It's really not good
When your patient tells you that her injuries are a result of an encounter with the boyfriend (or rather, ex-boyfriend)...and then he turns up at reception and demands to be let in to see her.
This sort of situation can lead to all sorts of badness.
It can't be good when...
I get to work, and I can't get into the department because of all the patients queuing on trolleys all the way down the corridors to the main entrance of the hospital. I finally squeeze my way in, and the other doctor who has been working there for the last 5 hours looks up at me, frazzled strands of hair escaping from her normally perfectly lacquered coiffure, says something to the effect of "I'm so glad to see you, it's been hell...", then promptly bursts into tears.
Grand Rounds 3:17
Medical Grand Rounds are up at Six Until Me, beautifully written by Kerri, starring the top 20 medical submissions from this week. Surf on by and check it out, see what it is all about. (Yes, I know. Feeble, isn't it?)
Never leave the man of the house unsupervised in the kitchen. MDH was preheating the oven for dinner and forgot to take out the cookware that I normally store inside it. He has melted one of my little saucepans. It's now a sticky mess on the bottom of the oven. Fortunately, the wok and pot escaped harm.
It can't be good when...
I answer my on call bleep and the nurse says:"Doctor, can you come and see this patient? He's a bit....agitated and we've had to send the our ward doctor down to A&E to be seen for a head injury..."
He pursed his lips, concentrating, whilst drawing a clock face with a shaky hand. I had set him a series of tasks to complete as part of the Mental State Test - a 100-point test which is surprisingly sensitive to fluctuations in cognition. This test covers all parts of long and short term memory, as well as the various facets of cognition. This means that the tasks range from answering questions like "What is your name?" to "What is my name?" to "What is the name of the leader of the opposition party". It also involves completing instructions like "Point to the door using your left hand, then pat your head" or "Repeat this phrase after me", and bizarre requests such as "Name as many words as you can, beginning with the letter 'T' in one minute...GO!" and "Write down a sentence on this paper, any sentence you can think of".One of the questions I asked him was "When was the end of the 2nd World War?".To my surprise, he answered, "Which end? I was there for both."It turns out that he was serving in the Royal Navy and had been stationed in Europe, dodging U-boats until Germany surrendered on the 2nd of May 1945. Not long after V.E day, he was posted back to the warfront, but this time in Asia.He was on the ship's prow, when the bombs went off in Hiroshima and Nagasaki in August. All the crew on the boat were silent, watching as the great mushroom cloud formed far off on the horizon, 18 miles high. "And when I saw the bright light, and the cloud rising up from the horizon, I cheered, and everyone else on the ship hurrayed. We ran up the flags and flew them, and that evening we had a party. Because we knew that the war was finally over. There would be no more fighting, no more death, no more burials at sea. I would never have to stand and count the planes that return. We could go home at last." His eyes were bright with the memory of that moment, looking back over the grey sea, at the Union Jack flying high and proud in the morning, at the expanding white cloud that signified for him the end of years of horror. Then, the brightness in his face dwindled, and he said, sadly, "I guess it's not acceptable nowadays, cheering at the dropping of the atomic bombs. We didn't know then how much devastation it caused. But people now, they forget how terrible it was, how much more terrible it could have been. They forget that if the war had not ended then, Japan would have continued to fight for years, until their very last soldier died. They would never have stopped. It was their way, you know? The war would have gone on for who knows how long. And it would have been long, horrible and bloody."Lines appeared on his face then, and I saw the heaviness of his shoulders as he remembered the anxiety of the times. I saw him crane his neck to look over that ocean, waiting for his friends to return, counting the planes returning to the carrier, some of them riddled with bullet holes, hoping that he would not lose another comrade.I looked back on the test paper with his (unsuccessful) rendering of the clock face. On it he had written a sentence, just as I had asked. Any sentence would do, I told him. But this one obviously had great significance to him - "All aircraft have returned safely."
So, it's January and the balconniere that MDH planted for me is still alive. In fact, the pansies and violas are blooming crazy, and you can see the green shoots of the crocus poking up through the soil.
I think I am partially responsible for the current success of our balcony garden, seeing as I have not tampered, meddled, tinkered or otherwise interfered with the well being of the plants. I leave them well enough alone.
MDH, however, often can be found crooning over them, stroking the dark soil, whispering sweet nothings and whatnot. Occasionally, he will also prune the withering blossoms in order to encourage more flowering.
I think he just likes playing with mud.
It's finally happened
Today, I had to euthanise one of the fish in my tank...it suddenly got all bloaty like a pinecone and I didn't want the disease spreading to the other fish.When I was watching it flip its last flop, I suddenly realised that it was harder watching a fish die than watching one of my patients die. This means that I've finally turned into one of them. One of those stone-hearted, cold-blooded cynical doctors that I promised myself I would never become.I'm a sick, sick person.
Happy New Year!
I can hear the fireworks, but I can't see them, because I am stuck in the frigging medical unit that is located underground and there are no windows here. The fireworks are in my own head (having been without water for 8 hours already).
I am surrounded by crumbling elderly folk who have been dumped here for the holidays. Great way to spend my last day of 2006.
Happy New Year, everybody!
This year has definitely been a particularly challenging one for me. Aside from handling irregular hours and the fact that MDH and I hardly saw each other for 8 months of the year, I have learnt some very hard lessons about people, and also about myself.As much as I hate to admit it, I've lived a very sheltered existence, which means that I am often naive in the manner with which I deal with people. I have learnt that a little bit of paranoia is often the better, safer way to do things, even though it means that I am perpetually looking over my shoulder. My trust is best left in the hands of God, who is infallible and always above reproach. Additionally, I have realised that not all patients need to be seen by a soft-hearted, kindly angel-doctor. Some of them need the heavy-handed treatment of the stern, mean, steely-eyed physician. It is often necessary in my line of work, to stare imperiously at elderly men and treat them like errant schoolchildren. In order to do this, I have had to hone my skills as an actress. Every morning, my routine begins with a prayer to the Almighty and a good long stare into the mirror, recharging the id and ego. A few preparatory deep breaths and I enter the ward with a big smile, exuding self-confidence and (in my mind at least) glamour. Inside of course, I am crying like a scared little girl. The positive side to having to wear a facade all day, is that all patients and their relatives call me 'Doctor', even if they have not met me before. This either means that I meet their expectation of a competent physician, or they are too scared to call me anything else. Either way works for me.My most difficult challenge this year is trying to keep my work stress in the hospital, so that I can come home and be an attentive and loving wife. It's too easy for MDH and I to come home and bring back all our medical conundrums with us to share with each other. It's too easy for us to allow our world to be completely taken over by Hippocrates. With all our conversations focussed on work, we may soon find that we have nothing else in common to talk about. I'm still struggling with leaving work in the workplace and with God's help, I am getting there, but it is very hard, and I have had many sleepless nights spent mulling over a difficult case. Fortunately, MDH and I have been able to spend many magical hours together still, just laughing, having fun together and enjoying our marriage.Well, that is all I have to say about 2006 and I look forward to 2007 with a mixture of trepidation and excitement. I wonder what God has in store for me this year.Have a great new year, everybody!