Around the time that interviews started this Fall, making the trip across the Bay became less and less frequent for me. Ironically (even hypocritically), my personal statement for medical school is about riding the shuttle to The Hospital.
Over the last three years, as my colleagues stopped volunteering for
personal, work, or professional reasons, I always maintained that I
would faithfully serve until I moved away for medical school. I sacrificed much to be at The Hospital as an undergrad at Berkeley. And even when I regularly showed up an hour late to Large Group, having not eaten dinner, exhausted and soaked from walking in the rain, I knew God's calling for me was to serve in this way. It has changed my life forever. And I loved it. I've probably logged over 1,000 hours volunteering, but I helped to implement the electronic tracking system some time during my second year, so I guess we'll never know.
This past summer, the weariness started to set in. I simply saw one too many broken bodies and broken lives in the Emergency Department (I recall one particular car accident on one particular day caused me to burst into tears). And that was that. I reluctantly put away my scrubs and said goodbye to serving the community I loved, so entrenched in drugs, poverty, violence, and abuse....until I joined the Pain Clinic at The Hospital. I figured that it would be a good way to cling to my conviction of serving the same people, only in a less traumatic and less heart-wrenching way.
At the Pain Clinic, I told myself it was the boredom. I wasn't needed there. Being needed is the number one reason why I do anything in life, and without it, I feel purposeless. At the Pain Clinic, it didn't matter if I showed up or not, there was nothing for me to contribute. The doctor didn't remember my name even after six months. He would always--not very inconspicuously--sneak a peek at my name badge during the morning meetings, and if my badge was obscured, I would just be Hello there.
In some ways, being at the Pain Clinic was more heart-wrenching than being in the Emergency Department. The ED was a beacon of hope and brimming with life-saving bustle. The Pain Clinic was an experimental dose of maybe-this-will-help, and the patients must live with persistent suffering from chronic pain. I found ambulatory care boring and uninvolved. When my interviews for medical school started in the fall, I was happy to fade away without anyone noticing.
I haven't been to The Hospital in months, due in part to a flu shot technicality. But the day has come. Tomorrow, I am going in to inform Boss Man that I am not coming back, for good. It feels strange to me that I will be boarding the shuttle tomorrow (does it still run?) just like I did all of those years, but am actually quite nervous. How strange it is for me to return to a routine once familiar, and now so dreaded. I am mourning the loss of a big part of my life, much like when I graduated college and left IV. But new beginnings occur when we least expect them, right?
I'm bringing Boss Man some lemon bundt cake.
Showing posts with label The Hospital. Show all posts
Showing posts with label The Hospital. Show all posts
Friday, January 04, 2013
Friday, October 12, 2012
OREX: the conclusion
Remember how excited I was one year ago about OREX at The Hospital? Well, I missed my last surgery observation day a couple of weeks ago, and I'm missing the final meeting on Saturday due to a pesky medical school interview. Oh well!
OREX has been really amazing. But honestly, on many days, I didn't feel like waking up at 5am to bus to The Hospital in darkness--my safety feels threatened as it is in the daylight. I didn't feel like standing stiffly for 3, 4, 5, 6 hours in refrigerator-like operating rooms and smelling my own breath under my surgical mask. I didn't feel like hiding invisibly in the corner for fear of disrupting that magical surgical flow....or touching anything sterile that will potentially have serious consequences. But man. What a great opportunity. I will admit that even before I started volunteering at The Hospital, I had my sights set on being one of those 15 people who get to stand bedside in that operating room floor. I tried my best to not squander that privilege, or let my hunger, impatience, or desire to sleep in dilute my experience.
I read through a lot of my old OREX forum submissions in preparation for said interview, and wanted to share a couple with you. I've changed the names, but everything else I left in gory detail. Read on if you're into that kind of stuff! :)
FESS-- “Functional Endoscopic Sinus Surgery”
Dr. McDonald was performing a FESS procedure on a middle-aged male patient with polyps in his sinus cavity and a deviated septum. The procedure is done with a probe camera, and so it was very clear and easy to see on screen, just as Dr. McDonald had promised. He started with inserting the camera into the nose, past the nose hair forest, and it revealed many grayish blobs in the nasal cavity. These are polyps, or abnormal growths in the mucous membrane. They were simple to remove: a long device was simply inserted and clamped around the base of the polyp to pull it out of the nose. The motion was really as simple as clamping and yanking. Some bleeding ensued, but the blood was staunched later with packing of gauze after all polyps were removed. I’m normally not squeamish, but when Dr. McDonald dangled an especially large 2-inch blob of mucous-dripping tissue near my face, I had to turn away for just a minute. A microdebrider called "the hummer" was used to cut away excess tissue around the sinuses to further open the airway. I marveled at how clear the sinuses looked after removing about a dozen polyps from the man’s sinus cavities, and how in the world he managed to breathe before the procedure.
