Saturday on-call was eventful up till 5am. That was when my imaginary guardian angels (... well you know what i mean) finally decided that my battered knees and sprained right wrist could need a bit of a break.
8.05am - Ashraff, the senior A & E registrar called in from the resus room, a 65y man with sudden onset breathlessness, fever and cough had a high cardiac enzyme which may signify a heart attack requiring a CCU bed.
12pm - 2 patients in CCU needed a central venous line each. "Well, no problemo gentlemen. Just show me your lower necks. I'd love to puncture those areas with my sharp 18 gauge needles."
5pm - Suraya, a super bright and vibrant 2nd year internal medicine MO called in for a CRW bed. She wanted a bed for her 60y old lady with fast atrial fibrillation secondary from thyrotoxicosis. Rate about 110/min, no failure symptoms. BP holding on with no inotropes.
10pm - another man with a heart attack had gotten worse. His type 1 respiratory failure had now complicated by severe metabolic acidosis, slowly poisoning his vitals organs and could push him into comatose state within next few hours. Respiratory fatigue will be inevitable. His BP was rather low with 3 inotropic support.
Shit. Time to intubate him.
"Uncle, you're not doing too well at the moment. We need to put you into sleep in order to make you feel better. Now before we do that, I want you to think of God in your heart and mengucap okey."
He looked weak and nodded quietly.
3am - intubated man now developed coffee ground coloured material inside his nasogastric tube.. ?? We dealing with an upper GI bleed until proven otherwise. DAMNIT. Well at least there is no malaena.
"Okey, start IV pantoprazole 80mg STAT, followed by 8mg/hour infusion. Gotta call in the bleeding team."
At that point, the patient's wife looked at me. Tears started to flow down her cheeks "What have you done to my husband, doctor... ? He was well 5 hours ago. Now he bleeds after you connected him to that breathing machine..."
I tried to comfort her "Auntie, your husband is very ill... he might be bleeding from his tummy, but it is not related to the intubation, I will..."
I couldn't finish my sentence. She already left the room with tears flowing heavily.
10 comments:
All in a day's work eh? Sounds like a shitty call but I get the feeling you walked out of that one feeling pretty good about yourself.
She must have left somewhere between the words you had to say, and the ones she didn't wanna hear...
Having been married to a Doctor before, I know how emotionally hard things can sometimes be. You can only do so much. The rest you have to leave to The Almighty. But it will still get to you every now and then, no matter what.
May you see sunshine in the things that you do everyday
Hi Doc,
Gosh! No joke, seh. Always on the run.
You did what you had to do.
To loose someone dear is tragic, but she has to remember, doctors are not god. She should pray for the best rather than putting the blame on you.
Think of all those you've saved and made their life better. Probably that'll cheer you up.
Gripping. So what was the conclusion to this "just-another-day-in-the-office" suspense? Did the Uncle get to see the dawn of a new, sunshiny day, Dr T? *fingers crossed*
how u do wat u do everyday, i only can imagine....
I always admire Docs for many reasons. One of 'em is abt their level of patience - I salute them. Oh..also on their ability to deliver the bad news.
What a tiring day-in and day-out for u, Doc. But am sure...you are used to it.
Have a great weekend, Dr.T ;-)
Olga: Wow. Shitty call? I'm not sure about how easy on call can be in Norway.
Effa: They are usually ready for the bad news. They just don't know it.
Andrea: Yeah they do get to me from time to time. Especially the younger they are.
Pat: Uncle gets better actually. Thank God.
Naziah: Thank you for your words of encouragement.
Zack: It's tiring but rewarding. Thanx, I hope you have a brilliant weekend too.
you notice tak, that you have a long list of female readers kan? :P
dottie is jealous!~ ahahah
Post a Comment