Blood, guts and drama

The other day I had an exciting little episode at the hospital. By exciting, I mean anything involving blood, guts and drama. This episode had all of the above.

I was shadowing the head doctor in an emergency department. He would periodically send me and another medical student to assess patients before he got to them, and the unfortunate young man brought in by ambulance was one of them. He'd come over his handlebars and his friends called 911 when they saw his face. The paramedics had stabilized his spine in traction and rushed him to the ER and here he was, wheeled into the resuscitation bay.
I joined a couple of nurses at the bedside while we hurriedly attached him to a heart and blood pressure monitor and ran an IV and tried to assess the damage. He was choking on his own blood and someone stuck a suction tube into his mouth and fluid started pouring out. He was conscious and crying and one of the nurses quickly unstrapped his legs from the board and I helped her tug his jeans off. We tried to see what looked broken and what was just abrasions, and if there was a way to stop the bleeding immediately. Someone was calling his family on the phone.
He suddenly began to gag. A nurse jammed the suction in his mouth and I grabbed a towel but there were chunks appearing.
"Log roll! We gotta log roll him!" One of the male nurses shouted.
Like a fountain he began to projectile vomit, heaving under the neck brace that held him down. Everyone turned their faces and 3 or 4 of us grabbed him and on the count of 3 rolled him on his side, supporting his head and frantically trying to suction out his mouth so he wouldn't choke.
The whole area was spattered in red and he heaved and gagged and we stripped the soiled sheets out from under him and rolled him back down onto clean ones.
"Get housekeeping over here right away to clean this up!" I heard someone call.
The poor boy was crying and trying to breathe. Every few minutes he'd bring up more blood and we'd try to suction it out of his mouth. His whole body was shaking and a nurse and I covered him in a blanket, while someone tried to take a history.
I turned to one of the nurses. "Is there something in my hair?"
"Yes, honey." She said with a funny look on her face. She changed her gloves and grabbing a wet cloth, began to try to wipe the vomit out, and sponge the blood off my neck. "Hold still."
One of the male nurses glanced up at me across the bed.
"Um, Heather, you'd better go and change your coat, too."
My lovely white coat that said 'emergency department' was spattered with blood. He didn't need to tell me twice.
I felt exhilarated. How can I explain it? I wheeled the young man down the hall to get X-rays, suctioning him every now and then, and then when I brought him back, I assisted the other medical student in suturing up his lacerated mouth.
"Count the stitches." I told her.
"Why? They're dissolving sutures."
"It's something he'll want to brag about later." I said so he could hear me. "Guess how many you got, hon? 8 on your upper lip and 7 or so inside your lip."
I felt him move under my hand and I think he might have been trying to chuckle.
Later I was standing in front of the X-ray screen with my supervising doctor, the other medical student, and the nursing director. We were looking at the X-rays of his face, trying to decide what might be broken, and the nurse was trying to get the doctor to sign an ultrasound order.
"The ultrasound team is never here when I need them!" The doctor complained, annoyed. "How come they can't just run an ultrasound when I want one?"
Now here is where the drama comes in, dear readers. I didn't intend to say it, but it just popped out.
"Oh, would you like some cheese with your wine?" I said to the doctor impatiently.
There was a sudden silence. Then two simultaneous reactions. The nurse director started laughing. "I can't believe you said that, Heather! You're my new best friend!"

"Goodness, woman!" the doctor roared at me. (*See me personally for the uncensored version of his reply) "Stop acting like a nurse! You're a medical student, not a nurse! Medical students don't talk back to the doctor!"
He was right. Medical students usually just grovel. I turned six different shades of red.
"I'm really sorry. I shouldn't have said that."
But when he turned back to the X-rays I could see that he was laughing. The other medical student looked like she had swallowed something wrong.
Well, by the end of the day I'd pretty much decided I wanted to do this for the rest of my life. The young man with the smashed up face, when his mother heard what had happened to him she collapsed and had to be admitted into emergency as well, and was lying 12 beds down from him. And before I left, the doctor took me aside and offered me a job in the department.
You never know how these things are going to turn out after all.

