Tuesday, July 29, 2008

He went to Paris

Through eighty-six years of perpetual motion
if he likes you, he'll smile and he'll say
"Some of it's magic, and some of it's tragic
but I had a good life all the way"
Jimmy Buffett

Magic and tragic pretty much sums up this week of my externship. I've gotten the chance to do and see some pretty cool things, and I've been able to see people who are broken get fixed and start to get better. I've had some ridiculously hilarious situations occur. I've also seen the most tragic side of life, more than I'd like to.

There was a very interesting small bowel obstruction case that I got to be a part of. Middle age man came in with severe abdominal pain and vomiting. The vomitus got progressively darker and fouler smelling throughout the few hours he was in the ED. Eventually a surgical consult came around to look, and decided he had a SBO that needed immediate surgery. I asked if it was okay to follow the case to the OR and got the green light. I stood at the foot of the bed (very careful not to screw up the sterile field, mind you) and watched as an awesomely morbid 1.5 foot section of rotten bowel was pulled out of a hernia and removed. There is something surreal about seeing someone's entire set of intestines heaped outside their body. There is something even more surreal about being handed a bowl with a still warm piece of person. I can't even lie, it was awesome.

I was also told off by an 8 year old this week. Like, I was put to shame. I had nothing, not even a lame comeback. This little boy had fallen off a swing in his backyard and sliced his knee open on a very jagged piece of rock. When I did his assessment, he politely asked me to let him know when I was going to pull off the gauze covering his knee so he could hide his eyes. "I really don't want to look at it," he says. That I can handle. Later when the doc is getting ready to stitch him up, I naturally want to watch how she does it. She irrigates it and snips off the dead edges of skin. I'm asking a bunch of questions, and all of a sudden this little 8 year old pipes up, "I would prefer it if you don't talk about my knee while this is happening. I don't want to hear it at all. Thank you." And then he proceeds to put his hand over his eyes and turn his head. I was dumbfounded. His mom was shocked. And the doc? She burst out laughing. I had no choice but to leave the room in sheer embarrassment. I don't think I'll ever live it down that I was silenced by someone still in the single digits of age.

Unfortunately, there is always the tragic side to the ED too. I had hoped that I would never again have to watch an infant in full cardiac and respiratory arrest. I hoped...but we all know you can't escape those things. A two month old came in full code. Watching that infant pumped full of fluids and meds, with CPR being done by two thumbs only...and knowing that nothing you do will bring this baby back is a devastating reality to accept. Even harder is hearing the parents break down in the middle of the ED. That's something you don't ever really get over.

But like Jimmy says, some of it's magic and some of it's tragic - all I can do is have a good experience through it all.


keepbreathing said...

Pedi codes suck.

CountyRat said...

"That's something you don't ever really get over." No, you don't. And you never will. You're not supposed to get over it.

shrtstormtrooper said...
This comment has been removed by the author.
shrtstormtrooper said...

Countyrat: True, but you have to get over things enough to be able to keep working. If I couldn't get over and get past things, I'd consistently be having mental breakdowns.

Seeing an infant die is not something I want to "get over" in the sense of not caring about it; instead I need to be not affected by it so I can move on to other people who need help and not be stuck in one sad place.