Medicine Sucks

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ERMudPhud said:
I just heard from the PICU he's awake, eating, and "mad as hell"

made my day

those are the stories that keep the peds folks going in the PICU. it's amazing what they can pull through sometimes.

when/if i get to heaven God and I are having a serious "come to jesus" meeting concerning the miscellaneous BS stuff he pulls with kids. i have too many to recount.

a month in the PICU and you'll never let your kid outta the house and keep them in a padded room. i've seen horror stories, everything from "kid falls on bike" and later dies to "kid pulls TV over on self" and later dies. yet in my outpt clinic setting i these stories have no effect. i still get eye-rolling when i go through my anticipatory guidance with parents. it's frustrating. at least i can vaccinate 'em (the ones that aren't crazy with the MMR = autism bug).

--your friendly neighborhood anticipatory guiding caveman

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Homunculus said:
...at least i can vaccinate 'em (the ones that aren't crazy with the MMR = autism bug).

--your friendly neighborhood anticipatory guiding caveman
But any vaccine (with or without thimerisol) instantly causes autism. If you say it doesn't then you are just a part of the conspiracy and probably fly around in black helicopters with the drug companies, the chemical industry, nuclear power companies and Dick Cheney.
 
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docB said:
But any vaccine (with or without thimerisol) instantly causes autism. If you say it doesn't then you are just a part of the conspiracy and probably fly around in black helicopters with the drug companies, the chemical industry, nuclear power companies and Dick Cheney.


Oh, he does. Send me a new black helicopter or I'll tell all!
 
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kungfufishing said:
Oh, he does. Send me a new black helicopter or I'll tell all!

Damn, you're expensive.

My price is much more realistic. I just want a nice pin and a free lunch. :)

Take care,
Jeff
 
80 M syncopal at casino. EMS finds in brady at 20. Full court press code for over an hour. I tried everything. I got the wife in the code room for the end.
Me: I'm so sorry. He's passed away.
Wife: But we were going to have been married 57 years tomorrow. We came to celebrate.
Me: We just weren't able to get his heart muscle going again.
Wife: I don't know what to say.
Me: There's nothing to say. I'm so sorry.
We got social services involved and talked to the family back home but that poor little old lady is going to wake up all alone in a strange bed in a strange city tomorrow to begin her first day as a widow.:(
 
Anyone who berates you people in the "things I learned from my patients" thread should be automatically directed here.
 
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From my first week as a paramedic...
Drunk driver plowes into a family of 4... 8 year old ejected from back seat. Posturing on scene, obvious head injury, later dies. I got subpeonaed (sp?) to the trail 18 months later... drunk driver got community service and probation :mad:
 
Not me, but one of my vascular surg attendings. He hears there's a code in the er, so he waltzes down to see if they need any help. er attending tells him that the woman is probably a goner, so he should just go and get some sleep. A few minutes later, one of the other er nurses walks into the room and recognizes the woman as that particular vasc. surg. attending's wife. :eek:

They call him and tell him the situation (apparently, she was in a really bad MVA--turns out she dissected). He rushes in and codes his own wife for 45 minutes to no avail. :(
 
Not about a patient, just my personal sob story. Thanks for indulging me. I thought of this because of docB's post about the newly minted window. Prior to the saga, my parents had just celebrated their 32nd anniversary. Mom hadn't managed her own checkbook in thirty years.

My Dad died during my intern year of previously occult multivessel CAD. He had some check pain going up the stairs at 7000 feet (we live at sea level - he was on vacation in Colorado) but it went away.

He didn't tell anyone about this.

But he decides that he's gonna go see his internist and they slap a 12 lead EKG on him. And he's had an inferior wall MI. Angiogram at an outside hospital shows four vessel disease. The OSH wants to operate that day (which happened to be late Saturday at this point.)

Dad smells a fish and calls our cardiologist neighbor (still hasn't called me, his doctor daughter, btw.) They tell him to get the hell out of Dodge and get himself to the specialty center at Washington University (BJC system). And off he goes. Being sensible people confronted with an ill, but reasonably stable patient, and since my Dad's MI is >7 days old at this point - the BJC docs slap him on tele and delay his surgery until the work week.

Surgery goes well. They find 4 vessel disease with >90% occlusion. He gets sent home.

Day of discharge, Mom leaves to get Dad some yogurt (the only food he felt like eating.) Something goes wrong and Dad calls 911.

