little guy/girl…wish it was there

    The baby was placed in an opaque bucket at the nurse station to be sent to the pathology lab when it opened. Later on, an unknowing nurse placed her dinner, some KFC next to the bucket in an awkward yet still mildly amusing juxtaposition, given that one would not want to mistake the contents of the two buckets

    yes, i am a terrible person. Trust me, you dont work for any length of time in medicine without being able to find humor in some truly horrible situations.

    However, so as not to end on a down note

    Saw a patient in for drug abuse who i inadvertently offended. When asking him about his recreational drugs he mentioned heroin.

    Dr J: So when was the last time you injected heroin?
    Pt: Aw HELL NO, doc, i aint never injected no heroin! That shit is dangerous, it bad for you, and can give you AIDS. No i aint never injected nothing.
    Dr J:….
    Pt: I snort it
    Dr J: terribly sorry sir. my mistake.

    Talking with Ritika, she said we should have informed him that SHARING NEEDLES leads to AIDS. So as long as he used his own private sterile ones, he would have been fine

    Hope you have enjoyed my month in ER. I certainly have. Lessons learned and a glance back at the career o meter to follow in the next post.

Comments (6)

  • I’ve missed your stories and I know read there will be no more? I don’t think you’re what’s the word you used? Terrible? I find a sense of humor helps us in any situation. I took your advice by the way, I have a lot of stories from teaching, some days ago I wrote about a kid called Usmail.

  • happy talk like a pirate day, matey.

  • Gosh that’s so scary!  Eeeks….can’t wait for my ultra sound. 

    Hey, I have no morning sickness yet and I clocked myself in at 7 and a half weeks.  In a way I like it and in a way I’m wondering if the urine tests and the blood tests were wrong and that my growing boobs, mood swings, fatgiue and hunger pangs are a figment of my imagination.  Know any patients like me who are halfway in denial?

  • wow. yeah, just wow.

  • No more Josh in the ER?  Sad, such enjoyable stories have been shared!! 

  • ohman that is pretty chilling. i wouldn’t have been able to handle that. freak-out queens cannot attend med school.

    good luck on your final shift. it’s been interesting huh

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