Who Reads My Blog?

I've always thought this blog was primarily read by my sister, since I don't publicise its existence too much. A few friends know of it, as well as my immediate family, but otherwise I figured it sat in blissful peace in a hidden corner of the Internet.

Anyway. I was rather startled to discover that the keywords associated with my blog are (in order):

"i hate residency"

"hate residency"

"hating residency"

"hate residency" surgery

"i hate being on call"

"i fucking hate residency"

and - most oddly

"newfie has hard time pissing"

This speaks to the toll residency takes on us... I wrote that post in March 2009 and it remains the most-read post of this blog.

I am so grateful that I am no longer a resident...

To all my fellow-residents who stumble across this blog, try to take some comfort in knowing you will also someday finish the retarded shit-filled journey of residency and come out the other side. Don't ever forget what it was like, and try your very best not to perpetuate the cycle by torturing your own residents as an attending.

Code Lesson

" “Call it.”

“The Intern looked at me mid-compression, sweat beaded on his brow.

““Sir?” His voice was unnaturally high.

“You heard me. Call it.”

“She can make it,” he insisted.

I heard another crack crack as he continued the compressions. Surprising – I hadn’t thought there were any ribs left to break. The woman’s arms flopped up and down as he pounded on her naked chest. Bloody froth bubbled up the snorkel I’d jammed down her trachea earlier. It didn’t budge despite the violence of my Intern’s efforts. I pushed aside the guilty pleasure this evoked.

“It’s been forty minutes. She’s gone.”

“No.”

I glanced at the watching nurses. Only the Intern - whose name I couldn’t remember – was still working on the woman. The rest of us had stopped five minutes ago. Always in July, when the new interns arrived, we went through this. The medical schools taught them to fight. Here we would teach them how to cope with losing.

I moved closer to the bed. Touched the woman’s forehead. It was cold and mottled. Shining a light into her glazed eyes, I was satisfied – fixed, dilated pools of unseeing black stared back.

I reached out and took the Intern’s sweat-soaked shoulder. “She’s gone,” I said. “You’re not doing her any favours. She deserves a little dignity.”

“She can make it – she’s only thirty, you said the young have a better chance – we can’t just give up – “ His voice broke.

“Look at the monitor.”

We both stared at the machine.

“What is that rhythm?”

“Asystole.” I could barely hear him.

“And what do you do when you see asystole?”

“Check another lead.”

A nurse switched the machine to a second lead. The flat trace on-screen did not move.

He looked down at his hands, which shook from – exhaustion? emotion? both? I couldn’t tell.

“Call it,” I said.

He unslung the stethoscope from around his neck and placed it against the woman’s breast. I knew there was nothing to hear, no textbook lub-dub lub-dub there, but he listened intently for an eternity before he straightened and made his way to the woman’s head. Shone his penlight into her eyes as I had just moments ago. Nothing there either.

He licked his lips, looked up at the clock. Looked back at me. He looked old, his shoulders stooped. Defeated.

He cleared his throat. “Time of death fifteen forty.”

The nurses moved quickly, an army of worker ants covering up the dead. I watched as they removed all the things with which we had invaded the woman’s body. Lines, catheters, leads – a finger or tube in every orifice was the protocol – with them gone, she looked startlingly human.

The nurses covered her with a blanket, tucked in at the sides. I lingered behind, alone with the woman and the Intern. I watched as he moved to the head of the bed where she still stared at the ceiling. Putting a finger on each eyelid, he nudged them closed.

“I’ll be outside,” I said quietly.

He nodded, unable to meet my gaze.

As I slipped out, I heard him begin to cry.

---written for Creative Writing (Fiction) course

Alzheimer's

Have you seen your mother, Barry? She was just stepping out to get a cup of tea. You know how she is, her and her tea. She’s always been a fan of tea. Now me, I’m a coffee man. I forgot to ask her to make me a cup of coffee. I should have… God, I’d kill for a cup… But she should be back soon. Maybe she’ll have remembered to bring me coffee. She’s a wonderful woman, your Ma. Oh we had some good times…. We met in – in… gosh, I can’t remember, where was it we met?

Jakarta, Pa.

Jakarta… you know, I’ve always struggled with that… sounds too much like that other place, that island one, the one that’s sunny –

You mean Jamaica?

Ja…may…ca…. It doesn’t sit well on my tongue, no sir! But those were the days… Oh! I’m sorry, sir, I was just lost in my thoughts. Are you here to visit someone? I can someone to help you. There’s this little button here, I push it when I need help. Marvelous thing. Who are you visiting? Funny, you look like someone I used to know… a long time ago, it was –

Pa, I’m Peter. Your son, don’t you remember?

Peter? Is that really you? You’re so tall! Your ma would be so proud to see you. Where is that woman? May! May! Peter’s come to visit! She was just here a moment ago. May! Oh, I think she’s gone to the store to get some milk. Anyway, how are you? It’s been such a while since you came to visit. You know, this place isn’t the same without you… it gets so quiet here. I don’t like it but they won’t let me turn on that – that thing – the one that shows pictures, I forget the word –

The TV?