The cardiologist neighbor sees EMS fixing to break the front door in to get to my Dad. He grabs the key and then hops in the trunk to run the code. He told me later that Dad was able to talk going into the truck, but he was called just after on arrival to the ER.

I had left him the day before.

I always wonder what would have happened if I had stayed one more day and had been at home when Dad first started getting symptoms. But at least the cardiologist - a good family friend, a great doctor, a lovely person - was there when he died.

I hold on to that.
 
Sphincter tone... i feel your pain
First DAY as a Paramedic. Car with two mom's and four kids from a small town come to the city to shop. coming in on back roads just before corn harvest they decide to roll a stop sign. what they never saw coming was an oilfield saltwater disposal tractor trailer that literally cut the car in half . No ejections the kids, ranging in age from 11 to 1 yr old wer all properly restrained in the car. I, for my first call as a career paramedic had to call the coroner for to pronounce two families dead on scene. not to mention the fact that two of the kids were the same ages as my own at home, and the other two looked exactly like my two nieces that were killed 10 yrs earlier in a very similar collision that i had worked as an EMT-B ....
Brujo
 
On an ob rotation as a med student:
Sorry ma'am but your 40 week fetus doesn't have heart tones. Yes I know that you were just at your ob's office yesterday and everything was okay.

On trauma call as med student:
7yo girl celebrating first real snow of season and her 7th birthday by sledding (nevermind that it's on the hood of a car that has been removed from the car, and attached to the back of a truck that drives in circles on a vacant parking lot). Evidently the slack in the rope changed with a direction change of the vehicle (or some such nonsense) and the child was ejected from the hood, flew through the air to hit the truck pulling her with her head. On arrival, not a single shred of evidence to suggest any injury, CT head 8 skull fractures, midline shift, bleeds, etc...Happy Birthday:(:thumbdown:
 
80 M syncopal at casino. EMS finds in brady at 20. Full court press code for over an hour. I tried everything. I got the wife in the code room for the end.
Me: I'm so sorry. He's passed away.
Wife: But we were going to have been married 57 years tomorrow. We came to celebrate.
Me: We just weren't able to get his heart muscle going again.
Wife: I don't know what to say.
Me: There's nothing to say. I'm so sorry.
We got social services involved and talked to the family back home but that poor little old lady is going to wake up all alone in a strange bed in a strange city tomorrow to begin her first day as a widow.:(
Sorry to hear that, DocB. I have a feeling you must deal with that on occasion being in such a huge tourist spot. :(
 
Sorry to hear that, DocB. I have a feeling you must deal with that on occasion being in such a huge tourist spot. :(
Yeah, but the instances where the death was truly unexpected (this guy was a really healthy 80yo) and where there is no other family around are rare. It was a tough case on everyone.
 
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My partner had an elderly guy today who developed crushing chest pain today. EMS loads him on the rig, wife is in the ambi with him. He turns to his wife and says "I don't feel very good. I think I'm going to die. I want you to know that I love you and I always have." Wife says she loves him too. about 2 min later he loses his pulse and goes into an unrecoverable PEA. Everyone in the ED, nurses, docs, social workers, housekeepers, everyone was teary eyed over that one.
 
64 yo male BIBA PEA arrest, U/S shows a serious pericardial effusion, go in sub-xipoid, get a bit of foam but that's it. Probably clot, definitely not helping his extremely poor cardiac function. Questionable, but think we see interruption in cardiac wall tissue on U/S. Maybe ventricular rupture? Patient dies. I go in to see the family, including 10 yo granddaughter. Explain our suspicions for ventricular rupture, had no chance, felt no pain, did all we could, etc. Granddaughter starts screaming "it's my fault, it's my fault" and really losing it. It seems grandpa used to tell her he "loved her so much (he) thought (his) heart would burst." I'm on my second scotch tonight and crying while I type. First time I actually had to excuse myself during a notification.

Medicine ****ING SUCKS!

- H
 
57 WF, comes in with mild epigastric pain.
Put on the monitor, she's hypertensive, but otherwise normal.
CXR shows mediastinal widening.
CT shows dissection from her carotids to her iliacs, and one of her renals. Was in surgery later that day, I don't give her too long. That is going to be one massive sheath.
 
