Monday, March 7, 2011

Tales from Intern Year: 22 Short Films about the ER

2000: I arrive at the hospital, bright eyed and bushy tailed.

2005: I realize I forgot my stethescope at home. Fuck!

2012: I arrive at the hospital again, somewhat less bright eyed but equally bushy tailed.

2020: I pick up my first patient, a woman going through alcohol withdrawal.
Woman: "I'm going to have a seizure."
Me: (checks her pulse, which is 65) "No, you're not."
Woman: "I really am."
Me: "I don't think so."
Woman: "I definitely am."
Me: "OK fine, here's 1mg of ativan."
Woman: [falls asleep]

2200: I see a guy who cut his leg open with a bandsaw. After cleaning it off, the wound is judged to be "too deep" for me to be allowed to suture it by myself. Lame. At least I got to cause him lots of pain by injecting inside the wound with lidocaine.

2230: I'm discussing my shifts with the PA on duty. When I tell him that I have to do five 11-hour overnight shifts in a row, he says, "Wow, that really sucks!"
And I think to myself, "Hey, yeah... that DOES really suck."
I spend the next half hour wallowing in self-pity.

2300: Suicide attempt. 16 year old bipolar girl swallowed 50 Tylenol... not to kill herself, mind you, but just to "get sick or go into a coma". I spent a while talking to her. That poor girl was a mess.
Attending: "Is there a diagnosis code for bad fashion sense?"

2345: Most uninteresting patient ever. Guy who can't pee has foley catheter placed. Tries to take shower and foley falls out. Patient comes to ED. I write order that says: "Put in foley catheter." Learning value: 0.

0030: Baby with fever. There is nothing I hate more or suck at worse than looking in little screaming baby ears.

0130: Guy from prison with vomitting and diarrhea after eating some burritos. Apparently there were two other prisoners in the back of the ED who ate the same burritos. It's a prison diarrhea outbreak.
Prisoner: "Can I have some orange juice?"
Me: "You want orange juice? But I thought you're nauseated and you can't stop vomiting?"
Prisoner: "Yeah, but isn't orange juice, like, medicinal?"

0200:I discover that the box of free candy I've been taking candy from the last few days actually has a sign that says "$1 each".

0300: Woman who just had abdominal surgery presents to ER with abdominal pain. She didn't take any of the painkillers that they gave her after the surgery. Maybe I was misinformed, but I heard having your belly cut open kind of hurts. (I'm being a little overly sarcastic, but I later found out that the symptoms the woman had were exactly what the surgeon told her to expect.)

0330: Woohoo for testicular pain, especially when associated with lots of psych comorbities and no health insurance.

0400: Girl who accidentally poisoned herself when she locked herself in the windowless bathroom and tried to clean with a new mold remover product. What did she think was killing the mold? Sugar water? (OK, I've done it too.)

0430: I take a half hour break, where I hide in the family conference room, drink a glass of water, and eat three marshmallow cookies. I feel guilty for it.

0500: Woman with severe migraine who looks like she's in a hell of a lot less pain than I'm in right now.

0530: At this point, I realize that although I feel really dizzy and tired, if I pass out and fall to the floor, they'll have to scan my head and I'll never get out of this fucking emergency room.

0535: Another screaming baby with fever.

0600: 16 day old baby boy who has little boobies.
Me: "I wouldn't worry about it. It's very common for newborn babies to get a little bit of breast enlargement due to the mother's hormones during pregnancy."
Father: "Are you a pediatrician?"
Me: "Uh... no..."
Father: "Well, we want to get a real professional opinion."
[I bring in attending.]
Attending: "I wouldn't worry about it. It's very common for newborn babies to get a little bit of breast enlargement due to the mother's hormones during pregnancy."
Father: "Oh, thank you, Doctor."

0630: Hypertensive guy who woke up with arm numb, now resolved. Differential: transient ischemic attack vs. arm fell asleep.

0700: "Well, the sun is up. I guess you can go home."

15 comments:

  1. Boxes of candy ARE free when you are on 5 overnights in a row, despite what any signs may say.

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  2. You actually got to go home after 11 hours? Hon, you don't know how good you had it!

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  3. Marshmallow cookies? Sounds wonderful...what are they called?? Do tell

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  4. "0500: Woman with severe migraine who looks like she's in a hell of a lot less pain than I'm in right now."

    I blew coffee out my nose when I read this snippet. The whole post is like a cartoon in word format. Love it.

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  5. I feel your pain. Really I do. Especially with the little kid ones. It's one of the reasons I try to avoid going over to the peeds side of the ER when I can help it.

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  6. i empathise with u totally... and reading it makes me remember all the torture iam going thru but in a good mood!

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  7. nice post!! I spent last Thursday afternoon looking in screaming infant ears. I was viewing tympanic membrane roughly 0.00000002% of that time (about 1.3 seconds total for 5 sets of ears).

    I do NOT want to do peeds.

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  8. i laughed so hard my stomach hurts! can i get some orange juice?

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  9. I am done with day 1 of 7 12 hour overnights straight. I have to be back there in 2 hours and 45 minutes...not that I'm counting, obviously. Not fun.

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  10. OMDG: 11 hours was longer than anyone else's shift! The attendings, the EM residents, and med students all did 8-9 hour shifts.

    Mal: It was too long ago and I don't remember what they were called, but they were gross.

    fortytwo: By the end of my ER rotation, I used to dread those shifts with every fiber of my being.

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  11. Why is it always the 16 do with no problems come in at 6 in the morning? I just don't get it.

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  12. This was fantastic, but for some stupid reason I thought these were years until I got to 0030. I was quite confused why you'd still not "be allowed to suture it by myself" after 200 years of practice.

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  13. I love the 6am visit for neonatal gynaecomastia.

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  14. I was considering emergency medicine until I realized that it was just medicine, sped up, light on the rapport, with a healthy dose of "how can you consider that an emergency!".
    That being said, I did enjoy the minority of cases where I could actually help someone.

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  15. 2300: 50 Tylenol - doesn't 100 or so pretty much fry your liver? Did she have any damage with 50 tabs?
    "Is there a diagnosis code for bad fashion sense?"
    hmm - maybe got dressed during 30,44,45,48,65 or if all else fails you could probably use 470 . . .

    0400: Is mold remover as bad as mixing ammonia and chlorine cleaners?

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