Yes, that’s it. Anyway, they don’t let me turn it on. I bet if your mother was here she’d say screw ‘em and turn it on all the same. Where is she? May! Gosh, will that woman ever come? Have you seen your mother, Barry?

Pa – I don’t know how to say this – she’s gone two years now….

Gone? Oh my god! It’s not true, tell me it’s not true! May! My May… How’s that possible? What will I do without her? Oh, I must call the boys and tell them… whatever will I say? May…

Why, it’s you, Barry! When did you arrive?

It’s Peter, Pa….

So it is! Peter, would you go get your mother? Outside, at the nurses’ desk, they’ll know where to find her. I think she just stepped out for some air. She loves to socialize, you know. Most days I have a heck of a time tracking her down, always did. Be a dear, Peter, just pop out and ask the nurse where your Ma is.

All right, Pa. You stay here. I’ll go ask in a minute.

Ah, what a good fellow! I hope you find that woman. May! I swear she doesn’t pay me any mind at all… women! I wonder if they’ll let me turn on that thing… that – what did you call it again? The one that shows the pictures. I wonder if they have pictures of that place I liked so much. The one with the beaches. That’s where – why are you crying, Barry? Don’t cry… your old Pa is here… it’s going to be all right. Did you skin your knee?

---written for Creative Writing (Fiction) course

Sore Nostril

0200hrs

It is raining heavily outside. Hurricane Igor is approaching, and the roads are slick and wet. The ER is empty - and rightly so, considering the weather conditions.

Then a bedraggled, drenched man in his 30s walks into the department. He checks in at the desk and is triaged. I keep an ear open from my hidden place behind the triage area.

"What brings you out in this awful weather?" the triage nurse asks.

"My bed has bedbugs."

"Yeah, there's an infestation across Canada. But what can we do for you today?"

"Get rid of the bedbugs."

There is a short silence as the triage nurse ponders this serious predicament.

"Sir," I hear him say, "we unfortunately do not exterminate pests here. Go home. Open the Yellow Pages. Look under Pest Exterminators. This is not the place to be coming for bedbugs. Or rats, or insects or wasps for that matter. Now, go home."

And with that, the triage nurse ushers him out the door and gently shuts it.

0400hrs

A 19yo woman checks in at the front desk. I pick the chart up. "Nose Problem", is the chief complaint noted on it.

I read the triage note. The triage nurse is having a hard time keeping a straight face, as a look of utter disbelief is written all over mine.

I call the patient in and wait as she sits down. She is soaked from the sheets of rain pouring down outside.

"What's going on?" I ask, in as neutral a tone as possible.

"My nose hurts. I was picking it all day and now the nostril hurts."

I can't think of anything to say.

"Can I have some cream for it?"

Silently, I stand and reach for the otoscope. I shine the light up the nostril she points at. The mucosa is raw and red.

"You don't need a cream," I say, replacing the otoscope. "You need to stop picking your nose."

"There's no cream that will fix this?"

"No, there's no cream for this. You just have to stop picking your nose."

I can't believe I'm having this conversation - in the back of my mind, I wonder how it's possible that I spent 5yrs in medical school, 3yrs in residency and am now sitting in an ER at 0400hrs advising a woman not to pick her nose.

She's not happy, but she leaves. The triage nurse waits until she is out the door, then bursts into laughter. I roll my eyes at him and go back to my game of Jumbline on my iPhone. Darwin loses another battle.

Feather Shedder

"I'm dying", she said. "I need to be admitted so I can spend my last days in comfort."

I eyed her dubiously, a thirty-something year old woman who looked unkempt and smelled rather noxious.

"What makes you think you're dying?" I asked.

"I saw it in the newspaper," she said. "It announced I was dying."

While I searched for an appropriate response, she dug a piece of paper out of a pocket. Unfolding it, she handed it over to me.

"See?" she said. "It clearly says I am dying."

I perused the ragged piece of paper:

SALE! SALE! SALE!

TIME IS RUNNING OUT!

IT ENDS IN ONE WEEK!

"I don't understand," I said. "Where does it say you're dying?"

She sighed impatiently and pointed at the words. "Don't you see?" she said, as if speaking to a child. "Time is running out! I'm going to die in one week!"

I scratched my head.

"Hmmm. Are you feeling ill? Is anything out of the ordinary happening?"

She bit her lip. "My body is collapsing."

"Oh."

"I'm telling you - there's something terribly wrong with me!"

"Can you describe what's happening in your body? It might help me understand better."

Wringing her hands, she stood up and began pacing about the small examination room. "I'm shedding feathers... everywhere I go I'm shedding feathers. And I'm passing out often. And when I use the bathroom, I'm pooping feathers!"