64 yo male BIBA PEA arrest, U/S shows a serious pericardial effusion, go in sub-xipoid, get a bit of foam but that's it. Probably clot, definitely not helping his extremely poor cardiac function. Questionable, but think we see interruption in cardiac wall tissue on U/S. Maybe ventricular rupture? Patient dies. I go in to see the family, including 10 yo granddaughter. Explain our suspicions for ventricular rupture, had no chance, felt no pain, did all we could, etc. Granddaughter starts screaming "it's my fault, it's my fault" and really losing it. It seems grandpa used to tell her he "loved her so much (he) thought (his) heart would burst." I'm on my second scotch tonight and crying while I type. First time I actually had to excuse myself during a notification.

Medicine ****ING SUCKS!

- H

Aww FF, I'm so sorry. Big Internet hugs coming your way.
 
64 yo male BIBA PEA arrest, U/S shows a serious pericardial effusion, go in sub-xipoid, get a bit of foam but that's it. Probably clot, definitely not helping his extremely poor cardiac function. Questionable, but think we see interruption in cardiac wall tissue on U/S. Maybe ventricular rupture? Patient dies. I go in to see the family, including 10 yo granddaughter. Explain our suspicions for ventricular rupture, had no chance, felt no pain, did all we could, etc. Granddaughter starts screaming "it's my fault, it's my fault" and really losing it. It seems grandpa used to tell her he "loved her so much (he) thought (his) heart would burst." I'm on my second scotch tonight and crying while I type. First time I actually had to excuse myself during a notification.

Medicine ****ING SUCKS!

- H

Hey FoughtFyr,

Glad to see you still have that empathy for those under your care. I hope you can get past it without too much trouble. :oops:
 
What would make you think I didn't (have empathy for those under my care)?

- H

Absolutely nothing. You had a really crappy day, and I'm sorry.

I hope the day after the night before wasn't too bad... and I hope the next 'oh ****' patient that rolls into your ER walks out of the hospital hale and healthy.
 
...I go in to see the family, including 10 yo granddaughter. Explain our suspicions for ventricular rupture, had no chance, felt no pain, did all we could, etc. Granddaughter starts screaming "it's my fault, it's my fault" and really losing it. It seems grandpa used to tell her he "loved her so much (he) thought (his) heart would burst." I'm on my second scotch tonight and crying while I type. First time I actually had to excuse myself during a notification.
Holy crap. I'm sorry, man.

But what I'm thinking is, after the shock and the pain and the acute part of the grief is done with, that little girl is going to have at least a chance at a really positive outcome from this experience. Every kid has to learn that adults can be wrong, mistaken, even stupid; that adults can't predict or control everything, and people you love can wind up making things worse despite good intentions. Knowing it works like this makes it tough to be a kid -- but it also makes it a lot easier, in some ways, to be a teenager and then an adult.

So the fact that her grandfather loved her won't change. The awful facts of his death won't change. But maybe, someday, the weird collision between his words and what happened won't seem sinister and painful. It'll be a part of how life can be random and unpredictable, and maybe she'll be better than most at accepting that.
 
Last year while being the intern on medicine, I was in the depths of depression. Partly depressed because I was on medicine but mostly because it was christmas time and I was ~1200 miles away from most of my family. My team is admitting and I get sent to see a 30 yo guy with a mass overlying his left scapula. Apparently, he first noted some "stiffness" there a month ago that just kept getting worse until this knot appeared 1 week ago. Path ends up coming back as some kind of poorly differentiated sarcoma. Bone scan shows multiple hot zones including L.spine, pelvis, multiple ribs, and hip. Pt. admitted on 3-4 days before christmas. In my own selfish pit of despair I manage to appropriately distance myself while still making myself available to answer all of the questions that I can. Kind of robotic I'm ashamed to say. Then, I go into see him on the morning of christmas eve when the guy says, "Look, I know things are bad. If there's anyway possible and even if there isn't can I go home to see my 3 month old on his first christmas morning. I know it's a lot to ask, but I know I probably won't be here next year." I had to excuse myself because I couldn't talk around the lump in my throat. Then with tears in my eye and several nurses looking on I called my attending and the Orthopedic and Oncology attendings at home (both are incredibly nice guys by the way) to let them know my intentions. We got him home later that morning only to be readmitted 2 days later. I dare say that I was more thankful that christmas than ever before. Now if I could only manage that kind of clarity on a daily basis. Medicine sucks...
 
I just want to let all of you know that the work you all do is phenomenal. I am a pharmacist and some of these stories are gut renching(sp?). I went into pharmacy so i would not have to deal with the emotional turmoil it has on the mind. Good luck to all of you and keep up the good work.

