There is no modesty in being a patient who undergoes surgery. You are exposed, naked; there are no secrets about the things normally concealed under your garments, not to mention the anesthesiologists who, under the guise of making you more relaxed, administer medication that will lessen your inhibitions...
Let this serve as my warning to those who wish to tattoo themselves...
A respectable gentleman once appeared on my OR table to have a benign tumor removed. After receiving the aforementioned anesthesia "cocktail," he lay on the table with his hospital gown askew (well, really, are hospital gowns ever really NOT askew?) exposing his medial calf where a good-sized tattoo had been emblazoned. It was simply a chicken with a noose around it's neck.
As my mind raced through all of the racy implications this tattoo could represent, the term "choking the chicken" came into my head...and I figured I was entitled to the explanation for such a unique piece of body art. The actual explanation exceeded all expectations, and I must thoroughly commend the patient on his sense of humor and cleverness that far exceeded my wildest imagination...
He stated that he had gotten the tattoo in college, not on a bet, not under any duress or even in an altered state of mind...but he simply had gotten it so that he could say, "I've got a cock hanging below my knees"
Indeed.
Thursday, August 30, 2007
Wednesday, August 29, 2007
On this day in 1982, chemical element 109 (Meitnerium) was discovered
Patients ask a lot of questions...sometimes surprisingly few regarding their own health. More frequently they ask personal questions and queries about how realistically medicine is portrayed on television.
Some of the most frequently asked patient questions (apart from the ones they SHOULD ask):
-How old are you? Are you old enough to be a doctor?
ANSWER: "That's none of your business and yes"
-Are you married? (Frequently followed by "I have this son/friend/nephew who would be perfect for you..." or the ever-reassuring and not-at-all patronizing "Oh, that's ok")
ANSWER: "No" (followed with the polite smile and self-deprecating comment about how young female surgeons are surprisingly not good wife material)
-Is your life just like Grey's Anatomy? (or House or Scrubs or ER...fill in medical show here)
ANSWER: "Unfortunately my hospital life is far less interesting" (but in case you're wondering...medically speaking, the order of most realistic to least realistic goes like this - Scrubs, ER, Grey's Anatomy, House)
But honestly, the aforementioned patient questions were really just a long segue into how my life sometimes IS just like an episode of ER. As today commemorates the anniversary of Hurricane Katrina, I'd like to discuss my dramatic day on the trauma service a week ago (courtesy of a local weather emergency)
The day of covering "the bomb" (the pager designated for all new consults and ER calls) started off with a routine orthopaedic procedure. Pulling off a guy's thumb nail to repair the nailbed injury he sustained by cutting halfway through his finger with a table saw...yes, it's just as medieval torture-esque as it sounds...
Saw a few more consults, put some casts on, repaired an ankle fracture in the OR...was seeing a inpatient with vertebral compression fractures in her 7th floor room, when an announcement came over the hospital PA system "THIS IS A WEATHER EMERGENCY, A TORNADO HAS TOUCHED DOWN WITHIN 5 MILES OF THE HOSPITAL, PLEASE MOVE AWAY FROM WINDOWS AND DOORS" This presented a challenge to my bedridden patient, so I pushed her bed as far from the window as possible and went over to close the curtains on the window (as if the cheap, vinyl hospital curtains would stop some 100mph debris from crashing through the window...but whatever) As I did that, I caught a glimpse of a pretty eerie looking wall of black clouds, some swirling leaves and dust, and an impressive lightning display...then finished talking to the patient (because what else was I going to do...abandon the helpless old lady in the midst of a tornado?)
Half an hour later, the loudspeaker came on again saying "THE TORNADO EMERGENCY IS OVER, BUT SEVERE STORMS ARE STILL IN THE AREA" So I went about changing a splint on a teenaged kid who got shot, and in the midst of doing that, all the lights went out in the hospital. "Shit," I exclaimed as I struggled to finish the splint without grabbing the kid's wounds in the dark. I apologized for the profanity, but the kid laughed as the frequent lightning afforded just enough light to finish the splint change.
A mere minute or so later, the backup generator came on - generously powering only the hallway lights (no room lights or air conditioning) The "bomb" then went off signalling a trauma in the ER. I quickly walked down there (there is comparatively little RUNNING in real life hospitals compared with TV show hospitals - slightly less dramatic, but fewer physician casualties that way) Awaiting me in the trauma bay was a poor woman who thought she'd save herself some hassle by running out to her car in the storm to roll up her windows...when a large tree fell onto her car and gave her quite a nasty open fracture. During the "logroll" (when the trauma team rolls the patient over to inspect for injuries on her back while still protecting her spine from moving) a 5 inch piece of BARK fell out of the open fracture wound - even non-experts should piece together that tree bark falling OUT of a wound is not a good thing.
