Sunday, July 24, 2005

I am going to pop these tablets and go to bed. *Cough* Cough*

I have to write a few things though before they leave my pots of thoughts forever. I find this very easily achieved these days. Something some might agree as happening via a complicated passive process. No effort needed.

I have been on call 3 days in a row and I could easily say that the triple whammy weekend on call, Friday Saturday Sunday was probably the busiest on call ever. I take pride in talking about how well spaced this specialty is to my other doc friends, but tonight I think I should revisit those claims I made before.

While puffed out red in the face running to maternity, I was dreading having to put 3 epidurals which were requested probably about 2 hours earlier. For various reasons these women had to have them, big baby, OP presentation, slow progress which means high chance of the baby going to come out through the bikini line. But for various reasons they were refused as priorities, because, left right and centre angel of death were spreading his wings, strategically taking one after the other like lottery balls, so of course with my light saber I had to slay and slay and slay.

On my 3rd epidural lady, the girl, only 17 years old, said to me, ‘Dr Med (that’s probably the only bit registered in between the contractions when I introduced myself), thank you for coming anyway, I know you are up to your eyeballs’. She smiled and I thought how sweet coming from a really tiny girl with such big baby inside. It must have hurt all that 2 hours.

Felt a trickle of sweat running down the lordosis of my back.

Told her not to worry, I get paid for this, and plus I am really Batman’s girlfriend, and my job is to dry clean his wardrobe. This is just a hobby I said. Amazing how they just laugh at any stupid things that came out of my almost hallucinating slowly declining verbal ability. I was at the time thinking about lunch more than anything and it was 16:50 hr.

These women had to wait because the man who came yesterday with ‘dead’ legs and later went to theatre to have it sorted out, again losing his legs fast. White, cold and dead again. His bloods suddenly went really acid, enough to pickle onions for Christmas. His blood was slowly becoming not compatible with life. He stared at life passing by, chugging along to blow off the product of his dead legs. He was obviously struggling.

I have been looking after him since morning and God knows how many times he smiled at me as I was rushed off my feet shuttling between 6 other patients. I never stopped once to make small talk. He wasn’t top priority you see because he was getting better.

As he deteriorated at 7pm, in between heavy laborious breathing, which wasn’t a picturesque thing to see as I was so used to see him getting better, I spoke to the Consultant on call on the phone and the decision to put him back on the machine was made. So I had to put him back to sleep.

I know, and we all know that once a patient take a step back like that, it is almost like trying to climb over 2 mountains instead of one to get to the valley of lavish greens and meadows of marigold. It’s like an unwritten death sentence. I thought for a while and decided there was one thing human I had to do. It asked for his wife to come in.

I knew, he’d like that. I knew his wife would like that. It might be the last time his wife was ever going to see him ‘alive’. Being somebody who had been taught well by my predecessors, of course that’s not what I said to any of them. We were always told to be courteous and careful with people’s feelings when breaking bad news, which I always have a problem with. Not the way by how it’s delivered, but what to deliver.

As I towered over him with one hand ready to inject the hypnomidate, and the other holding the mask over his face, I let out a barking cough, and a nasty sniff. I have been like that all day, in fact since Friday and was contemplating whether to call in sick today, but I suppose it’s not like it’s my choice to come in or not. It’s more to die or not to die at work.

Hearing me hacking away, with his face covered with sweat, pale, clammy and cold, he said, ‘You sound worse than me’ and let out a weak smile. Broke my heart, him. Shit shit shit. I don’t know why but I felt obliged to give him hope, so I said, ‘We’ll take care of you’. Blantantly.

Only in the morning, when I took over from Dr. Suave, I thought I had my mind clear about deaths and living. The man I was looking after, for 2 days in bed 3, died overnight. Dr. Suave simply said ‘Fortunately Naj, he died in the night’.
Seeing me giving a strange look when he said ‘fortunately’, he said ‘Something has to kill the man Naj, he’s 80 and what good would we do if he stays on the machine with his waist down dying?’.

I certainly think the angel of death were doing locuming job this weekend. Maybe I even did brush shoulders with him. Maybe he disguised himself as a porter with a cap that covered half of his face. Maybe I even knocked him a bit while running to get to the cardiac arrest in A&E in the afternoon. What does he think of me?

I don’t think I am fit to go to work tomorrow. Maybe I should go but make myself look extra poorly so I get 2 days off, or maybe I shouldn’t take the tablets tonight so it gets worse. As I said, I should have just gone to sleep. I am hallucinating and this cough is leaving marks on my flatscreen.

p/s: My birthday was on the 21st and of course I was on call. Hhihihihihi *hysterical laughter verging into heightened euphoria akin to ketamine induced trance state*

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