CJM
 
From my first week as a paramedic...
Drunk driver plowes into a family of 4... 8 year old ejected from back seat. Posturing on scene, obvious head injury, later dies. I got subpeonaed (sp?) to the trail 18 months later... drunk driver got community service and probation :mad:

When I was a child, my mother was killed in an MVA after being rear-ended while stopped for a red light. (Gas tank caught fire, she was burned to death - think it was the infamous Pinto.) Like your drunk, the man who hit her got off easy. In fact, as he was the head of the county GOP and the county prosecutor was Republican, he didn't get so much as a ticket.

:mad: at how commonly it seems that deaths are just shrugged off.
 
I came to realize that, if you want to kill someone in the US and get away with it, do it drunk driving. The absolute same crime, but without alcohol, or drunk or not without the car, and you're going to the "concrete Hilton".
 
I get handed an ECG from triage this afternoon. Huge depressions across the anterior leads with elevations in aVR and aVL. I activate the cath lab and head to see him while he's still in triage.

He's looking scarred but otherwise OK. Having chest pain. A nurse and I wheel him back to one of our rescusciation rooms. As we're rolling into the room he codes.

1 1/2 hours of coding him later, I get to tell this man's family he died.

I always hate the patients (who always seem nice, BTW) who come in talking with you and die right in front of you.

Yup. Medicine sucks.

Take care,
Jeff
 
I always hate the patients (who always seem nice, BTW) who come in talking with you and die right in front of you.

Yup. Medicine sucks.

Take care,
Jeff
The first code I dealt with the patient was conscious and talking to me, scared and stressing that he needed to talk to his wife. He went unconscious before he could get ahold of her. I have to say I think it was a lot harder for me to deal with because I was talking to him at first and I had to watch him dying in front of me. The good news is that he ended up surviving anyhow after some epi, lidocaine, and a few shocks. Just the same, I was still thinking "medicine sucks" in the aftermath because I assumed he wasn't going to make it to hospital discharge. He already had a serious cardiac history and was in cardiogenic shock when I got to him.
 
working as the coroner's asst., i did a lot of nasty and gut wrenching removals.

one in particular, i show up at home of hawaiian family to remove a dead 23 month-old - cutest kid i've ever seen, despite being deceased. the bed is surrounded by family and extended family, everyone is in tears. my failry petite and taciturn investigator (my only companion) is in another room taking notes. as i go to remove the child from the bed, Uncle 450 lbs charges me insisting to replace the child on the bed, Papa 400 lbs, and other Uncle 450 lbs retrain him . . . and i'm not a large guy. so the room is loud, packed, emotionally charged and frankly scary as. eventually i made it out of there . . . only to go back to the lab and cut this kid apart.

may not be medicine technically . . . but it certainly sucked.
 
We had a patient come into our office a couple of months ago who had a large brain tumor.

I'm doing his H and P, as he is talking to me through his electronic voice box and tells me that he participated in D-day and was one of the few to make it out of his company.

He then tells me that he has survived throat cancer, lung cancer and malignant melanoma. This dude really does have nine lives.

Anyway, all our patients are supposed to be the same, but this guy was one of those people you are just instantly attached to. I mean he is just happy to be alive and he still has a wonderful sense of humor.

We do his surgery the next week and the frozen comes back as GBM vs. melanoma. Either way it sucks.

Then my doc and I go out to meet the family and I s**t you not, half of the waiting room is there for him. Like 30+ people and we ask the wife if she wants to talk to her in private and she says no and then have to break the news to them. Thirty plus people start crying. Sucks.

I walk into the ICU the next morning and this old bird is OOB sitting in a chair doing leg lifts. He grabs his voice box and wants to know when he can go to rehab. Then he asks me to sneak him in a cheesburger. Gotta love the guy.

He does well and goes to rehab on post-op day three.

A few weeks later one of his friends, who is also one of our patients, is there for a follow-up and tells me that our tumor patient was at home leaning against a spaceheater and caught his robe on fire. He gets third degree burns over forty percent of his body.

I called the burn unit a couple of weeks ago and they said he was doing well.

Then, last week some of the girls in the office tell me that they had seen his obituary in the paper.

I know he was not long for this world and he lived a good and full life and had a wonderful family, but I still had to choke back tears when they told me.

-Mike
 
It is impossible to scroll down a whole page without getting choked up. Thank you for this thread.

