Saturday, June 25, 2005
Life little packets
Just before Kevin injected the etomidate, the middle aged guy, half naked on the operating table, was staring up, glaring as if he is quickly drowning. The tubes were wrapping his top half like spaghetti bolognaise. Not much we can do about that. His breathing, rapid and shallow. He muttered something under the green mask I held tightly around his face.
I looked up to Kevin and he gave that ‘ok if I whack this in?’ and I nodded. The chap panicked, wriggled and I said, ‘it’s ok sir we’ll look after you’.
The five seconds that our eyes interlocked as he waited the etomidate to hit his brain and me waiting for the suxomethonium to paralyse him, felt like forever. His pupils were big discs of dirty blue and green. Scared and helpless looking. Not one I plan to see regularly in this job but it must have been a small print in the contract. That very moment my whole consciousness rebooted to 100% after being yanked out of bed at 3 am.
“Nope, whole of small bowel is gone and not much large bowel it salvageable. I am closing”. Mr. Posh was abrupt after moments later, but that’s probably the best thing to do. It’s not possible to live with your stomach connected to the rectum is it. What is the point of eating? Where is the joy of living?
Never mind the struggle putting the tube as this guy was soo dry his mouth wasn’t allowing anything to glide through. On top of that his teeth were effortlessly disorganized making the laryngoscope blade an awkward instrument to be of any help. ET tube, temperature probe, no way.
Never mind the struggle with CVP, arterial line, and peripheral lines.This chap had what we call peripheral vascular disease (PVD) which if combined with poor diet and smoking will make you end up with all sorts of nasty blockage resulting problems.
Pains in the stomach? Could be ishaemic bowel
Faint and giddy? Could be transient ischaemic attack, or mini stroke
Chest pains? Could be acute coronary syndrome
Cold and numb legs and hands? Peripheral insufficiency
If you have these symptoms and you are smoking? Be very very afraid. You can die a gruesome death. It is not the job of the doctor to sort you out, you have to look after yourself. Idiots spring to mind when people try to argue this. It’s really hard to care for people who are inertly stupid and proud. How about not be one of them for a change?
Mr. Posh the surgeon closed the midline incision while the SHO found a stool to sit as he didn’t look so well with that pale complexion. Probably the result of being dragged too quickly out of bed to then stand staring at loops and loops of dead gut. It wasn’t a nice sight. I agree.
I did look after him as promised but maybe people should look after themselves way before anybody tell them so, before it’s too late. It’s probably not obvious to those non- medic, but without sounding too pedantic to the fellow medics, yes this chap is going to die in the next hour or so. His body will have so much acid it will be too toxic for any organ to function. His brain will be pickled, his kidneys will cease filtering. His death is certain and soon.
My compassion is for those who are still alive and healthy but investing heavily in premature death bonds and equity. Love those that love and dependable on you if you have no regards for your own health.
Fedup.hungry.tired.sleepy.BluEScrubs.hitting.lights.off
Just before Kevin injected the etomidate, the middle aged guy, half naked on the operating table, was staring up, glaring as if he is quickly drowning. The tubes were wrapping his top half like spaghetti bolognaise. Not much we can do about that. His breathing, rapid and shallow. He muttered something under the green mask I held tightly around his face.
I looked up to Kevin and he gave that ‘ok if I whack this in?’ and I nodded. The chap panicked, wriggled and I said, ‘it’s ok sir we’ll look after you’.
The five seconds that our eyes interlocked as he waited the etomidate to hit his brain and me waiting for the suxomethonium to paralyse him, felt like forever. His pupils were big discs of dirty blue and green. Scared and helpless looking. Not one I plan to see regularly in this job but it must have been a small print in the contract. That very moment my whole consciousness rebooted to 100% after being yanked out of bed at 3 am.
“Nope, whole of small bowel is gone and not much large bowel it salvageable. I am closing”. Mr. Posh was abrupt after moments later, but that’s probably the best thing to do. It’s not possible to live with your stomach connected to the rectum is it. What is the point of eating? Where is the joy of living?
Never mind the struggle putting the tube as this guy was soo dry his mouth wasn’t allowing anything to glide through. On top of that his teeth were effortlessly disorganized making the laryngoscope blade an awkward instrument to be of any help. ET tube, temperature probe, no way.
Never mind the struggle with CVP, arterial line, and peripheral lines.This chap had what we call peripheral vascular disease (PVD) which if combined with poor diet and smoking will make you end up with all sorts of nasty blockage resulting problems.
Pains in the stomach? Could be ishaemic bowel
Faint and giddy? Could be transient ischaemic attack, or mini stroke
Chest pains? Could be acute coronary syndrome
Cold and numb legs and hands? Peripheral insufficiency
If you have these symptoms and you are smoking? Be very very afraid. You can die a gruesome death. It is not the job of the doctor to sort you out, you have to look after yourself. Idiots spring to mind when people try to argue this. It’s really hard to care for people who are inertly stupid and proud. How about not be one of them for a change?
Mr. Posh the surgeon closed the midline incision while the SHO found a stool to sit as he didn’t look so well with that pale complexion. Probably the result of being dragged too quickly out of bed to then stand staring at loops and loops of dead gut. It wasn’t a nice sight. I agree.
I did look after him as promised but maybe people should look after themselves way before anybody tell them so, before it’s too late. It’s probably not obvious to those non- medic, but without sounding too pedantic to the fellow medics, yes this chap is going to die in the next hour or so. His body will have so much acid it will be too toxic for any organ to function. His brain will be pickled, his kidneys will cease filtering. His death is certain and soon.
My compassion is for those who are still alive and healthy but investing heavily in premature death bonds and equity. Love those that love and dependable on you if you have no regards for your own health.
Fedup.hungry.tired.sleepy.BluEScrubs.hitting.lights.off
