Why wouldn’t you want to be an emergency medicine doc?
That week just gone saw the first ‘case’ of ‘swine flu’ in Australia, with the ED continuing to see steady streams of suspected ‘swine flu’ victims, with many of the scenarios nearly as ridiculous as a patient coughing after shaking hands with his sister’s new boyfriend who works in a Mexican restaurant and has a pet pig… Meanwhile over 2000 people have died in Nigeria from a meningitis epidemic that began just before the New Year.
The rest of the week included the fourth presentation to ED (within a week) of a man who somehow manged to get his soupy green diarrhea up the walls of his cubicle.
(Incidentally, that’s probably a good answer to the question: why wouldn’t you want to be an ED nurse?)
There was also the unfortunate nonagenarian whose runaway wheelchair was reputedly in danger of breaking the speed limit as it careened downhill, crossed a main road, then hit an onrushing curb before launching it’s hapless occupant skyward like a human satellite (reminiscent of Clay vs. Liston). Incredibly, the man emerged from this terrifying (exhilarating?) ordeal remarkably unscathed.
There was the lesson on why a young man might try to cut his own throat then hang himself from an overhead rafter. Fortunately as he shifted his weight to the noose around his neck, he decided that the whole thing was a ‘bad idea’ and managed to shift his weight back onto the chair he’d been standing on. How did it all come to this? A profound despondency following two relationship break-ups – each was with a woman that was pregnant, a prostitute, and still using the IV drugs that he was trying to give up.
There was the French-and-German-speaking woman who had a chest infection a few weeks ago and now presented with a headache and clumsiness. It took a while to work out that she was disorientated to time and could not tell left from right, do simple calculations, or name her fingers – which given the difficulties I have speaking just one language, made for a challenging neurological exam. I was saved by the handily available nurse with the French accent. However, all Sherlockian pontifications (Gerstmann’s anyone?) were rendered futile thanks to the wonders of modern diagnostic technology – the INR of 23 (antibiotics for a chest infection and warfarin for a mechanical heart valve make for very runny blood) in combination with an intracranial bleed on the ‘CT head’ led to urgent phone calls to the on-call neurosurgeon and hematologist…
I wonder what next week will bring?
About Chris Nickson