One more:
Years ago, my uncle was working his shift in the ER. A kid comes in after being in a car wreck. My uncle is running the trauma. The kid's really banged up with massive head trauma, bleeding, etc. Full resuscitation effort by everyone involved but unfortunately he never had a chance.

After the dust settled, my uncle realized that the kid's shirt had an odd familiarity about it. The kid on the table in front of him was his teenage son.
 
When I was a child, my mother was killed in an MVA after being rear-ended while stopped for a red light. (Gas tank caught fire, she was burned to death - think it was the infamous Pinto.) Like your drunk, the man who hit her got off easy. In fact, as he was the head of the county GOP and the county prosecutor was Republican, he didn't get so much as a ticket.

:mad: at how commonly it seems that deaths are just shrugged off.

:eek: :( man that's horrible, im sorry for you..
 
It is impossible to scroll down a whole page without getting choked up. Thank you for this thread.

One more:
Years ago, my uncle was working his shift in the ER. A kid comes in after being in a car wreck. My uncle is running the trauma. The kid's really banged up with massive head trauma, bleeding, etc. Full resuscitation effort by everyone involved but unfortunately he never had a chance.

After the dust settled, my uncle realized that the kid's shirt had an odd familiarity about it. The kid on the table in front of him was his teenage son.



:(
And I'm sure he began to question every single decision he made. That sucks. :(


I worked Christmas Eve and New Years Eve. Both days we had new cancer discoveries, one not related to the patient's complaint so I guess it's good since it was found earlier rather than later. Nothing official, but the radiologists in a couple of cases called the docs I was working with to say it probably was.
Merry Christmas and a happy New Year. :(

Of course the drunks, drug addicts, and various others who are a drain on society are perfectly healthy aside from over endulging or being stupid. :rolleyes:
I guess that's why it can be so iritating.
 
I helped with CPR on a ~10 y/o drowning victim. The poor kid was under water for 2 hours before the rescuers got to him. We worked him for 7 hours:eek: until his body temp reached a certain point and the docs pronounced him. A towel covered the kids face the whole time and the mother lay on top of his legs while we did CPR. THe whole situation was so messed up. I still don't know why we allowed the mother into the room and let her lay on top of his legs like that.
 
Walking the dogs not an hour ago.
MVC, van runs light. Kills mom and daughter in car, people in van hurt bad.
Wasn't anything I could do but wait until EMS got there.
 
I'm on my field time as a paramedic student and about a month in already had 2 or 3 field codes, a code on arrival to the ED, and a GSW as highlights. Had a code tuesday where I blew my first shot at an intubation...


Dispatched this afternoon for an "unresponsive with caller unsure if patient is breathing." Arrive to find an 87 year old male in a hall apenic with a rate of 60and B/P of 40/p. Found he was incontent as I kneel down into piss to try and find an IV. I switch with my preceptor to take the tube and come up with jack on the first attempt. BVM, etc and on second try the patient starts to fight the blade, move and open his eyes as we are dumping NSS into him.

To make a long story short he comes around after some BVM, aprox 900 of NSS and is on a NRB talking to me about how he passed out on the way to the ED. I ask 'does anything hurt you right now?' and he says 'my throat is a little scratchy' needless to say we explained that the whole not breathing part ment we were trying tube you so we could breath for you and you decided you were having no part in that.

Passed the room later after another call and he was sitting up in bed, hopefully he goes home tonight and not upstairs on a vent.
 
My partner's patient. Previously healthy 30 yo F come in with pelvic/rectal pain and bloody diarrhea. Ordered a CT Abd to eval diverticulitis. CT shows a 9x14 cm retal mass with mets to the liver. My partner tried to explain the gravity of this to the patient but how do you do that?

"I know you just came in for diarrhea but you're gonna die."

I think the whole discussion of debulking, colostomy, chemo, rads and death sort of sailed right over her head. She did seem to understand when he told her she needed to have her husband leave work and come in now. It also said a lot that the nurse kept breaking into tears. Lady has a 7 yo daughter who came in with her dad. By the time she's 10 she'll have no mom. And the last years will be spent with a chemo and radiation riddled, colostomized shell.

Cases like that make me want to just leave the hospital, drive off into the desert and never come back.
 