So needless to say, the patient needed some emergent surgery, but the OR was not operational secondary to running on backup generator power, the radiology suite was not working due to computer short-outs when the electicity went out...complicated further by the fact that the ER was now 90 degrees due to the lack of air conditioning, and that sheets of water had just begun pouring out of the ceiling and flooding the ER hallway. Another casualty of the storm joined our patient in the trauma bay after a tree branch vs. head incident.
To add insult to injury, we couldn't even pass the time until the OR was up and running by eating some dinner, because the vending machines and cash registers were all nonfunctional.
About 2 hours later, the electricty returned, 20 people took wet vacs to the floor of the ER to mop it up, we took the patient to the OR, spent 2 hours cleaning dirt, glass, bark out of her wound, then fixed the fracture. I drove home at 1am (to a fortunately dry and still-standing condo)
Some of the most frequently asked patient questions (apart from the ones they SHOULD ask):
-How old are you? Are you old enough to be a doctor?
ANSWER: "That's none of your business and yes"
-Are you married? (Frequently followed by "I have this son/friend/nephew who would be perfect for you..." or the ever-reassuring and not-at-all patronizing "Oh, that's ok")
ANSWER: "No" (followed with the polite smile and self-deprecating comment about how young female surgeons are surprisingly not good wife material)
-Is your life just like Grey's Anatomy? (or House or Scrubs or ER...fill in medical show here)
ANSWER: "Unfortunately my hospital life is far less interesting" (but in case you're wondering...medically speaking, the order of most realistic to least realistic goes like this - Scrubs, ER, Grey's Anatomy, House)
But honestly, the aforementioned patient questions were really just a long segue into how my life sometimes IS just like an episode of ER. As today commemorates the anniversary of Hurricane Katrina, I'd like to discuss my dramatic day on the trauma service a week ago (courtesy of a local weather emergency)
The day of covering "the bomb" (the pager designated for all new consults and ER calls) started off with a routine orthopaedic procedure. Pulling off a guy's thumb nail to repair the nailbed injury he sustained by cutting halfway through his finger with a table saw...yes, it's just as medieval torture-esque as it sounds...
Saw a few more consults, put some casts on, repaired an ankle fracture in the OR...was seeing a inpatient with vertebral compression fractures in her 7th floor room, when an announcement came over the hospital PA system "THIS IS A WEATHER EMERGENCY, A TORNADO HAS TOUCHED DOWN WITHIN 5 MILES OF THE HOSPITAL, PLEASE MOVE AWAY FROM WINDOWS AND DOORS" This presented a challenge to my bedridden patient, so I pushed her bed as far from the window as possible and went over to close the curtains on the window (as if the cheap, vinyl hospital curtains would stop some 100mph debris from crashing through the window...but whatever) As I did that, I caught a glimpse of a pretty eerie looking wall of black clouds, some swirling leaves and dust, and an impressive lightning display...then finished talking to the patient (because what else was I going to do...abandon the helpless old lady in the midst of a tornado?)
Half an hour later, the loudspeaker came on again saying "THE TORNADO EMERGENCY IS OVER, BUT SEVERE STORMS ARE STILL IN THE AREA" So I went about changing a splint on a teenaged kid who got shot, and in the midst of doing that, all the lights went out in the hospital. "Shit," I exclaimed as I struggled to finish the splint without grabbing the kid's wounds in the dark. I apologized for the profanity, but the kid laughed as the frequent lightning afforded just enough light to finish the splint change.
A mere minute or so later, the backup generator came on - generously powering only the hallway lights (no room lights or air conditioning) The "bomb" then went off signalling a trauma in the ER. I quickly walked down there (there is comparatively little RUNNING in real life hospitals compared with TV show hospitals - slightly less dramatic, but fewer physician casualties that way) Awaiting me in the trauma bay was a poor woman who thought she'd save herself some hassle by running out to her car in the storm to roll up her windows...when a large tree fell onto her car and gave her quite a nasty open fracture. During the "logroll" (when the trauma team rolls the patient over to inspect for injuries on her back while still protecting her spine from moving) a 5 inch piece of BARK fell out of the open fracture wound - even non-experts should piece together that tree bark falling OUT of a wound is not a good thing.
So needless to say, the patient needed some emergent surgery, but the OR was not operational secondary to running on backup generator power, the radiology suite was not working due to computer short-outs when the electicity went out...complicated further by the fact that the ER was now 90 degrees due to the lack of air conditioning, and that sheets of water had just begun pouring out of the ceiling and flooding the ER hallway. Another casualty of the storm joined our patient in the trauma bay after a tree branch vs. head incident.
To add insult to injury, we couldn't even pass the time until the OR was up and running by eating some dinner, because the vending machines and cash registers were all nonfunctional.
About 2 hours later, the electricty returned, 20 people took wet vacs to the floor of the ER to mop it up, we took the patient to the OR, spent 2 hours cleaning dirt, glass, bark out of her wound, then fixed the fracture. I drove home at 1am (to a fortunately dry and still-standing condo)
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