Day 51, The absurdity of what we do here really hit home today. Unsurprisingly it takes an on call to bring it to light. I picked up a card in the OPD and saw my handwriting in the notes of the next patient I had to see. I had seen him a week ago and identified that he had a degree of heart failure but felt he would be alright at home. He came to today a puffy and bloated man who was essentially drowning himself. Something about a 40 year old with heart failure didn’t add up so I decided to stick the ultrasound probe on him. As I looked up at the dark area around his heart I realised it was actually fluid.
From radiographer I moved to paediatrician with the next patient. A 9 monther who had being given a Zulu remedy enema to help with her diarrhoea and vomiting. Earlier in the week we had a healthy 5 month child who had come following a Zulu enema. His kidneys eventually stopped working and before we knew it he had died, I did not want my patient to follow suit. It was as usual nigh impossible to get a drip into her arm, pudgy and healthy as she was, it made it much more difficult to do what I wanted.
I then got called to help with a caesarean and played anesthetist doing the spinal again. Of course there’s only two doctors out of hours and that means when the baby comes out and refuses to breath, one of you has to descrub and help the baby. This happened to me and the blue baby did not comply with the nasty oxygen habit we wanted to give it. I had to resuscitate the baby all the while hoping mum’s anaesthesia didn’t start to compromise her.
Of course whilst in theatre I received a call from one of the local clinics reporting a patient came in following a car versus cow accident. He said a few word before collapsing into a heap. The clinic sister had called to see what could be done as the ambulance service was not contactable. We gave some basic resuscitation advice but then remembered some of the doctors had gone out to the beach and were having dinner near by. I gave them a ring, more out of hope than expectation and they said they would swing by on their way home.
I got called again once they had seen the patient and they said it was pretty messy. The guy was responding minimally but things were deteriorating fast. The ambulance had mobilised at this stage and we were getting prepped in the OPD for the arrival. It was a far from pleasant sight. He had a bandaged head injury, he wasn’t making any sound or movement the oxygen masks were covered in rapidly clotting blood.
After I had attempted to enhance my intubation skills, and my colleague actually succeeding we started to manually respire for the man. Of course our ventilator was missing a piece so we were left with very few options for a man who was for all intents a purposes in a vegetative state. For my most recent transformation I turned into judge and jury as the staff present agreed to the most humane course of action was to give him pain relief and let nature take its course.
Its seems crazy what the variety of what my responsibilities are. I’m aware that as I fall asleep I will constantly be thinking about the next obstacle that will inevitably rouse me from my slumber during the course of the night. Of course the pizza my friends brought me back whilst performing the resuscitation does sum up the ludicrous world I live in.
No comments:
Post a Comment