Journal Entries
Festive Journal Challenge : Working at Christmas (1)
Posted Dec 7, 2011
I've been inspired by Create to, er, Create something. I"m going to share stories of working in a hospital at Christmas. I've been working every Christmas since I graduated, expect where I'm in jobs that don't give me the chance to. This is because I fall for sob stories about why other people can't work Christmas. Baby's first Christmas? sure, Sister's wedding in India? I'm your man.
The following anecdote is fictional - identifiable details have been changed, but it is based on a number of real life incidents.
Christmas Night.
In the years before I was old enough to be left alone in charge of the hospital I worked nights over Christmas There weren't many admissions on Christmas eve, all seemed to be going well. I saw a couple of possible heart attacks that needed observing overnight, the usual sort of thing, Midnight came and we wished each other 'Merry Christmas' and toasted each other with lemonade in a plastic cup. Shortly after that the Reg Susie was called to one of the wards to see someone who had taken a turn for the worse, and our house officer, Vicky was on top of the admissions and I was checking she wasn't killing anyone, and helping her out.
Half an hour later I got a bleep from Susie,:
'I really need a spare pair of hands up here on Laural Ward, can you pop up and give me a hand'.
A flurry of activity was clustered in around a pool of light around one bed on the ward. Once I could see past the nurses I saw Lucy*. Actually the first thing I did was smell the sickly smell of half digested vomited blood.
At the centre of the crowd of nurses was a woman, she looked like she was in her early 40s, tinged yellow with jaundice and semi conscious lay in a pool of vomited up blood. Breast cancer, spread to liver and bone, things weren't looking great. Susie asked me to get another IV line in, to get more fluid in, to take some arterial blood for various tests, I sprang into action, grateful that Susie was their and I wasn't in charge. As I knelt down to get the IV in I saw that on the bedside locker, pushed out of the way, lay a pile of neatly wrapped Christmas presents, arranged around a framed photo of a small child. Young to be a Grandmother, but not unheard of, not around here.
It was a struggle to get the IV in, she seemed to have no veins, her blood pressure was so low thatI couldn't get a radial blood sample and had to take one from her femoral artery.
I caught sight of a child's drawing 'Get Well Soon Mummy' . I checked her date of birth as I labeled her blood sample. She was 34, she looked a lot older. We got her blood pressure up a bit.
Her family arrived whilst Susie was on the phone to Intensive Care. A young well dressed husband, holding a sleeping blonde toddler'.
'Sorry, there's no one else to babysit'.
The night sister sat him down in the relatives room, and made tea with the full china tea service. The tea set that only gets used when things aren't going well.
Carrie, the ITU reg came up to help try and get her stable enough to go to ITU. We rang our consultant, and we tried to stablise her enough for him to take her to theatre to try and stop the bleeding.
At one point I rang a haemologist for advice on how to stop the bleeding, could we give any blood products. This one had a reputation for never giving up, we used to joke that we had to nail down the coffin lids to stop him trying just one more thingI recounted the whole stor to him.
'What are you doing?
', Getting in a second femoral line'.
'No I mean what are you doing, she's dying, but if you still want to treat her give her...'
We managed to get her stable enough for the first procedure. Half an hour later we were back to square one, the consultant hadn't been able to stop the bleeding. We organised a scan to get more information, the radiographer was wearing a hand knitted Reindeer jumper. The consultant decided to take her back to theatre for another procedure, this one might stop the bleeding. Susie prepared to go to theatre, I breathed a sign of relief as I'd left the house officer alone with the new admissions for far too long. I was looking forward a breather from the tensions on the ward.
About 3/4 of an hour later Susie came down to the admissions ward, looking exhausted, and puffy eyed. Doctors don't cry.
'How is she'?
'She died 10 minutes ago'
'Crap - coffee?'
She told me the full story over coffee, how she died during the second procedure. how they had been in such a rush her husband hadn't had the chance to say goodbye.
The next morning we told the story to the day team at handover.
'What the were you on? That woman was dying, and you took her to theatre! that's awful palliative care!"
I shrugged 'Dr Jones took her for the endoscopy'.
It wasn't true, it wasn't just Dr Jones' decision. We all lost our sense of perpective that Christmas Eve. There was something about the unopened presents, hansom husband, the blond toddler, about it being Christmas, that made us all loose our rationality. None of us could possibly face the prospect of a young mother dying at Christmas. And because of that we look away her husband's last chance of a goodbye.
Years later I still feel guilty when I think about it.
*not her real name
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Latest reply: Dec 7, 2011
The h2g2 Society for debating
Posted Dec 4, 2011
Just recently I had put an entry in Peer Review.
In response to the Create Christmas Recipe Share I put in an entry on what to do with a vegetarian at Christmas. It was a great success and lots of people commented in Peer Review, we also got into a lovely debate about the ethics of meat eating.
And you know what I miss about h2g2 - its some where to have a contentious debate in a civilised way.
We need a page to do this! Anyone with me?
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Latest reply: Dec 4, 2011
30.11.11 (2) Well that was fun
Posted Nov 30, 2011
Today I presented some research at the UK Stroke forum. It was data that we had discovered incidentally whilst doing another study.
It was about the amount of minor stroke that shows up on the modern MRI scan. I knew it was something that people found interesting because they kept asking me about it. So I look a look, wrote an abstract and submitted it. I was hoping to maybe get a poster and was delighted to get a presentation, and even more scared when I realised it was a presentation in the main hall of the conference, and not in one of the side rooms.
And the talk was very well received. Although my slides were clear (if dull) and the speaking was apparently clear. The thing that interested people seemed to mainly be the content, which was quite controversial. The other talks in the presentation got one or two comments each.
Mine got about 13, I lost track. I had prepared for the common questions, I hadn't prepared for a long rambling point which didn't have a clear question in. Through the break I had a lot of people come up to me and asked questions and gave various comments as well.
Actually it was scary, but it was exhilerating and it was fun. It reminded when why I'm involved in science, rather than just providing patient care.
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Latest reply: Nov 30, 2011
30/11/11 Dear British Geriatric Society
Posted Nov 30, 2011
Every time I have submitted an abstract for your conference you have extended the deadline by at least 7 days. And what do you think I do? Instead of submitting said abstract in a timely fashion I instead spend 7 more days moving the commas around a bit.
Now it's gone further, because I know that you will extend the abstract deadline I hadn't actually finished doing the experiment I intend to submit to you.
The funny thing is that every year you probably extend the deadline because not enough people have submitted abstracts to your conference. Do you know why that is? It's because we know that you'll extend the deadline, so we don't really take your deadline very seriously.
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Latest reply: Nov 30, 2011
29.11.11
Posted Nov 29, 2011
I went into the audotorium where i"ll be presenting tomorrow,and my isn't it huge! Well over 600 people.
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Latest reply: Nov 29, 2011
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