Wednesday, August 27, 2008

The Back Story

Well, I started my new rotation in the Trauma ICU at ECMC on Monday. It was actually kind of exciting to be back in the ICU, and I was on-call last night. Yes, 26 long hours of fun. Did I mention it's been a while since I've stayed up more than 24 hours straight?

One of the things I love about ECMC, as I have mentioned before, is that patients have the most interesting stories. Now, some of my colleagues will argue that BGH and Children's have their share of stories, and I agree that once in a while a good one will come up, but I still feel that the best stories come out of ECMC. And, getting to know my patients, plus the 5 new admits I had to the ICU, can be an interesting venture.

Two patients came in with blood alcohol levels that put them in the "inebriated" category having fallen. Mind you, both presented to the ED in the morning after their respective falls. They both admitted that they drank "a couple of beers a day." I guess they just didn't specify at what time of the day. Both ended up with back injuries requiring multiple scans and films. One had a broken wrist and the other had spinal shock. Both will end up doing well.

In the "payback's a b*t*h" category, don't mess with a mama's little girl. You might just end up getting a beat down with a lead pipe leading to a broken face, some major bruises and cuts, and the humiliation of having to spend the night under arrest in the ICU. Oh, and again, please stop doing cocaine, I'm having a hard time controlling your pain (because your synapses are all fried) and your blood pressure (because I have some limits on the kinds of medications I can use.)

And, again, you might want to reconsider your life's choices when you're in the ICU because you got kicked in the chest by a mad female. The bleeding led to an infection which led to a worse infection in your lungs which then led to the surgery where they had to cut into your chest to clean things out. Now, your heroin habit caused me problems like your fellow patient's cocaine habit with your pain control. Granted, you have four tubes sticking out of your chest so I feel just a little bit more sorry for you because I know those are uncomfortable. But still... rethinking those life choices might not be such a bad idea.

Of course, the worst are therandom events where someone was just having fun and it led to tragedy. Like riding an ATV and now having a spinal fracture leading to the strong possibility of never walking again. Hard when you're just 16. Or 17 doing something simple like working on your car. Now you'll be lucky to not be brain dead. Luckily both have very supportive families which will help as they'll have very long roads ahead.

One of the more interesting things is being pimped again (meaning being asked questions by the attending that tests your level of knowledge and puts you on the spot.) In the E.D., not so bad. In the ICU, back to pimping "surgery style." But still, very good to be back to the familiar. Can't wait to see what the rest of the month brings...

1 comment:

helmswondermom said...

I enjoyed this entry.  Glad you're back where you like to be, and I hope those long hours get easier to handle.