Someone hit the panic button, please

Have you ever heard stories about charlatans and con artists who faked a profession? Passing off as doctors, airplane pilots, businessmen.... but there always came a moment of truth, when they were revealed for who they truly were.
Well, you all probably know that I have been very busy studying very hard, but when it comes to knowing my stuff with medicine, all I can say is please hold off on getting sick for a couple more years, because I'm not ready to have your life in my hands.
Or at least I thought I wasn't ready.
Wednesday this week I walked into a busy ward at a nameless hospital (we wouldn't want anyone incriminated here....) to meet my supervising doctor, who had told me she'd be there when I got there.
"Hi, I'm Heather Davies." I introduced myself to one of the nurses. "I'm one of Dr. G's students and I'm supposed to meet her here."
The nurse looked relieved. "Oh good! Well, I'm sure you'll want to see Mrs. K first of all."
She thrust a chart into my hands.
"She's having an MI (heart attack) right now, we think. The lab results are in and she has high troponin levels and very low potassium. Her ECG looks sort of stable right now and we've followed all the ACS (acute coronary syndrome) protocol so far. I've sent a stool sample off to be tested for C-diff. I'm just about to give her potassium. Do you think that looks like 20 or 30 mg of potassium to give her?"
I suddenly felt the moment of truth hit me in a slow wave that made me feel sort of sick. Wait a second, I wanted to say. You've got the wrong person. I'm not the doctor. I'm just a know-nothing, stupid, first-year medical student. I didn't understand anything you just said. (Haha. Actually, I did.)
"That looks like 20 mg." I answered, gasping for courage. "You said she's stable right now? Let me take a look at the lab values, but I think I'll wait for Dr. G to arrive before I assess her."
Crazy, crazy Heather, I told myself.
I won't bore you with the whole long story. Instead, I'll skip forwards a few hours. Dr. G sent me to attend 'Morbidity and Mortality rounds' with another doctor. This very distinguished senior cardiac surgeon escorted me to a luxurious board room with a catered supper spread out and doctors sitting in plush chairs, with a view of the whole city from the wall-to-wall tinted windows that looked down from the top floor. I didn't know what to do, so I just sat down next to him in one of the plush chairs. More doctors came in, and suddenly I found myself in the middle of a meeting with 6 senior surgeons, 1 cardiac resident and the head of medical staff, as they went over several surgical cases that had ended in failure over the last few months. They were all male. They were all distinguished. They were all doctors.
I tried to sit tall in my chair and nod knowledgeably along, but inside I felt like a silly little girl.
One case that came up was a man whose wife had last seen him sitting by the computer in the evening, and the next morning she found him still sitting in the chair, in a coma. He was rushed to the hospital and one of the surgeons had performed open -heart surgery on him, but it was a lost case from the start and the man eventually died.
I suddenly felt like laughing out loud, and I opened my mouth to speak, but as I did, the surgeon next to me spoke, and I swear that he spoke the exact words that I had been forming on my tongue:
"Well, the moral of the story is, gentlemen, always sleep with your spouse."
We laughed for a long time, and afterward I thought about that for awhile. Maybe I wasn't as far off as I thought....
Today I was working nursing and the nursing supervisor asked me to take a toenail scraping sample for a fungal C&S.
"You know how to do it, right, Heather?" He asked.
I don't remember saying yes, I just remember him walking away and suddenly realizing, whatever it is, I certainly have never done or even heard of a toenail scraping before.
(Rest assured, readers, I did learn how to and did correctly perform a toenail scraping today.)
I don't mean this to sound like I'm fudging my way through medical school like a charlatan, and indiscriminately covering up my lack of knowledge, but the fact of the matter is, there are certain risks that have to be taken. One of my professors in Antigua gave me the best piece of advice I've ever had about such things. She said, "If your supervising physician asks you, would you like to do a spinal tap on this baby? Your answer is, yes sir. If they ask, would you like to assist in surgery? Your answer is, yes sir. If they ask, can you intubate this patient for me? your answer is, yes sir. If you don't know how, you learn. But you never say no."
It's not about putting your patient in danger just to save your pride. In fact, there are many times when it calls for extraordinary humility. To say, yes sir, I'd like to try the procedure, but I'm going to need you to walk me through the steps. Or yes sir, I'll take the toenail scraping, but you're going to have to remind me how to do it. Or yes ma'am, I'd love to see the patient, but I honestly can't give you an opinion on what to do with the lab values because I don't know much about them and I'm going to have to wait for the doctor. That all calls for humility.
And I suppose as a last resort, I could always just ask someone to hit the panic button.