"Feathers."

"Yes! It's a sign! When angels die, their feathers start falling off! That's what's happening to me!"

"You're an angel?"

"Are you one of them?"

I frowned. "One of whom?"

"Them. Are you one of them?"

"I'm not sure. Tell me... have you been taking your medications lately?"

"No, I won't take them! I'm supposed to take my medications as cold fusion monotherapy, and my medications are warm so it's poison."

"I see."

I pondered the situation for a moment, and then a brilliant idea seized me.

"Listen, I think I know what we should do."

"You think I'm crazy, don't you?"

"No," I lied smoothly. "I don't think you're crazy, but some of the things you're telling me sound quite unusual. I think that the best thing to do would be to have the psychiatrists declare that you're NOT crazy, and once they see you and decide you're not crazy, maybe we can look into finding you a nice place to spend the last days of your life in comfort. But, you see, this would be difficult until and unless the psychiatrists declared that you aren't crazy first."

Even as the words left my mouth, I was uncomfortably aware that I didn't make sense to my own self. I hoped she wouldn't pick up on it.

"Oh," she said. "So if I see the psychiatrist and they realise I'm not crazy then I can get some help?"

"Yup."

"Okay," she said.

So we sent her to the psychiatric hospital, where they admitted her and medicated her such that the problem of her feather-shedding resolved.

Creep

Him: "Doctor, I've been having pains in my stomach."

Me: "How long have you had this for?"

Him: "Two months, Doc."

Me: "And why are you in the ER at 3am instead of calling your family doc??"

Him: "I couldn't get satisfaction from the GP."

Me: (eyebrows raised) "Can't get no satisfaction."

Him: "Yes, I can't get in till tomorrow!"

Me: "OK... any nausea? Vomiting? Diarrhea?"

Him: "No."

Me: "Problems peeing? Bowel movements?"

Him: "No, that's all fine."

Me: (palpating his abdomen) "Tender at all?"

Him: "No."

Me: (pulling the drape back over him) "Well, your belly is nice and soft. I don't think there's anything terrible going on in there, you know?"

Him: "Wait, Doc! Can you press here again?" (he gestures towards his lower abdomen, near his pubic area)

Me: "I already did that."

Him: "No, I'd like you to do it again."

Me: "I'm sorry, but I'm not repeating that exam."

Him: "But really, Doc, can't you just press there again?"

Me: "Sir, I don't think there's anything wrong with your belly. I'm discharging you and I am not pressing there again."

A Long Hiatus

I assumed that nobody really reads this blog, but having taken a long hiatus from writing in it, I kept getting asked by some people as to "what happened" to my writing!

Life has been BUSY leaving me little time for "creative" writing. Since I last wrote, I began taking a course at Memorial University in playwriting. And being required to write about 3 pages of dialogue and scenes every week has taken its toll on any other writing. Thus, the paucity of entries lately.

That's not to say that work hasn't seen its fair share of "odd cases" - I simpy haven't had the time or wherewithal to document them for anyone's reading pleasure! It still amazes me how much variety I see in my line of work. Scattered among the bread-and-butter is always something weird and wonderful. In the herd of horses that come my way, there is often a zebra hidden somewhere.

Outside of work, I recently played at my first-ever cello recital. It was an awful affair. First, I arrived late. (The Starbucks line was unusually long, I was sleep-deprived and needed one desperately, and the venue for the recital was someone's house in an area of town I had never been to). I was third on the program, and had a terrible case of the nerves. All the other cellists seemed to acquit themselves marvellously, but I have an unfortunate habit of making faces when something is out of tune. This habit also manifests itself in choir practices and even performances so the recital was no different. My terrible playing was thus accompanied by (potentially more) terrible faces. Thank God for my teacher's wife who gamely accompanied me on the piano. Her lovely playing at least offered some redemption.

Oddly, I got numerous gracious compliments from the people at the recital. I think it is probably because I out-age the other cellists by a decade or so. Adult beginners, apparently, get cut more slack. People admire us for our guts in picking up an instrument about 25yrs later than most - and then playing horribly in front of guests. The other thing I learned from my cello recital was that I shall still be making "noise" in 10yrs time. It really struck me that some of the students, despite having played for 10yrs, still don't have as fluid or wonderfl a tone on the cello as, say, my teacher. Of course, he is a professional cellist (and the principal cellist of the orchestra, no less) - but still... after 10yrs of playing piano one can play some pretty impressive pieces, no? Not so for the cello.

In any case, I guess - to use a rather grotesque term - I "popped my cherry" in the world of recitals. Amazing that I did so with the cello. I'd never played at a recital, not even the piano which was what I was originally trained in. It's always hardest the first time around, so maybe next year will see me pulling off a maestro-like performance. Ha.

Anyway. Back to the original purpose of this blog. Because I'm sure you all can't wait to hear more tales from the land of the ER. No promises for regular updates, though!