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Thursday, September 08, 2005

Good sounds

Here are some sounds that make me feel very happy:

1. "Thonnk!" (sounds like a metal spoon hitting a wooden spatula).

The highly satisfying sound made when I relocate a dislocated finger or pull a wrist fracture straight. This sound also makes my patient very happy - because suddenly the pain just goes away. When the bones are still dislocated, patients can be in so much pain that they require morphine injections. After the pain is relieved, the morphine no longer needs exerts it's analgesic effect and my patients fall immediately into an opiate-induced (and usually well-needed) sleep.

2. "Fsss..." (sounds like air escaping from a balloon).

This is the sound made when a collapsed lung is reinflated. Sometimes, when a lung is punctured, the air escapes into the cavity surrounding the lung and this air is trapped and cannot escape (pneumothorax, for those of you who are interested)- it squashes the actual lung down and the patient becomes short of breath. Ordinarily, lungs will repair and reinflate themselves, but occasionally, the lung becomes so small that we have to give it a little help - by inserting a needle into the lung cavity, decompressing it. I often feel very relieved when I hear this sound because it means we've got the needle in the right place.

3. "Shfff" (sounds like a refridgerator door opening).

This is a cannula being flushed - which means that it is in the right position. It still gives me a kick to be able to put cannulas into veins - probably because I used to be very bad at it when I first started. The first time I got it in, I felt a great sense of achievement because it is one of those painful procedures that usually form a necessary part of inpatient treatment. Now that I am good at it, everytime I get a cannula in, I still feel that exhilaration just knowing that intravenous treatment can begin - I can put up a drip or give antibiotics or a shot of painkillers - and that my patient will start to feel better soon.

4. "Thank you!" (self-explanatory)
It's nice to be appreciated. Not very many of my patients bother to thank the nurses or doctors anymore. Especially not the doctors - nurses tend to be the ones who get most of the grateful smiles and handshakes (and rightly so, considering what they have to do for their patients). Doctors tend to be viewed with rather a jaundiced eye - we are the enemy who jabs them with needles, pokes them in painful places and puts them through nasty, uncomfortable or embarrassing procedures. Doctors often the bearers of bad news or harbingers of death or fearsome disciplinarians. It's very difficult to see that doctors and patients fight on the same side. But there are some people who appreciate what little help we can give - and it's nice to know that we've done something good once in a while.


Blogger Tym said...

Very vivid, and very illuminating to a non-doctor reader. And, as usual, very thoughtful as well :) I hope you had hear many more of these sounds, especially No. 4, in your career!

10:01 pm  
Blogger wahj said...

Nice post. I think we all could us more of No. 4 in our lives.

11:05 pm  
Blogger Beng said...

Very educational. As if I'm watching House, that TV serial.

And yes, patients should thank their doctors and nurses for taking care of their lives. :)

12:10 am  
Blogger Cecyl said...

Very interesting. :)

3:07 am  
Blogger tscd said...

tym, wahj, beng and cecyl: thanks! I hope to hear No. 4 alot more too.

8:12 pm  
Anonymous Anonymous said...

I love this. :) Am a medical student in London, also from Singapore: just thought I'd say HI! and that it's wonderful to read about the human aspect of your job, beyond the wretched hours and incredible workload. - Rachel

5:49 am  

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