At long last

Finally, now that I'm doing something interesting, I've decided to blog again.
Well, it's not so much interesting to some of my readers as it may be ironic.
Take, for example, where I found myself this afternoon: in an operating room overlooking the Fraser river with an open chest cavity exposing a heart that pumped in tune with 'it's raining men, hallelujah', which was playing softly in a corner of the room.
Or take, for example, the way my supervising doctor introduced me today:
"This is Dr. Heather Davies and she'll be sitting in on our consultation today, if that's all right with you."
Don't call me doctor, I wanted to say. I'm not ready for that. I'd rather be climbing trees in a skirt and flip flops.
I kind of blew it big time with one surgeon today. Apparently he's this big-wig hot-shot, and my supervising doctor introduced me and we shook hands and made small talk for a moment. He was looking me over from head to toe with a kind of look older doctors don't usually give young students.
"Is there anything exciting happened on the unit today?" my doctor asked.
"Nothing except me." The surgeon said, smiling at me.
I gave him a withering look. "I'm sorry, you're too old for me."
You should've seen the look on his face. And on my doctor's face. (Afterwards she told me, I couldn't believe you had the guts to say that. Right now you should be sucking up to those surgeons in the hopes they'll give you a position.)
We chatted for a few minutes and then went to leave, and the surgeon called out, "Well, stop by another day and maybe I'll have something interesting to show you."
Then under his breath he added, "even if I am too old for you."
But enough of that. I spent most of the day in an operating room with another surgeon, watching open heart surgery. The poor man was having a quintuple bypass and a valve replacement. It would be hard to capture in one short blog entry the majestic feeling of watching someone's heart quivering inside their open chest and the bright blood spurting out and the delicate silver instruments and the sight of it finally beginning to beat on it's own again after everything had been re-connected. I had always envisioned life-saving surgery to be tense and serious, but the surgeons and nurses and I talked and joked and listened to music while working (okay, I wasn't doing anything besides watching, to be honest).
At one point I suddenly thought, this is a real man we're operating on. I reached under the drape that was covering his head and lightly touched his hair, as if to say to him while he slept, I'm thinking about you.
I learned so much today, one of the most important things being, never wear high heels in surgery. Secondly, always go pee first. Thirdly, don't cry under your mask when you see something really moving because you can't wipe your nose with sterile hands. And fourthly, maybe I should become a surgeon. I bet underneath my surgical scrubs and shoes I could wear a skirt and flip flops and no one would ever notice.

boring, boring, boring

I know, I know. I haven't written on this blog in forever. the problem with taking a break is that I might lose my loyal readership. So in order to prevent that, I decided to make a short entry here.
The problem is, my life is sort of boring right now and there's not a lot to write about. For example, all I do is study. Who wants to hear about that? It's not even really cool stuff either, it's diseases of carbohydrate metabolism and biochemical pathways and types of tests used for psychiatric disorders. All important stuff, but probably not interesting to any of you at this point.
What is interesting right now is all the peripheral stuff I'm learning. For example, I am feeling quite anxious about a number of things, like not having my practicum set up yet, worrying about getting licenses, not having very much money, wondering where my future is going, contemplating various and particular relationships....
the long and short of it is that I'm having to learn to trust God more. It's easier said than done.
I read this story in Matthew the other day about Jesus walking on the water. Peter saw him coming and said, "Lord, if it's you, tell me to come to you!"
I thought, if it had of been me, I would have said, Lord, if it's you, make lightening spell out your name in the clouds. In other words, show me a sign that is unmistakable but that doesn't require me to put myself at any kind of risk.
Jesus just said to Peter, "come."
And Peter came, walking out on the water towards Jesus. Then he looked at the wind, the waves, and all the turmoil behind him and he began to sink and cried out to Jesus, "Lord, save me!"
Jesus immediately reached out his hand and grabbed Peter and helped him into the boat and said, "You of little faith! Why did you doubt?"
Why am I doubting, Lord? Well, have you seen the size of the waves?!!! Can you hear that wind? Do you realize how scary and out of control it is to walk on water?
But trusting God is less like seeing the lightening and being convinced God is real; trusting God is more like jumping out of a boat into a raging storm and keeping my eyes fixed on Jesus and believing that somehow I'm going to walk on water.
I think Peter's mistake was not when he jumped out of the boat, it was when he took his eyes off Jesus and looked at everything that was going on around him. Not only did it not make sense to his rational mind, but there was no possible way for it to turn out well.
But doesn't God delight in doing the impossible and blowing our little minds? At least, that's what I'm staking my hopes on these days!