My partner's patient. Previously healthy 30 yo F come in with pelvic/rectal pain and bloody diarrhea. Ordered a CT Abd to eval diverticulitis. CT shows a 9x14 cm retal mass with mets to the liver. My partner tried to explain the gravity of this to the patient but how do you do that?

"I know you just came in for diarrhea but you're gonna die."

I think the whole discussion of debulking, colostomy, chemo, rads and death sort of sailed right over her head. She did seem to understand when he told her she needed to have her husband leave work and come in now. It also said a lot that the nurse kept breaking into tears. Lady has a 7 yo daughter who came in with her dad. By the time she's 10 she'll have no mom. And the last years will be spent with a chemo and radiation riddled, colostomized shell.

Cases like that make me want to just leave the hospital, drive off into the desert and never come back.
Sorry docB, that sucks.
 
Working at the rural ER, late summer night...

EMS rolls in with a 3 year old, drowned at the lake, worked him for a long time. Family was partying with their beer and didn't realize their kid had walked into the lake to die

They were doing construction on the hospital, and the only way to get to the family room was to walk right by the ER room where he was at! Finally, they unlocked a door to let the other 20 family members walk around

We go to tell the family, and apparently the mom and dad aren't together anymore. Small fights break out between everyone - we call security and bolt it out of there.

This was my first peds case - its hard when things could be avoided:(
 
38 y.o male, previously healthy, drops over at home after eating dinner. Girlfriend freaks out, doesn't know CPR, guy comes in with no lines, combi-tube, asystole, no drugs given, girlfriend in hysterics. Get a peripheral, get a central line, get a perfusing rhythm right away that remains stable. O2 sats start going south, can't get the tube in around the combi-tube, can't deflate the combi tube despite cutting the line to the balloon. Finally yank it out with 02 sats to about 60, corn comes pouring out like chowder, mouth, nose, spewing everywhere. Suction won't work, scooping with hands won't work. I cric the guy, get the tube, 02 sats up to 100%. Guy makes it to ICU, brain gorked from the 15 minutes or so without CPR at home.

I go up to see the guy in the ICU. The family is devastated. But, they actually thank me for coming up and for giving him a chance. Sucks, but they didn't blame me, thank god.
 
I remember when I was doing my ER rotation we had an 8-YO girl who was lifeflighted in with CPR in progress.

As they bust through the doors there is this little golden-haired thing engulfed in this huge bed and she is clearly not going to make it. They coded her for what seemed like forever and finally called it.

It was only then that we heard the story of what happened. It seems that she was at her birthday party and her brother popped a baloon right in front of her face.

Apparently it startled her and somehow she sucked the baloon in and it got lodged in her airway.

All I can think of is that her brother will always, in some way, blame himself and that her birthday will always be living hell for her parents. Well, thats if it can be any worse for them.

-Mike
 
TV shows also gives false sense of hope to patients family where 95% of CPR on pt coming in arrested are successful!!! Real life number is closer to 5% and i think all the trauma pt in the show ER gets an open thoracotomy too.
 
I may have posted this elsewhere. If so, I'm sorry.

Saw a patient several weeks ago with hip pain - story consistent with transient (formerly toxic) synovitis. Got the routine stuff started (hip films, CBC, ESR/CRP) and then signed out. My shift was over.

Saw Mom and patient in the hospital cafeteria the next week. I saw that the kid had a PICC line in, so I assumed that she had had a septic hip. I'm glad that I got the labs... Mom sees me and says in a sorta happy voice - Look there's our ER doc... Hey doc, we got a diagnosis! I assume this is a good thing. Mom then tells me the kid has neuroblastoma.

Damn it.
 
Hi, I'm docB and you're here because you're 9 weeks pregnant and you have belly pain? Oh, you say that your husband was just deployed to Iraq for a year and you're all by yourself here in Vegas now that he's gone but that the thing that kept you going was knowing you're having a baby. Well I have to tell you that your tests show that your baby is actually an ectopic and now not only are you not having a baby but you're going to lose one of your tubes which will make it harder to get pregnant if your husband gets back in one piece. And as a bonus flip off to you from the universe you get to go through the whole operation alone. Once you're done with that you get to figure out how to tell you husband all this by phone if you're lucky. You'll probably have to write a letter.

Holy crap. She was still weeping as they rolled her out to the OR. That sound had been hanging with me for a few days. The image I can't shake is how I imagine her leaving the hospital the next day. I'm sure she got discharged and had to walk out of the hospital all alone, lost the baby and a tube, gonna get bills up the wazoo, husband's in Iraq and she's gotta tell him what happened.
 
Howdy DocB,

I feel your pain. We're right next door to Ft. Hood and you can imagine what portion of their population is deployed at any given time. I feel overwhelmed with it frequently. I can't even imagine how often our colleagues over at Darnall's EM program run into this.

Medicine may suck, but war sucks even worse. Worst of all, it makes medicine suck more.

Take care,
Jeff
 
Hi, I'm docB and you're here because you're 9 weeks pregnant and you have belly pain? Oh, you say that your husband was just deployed to Iraq for a year and you're all by yourself here in Vegas now that he's gone but that the thing that kept you going was knowing you're having a baby. Well I have to tell you that your tests show that your baby is actually an ectopic and now not only are you not having a baby but you're going to lose one of your tubes which will make it harder to get pregnant if your husband gets back in one piece. And as a bonus flip off to you from the universe you get to go through the whole operation alone. Once you're done with that you get to figure out how to tell you husband all this by phone if you're lucky. You'll probably have to write a letter.

Holy crap. She was still weeping as they rolled her out to the OR. That sound had been hanging with me for a few days. The image I can't shake is how I imagine her leaving the hospital the next day. I'm sure she got discharged and had to walk out of the hospital all alone, lost the baby and a tube, gonna get bills up the wazoo, husband's in Iraq and she's gotta tell him what happened.

docB - that's tough. I'm sure your compassion was comforting to her, though.
 
So I'm going home from a long, busy night in the ED and of course my gas light is on. I pull into a gas station and fill up. I walk into the store to buy a Dove bar and some Bugles (don't act like you all haven't eaten crap like that after a shift and remember the rule that most ER angst can be helped with empty calories). The guy behind the counter looks at my scrubs and says:

Cashier: ER doc huh? How was your night?
Me: Rough
Cashier: Yeah. We had a rough night too.
Me: Oh?
Cashier: Yeah. See that black crap all over the counter? That's finger print dust.
Me: Anyone hurt?
Cashier: No. But the girl who got the gun in her face was still shaking after the cops were done with her. I had to get her a cab home.
Me: That sucks. Hope it gets better for you.

So I guess everyone has a tough time now and then.
 
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My neurosurgery rotation started yesterday. 18 year old girl, MVA, severe head injury. At first, she was posturing and had a low GCS. After a couple of days, her condition started to improve and her ICP reads were good despite her cerebral contusions.

Huge family...mom, dad, sisters, friends, relatives constantly outside the ICU or by bed praying. I saw dad yesterday at her bedside. He looked at me with a big smile and said: 'That's my girl'. Some of his hope almost rubbed off on me. almost.

Today they called from the ICU. I overheard the attendings mumbling to each other in the OR:...lost gag reflex, left pupil blown, BP over 200.

They consented the family. Took her to the OR: Craniectomy. But the swelling didn't stop. She had brain oozing out of her head when we were closing.

Tonight as I was leaving, I saw all of them by her bed. Everyone crying. Priest talking to her as if she was awake. Dad quietly standing at the foot of the bed. She looked too much like my sister :(. As I left the hospital, I still could hear dad's voice: "That's my girl"
 
My neurosurgery rotation started yesterday. 18 year old girl, MVA, severe head injury. At first, she was posturing and had a low GCS. After a couple of days, her condition started to improve and her ICP reads were good despite her cerebral contusions.

Huge family...mom, dad, sisters, friends, relatives constantly outside the ICU or by bed praying. I saw dad yesterday at her bedside. He looked at me with a big smile and said: 'That's my girl'. Some of his hope almost rubbed off on me. almost.

Today they called from the ICU. I overheard the attendings mumbling to each other in the OR:...lost gag reflex, left pupil blown, BP over 200.

They consented the family. Took her to the OR: Craniectomy. But the swelling didn't stop. She had brain oozing out of her head when we were closing.

Tonight as I was leaving, I saw all of them by her bed. Everyone crying. Priest talking to her as if she was awake. Dad quietly standing at the foot of the bed. She looked too much like my sister :(. As I left the hospital, I still could hear dad's voice: "That's my girl"
It's amazing how important hope is for patients and families but how hard it can be for us to see that hope when it's misplaced. I've had similar situations where I trying to guide the family into acceptance and they are steadfastly sticking to hoping for a miracle. You've just got to let them find their peace in their own time but it's damn hard to watch.
 
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