Laparoscopic superovarian cystectomy and partial hysterectomy
The patient was a 44-year old woman who had a right ovarian cyst that measured 7cm in diameter, heavy menstrual bleeding, and uterine fibroids. Dr. Do explained that the woman would need to have her uterus, cervix, and fallopian tubes removed, but ovaries intact. She said that they didn’t want to induce early menopause in the woman and have to resort to estrogen therapy sooner than necessary. With patient in stirrups on the table, an incision was made in the belly button and widened by wedging metal prongs. The special camera was then inserted and just as images of adipose tissue and underlying tissues were showing up on the screen, everything was shut down abruptly. I asked Dr. Do what was going on, and she said that the nature of the cyst made laparoscopic surgery too risky, and an open cystectomy had to be performed. It turns out that the cyst was an endometrioma, or “chocolate cyst.” This occurs when the endometrial lining that is normally in the uterine wall and sloughs off during menses forms an outpocketing elsewhere, and thus the blood pools within in a membrane without being drained. The result is a dark brown-colored fluid-filled cyst.
A longincision was made in above the pubic line, and a circular metal retractor was used to hold open a space of about six inches in diameter. The plan was to drain and excise the cyst without touching the ovaries. Eventually 300 mL of brownish fluid was drained and its jellylike membrane was removed. Occasionally, Dr. Do would ask the anesthesiologist if the urine was clear or not--this was because the area of interest is very close to the bladder and ureters, and if it were disrupted, blood would appear in the urine. Luckily, there were no complications at this point. Two hours later, the uterus had been carefully sutured around and removed as well. It came out in three pieces--the apple-sized fundus (body), the smaller neck, and the cervix, a coin-sized, whitish donut of a specimen. The left fallopian tube was also removed, as were many little cysts that looked like clear yellow vitamin E tablets. Dr. Do later had me put on gloves to palpate the pieces in formaldehyde solution before they got sent to pathology lab, and it was neat.
Dental Extraction
Wound Debridement
I followed my curiosity and went to OR 5, which the white board had listed simply as a “wound debridement,” which in my experience, wasn’t a particularly interesting procedure. But I peeked in, and was immediately intrigued by the sight of a young Asian girl was sedated on her side with her left leg up to her hip entirely eaten away by necrosis. The fat and muscle on her buttock was putrefied and left the area concave. There appeared to be no healthy skin left on her leg; only exposed muscle with blotches of black skin and pus. My immediate thought was, “How in the world does this happen?”
..........
These were just a few of many things that I saw over a period of one year. I'm incredibly grateful that God has opened my eyes to this type of work, and for the restorative nature of surgery.
OREX has been really amazing. But honestly, on many days, I didn't feel like waking up at 5am to bus to The Hospital in darkness--my safety feels threatened as it is in the daylight. I didn't feel like standing stiffly for 3, 4, 5, 6 hours in refrigerator-like operating rooms and smelling my own breath under my surgical mask. I didn't feel like hiding invisibly in the corner for fear of disrupting that magical surgical flow....or touching anything sterile that will potentially have serious consequences. But man. What a great opportunity. I will admit that even before I started volunteering at The Hospital, I had my sights set on being one of those 15 people who get to stand bedside in that operating room floor. I tried my best to not squander that privilege, or let my hunger, impatience, or desire to sleep in dilute my experience.
I read through a lot of my old OREX forum submissions in preparation for said interview, and wanted to share a couple with you. I've changed the names, but everything else I left in gory detail. Read on if you're into that kind of stuff! :)
FESS-- “Functional Endoscopic Sinus Surgery”
Dr. McDonald was performing a FESS procedure on a middle-aged male patient with polyps in his sinus cavity and a deviated septum. The procedure is done with a probe camera, and so it was very clear and easy to see on screen, just as Dr. McDonald had promised. He started with inserting the camera into the nose, past the nose hair forest, and it revealed many grayish blobs in the nasal cavity. These are polyps, or abnormal growths in the mucous membrane. They were simple to remove: a long device was simply inserted and clamped around the base of the polyp to pull it out of the nose. The motion was really as simple as clamping and yanking. Some bleeding ensued, but the blood was staunched later with packing of gauze after all polyps were removed. I’m normally not squeamish, but when Dr. McDonald dangled an especially large 2-inch blob of mucous-dripping tissue near my face, I had to turn away for just a minute. A microdebrider called "the hummer" was used to cut away excess tissue around the sinuses to further open the airway. I marveled at how clear the sinuses looked after removing about a dozen polyps from the man’s sinus cavities, and how in the world he managed to breathe before the procedure.
Laparoscopic superovarian cystectomy and partial hysterectomy
The patient was a 44-year old woman who had a right ovarian cyst that measured 7cm in diameter, heavy menstrual bleeding, and uterine fibroids. Dr. Do explained that the woman would need to have her uterus, cervix, and fallopian tubes removed, but ovaries intact. She said that they didn’t want to induce early menopause in the woman and have to resort to estrogen therapy sooner than necessary. With patient in stirrups on the table, an incision was made in the belly button and widened by wedging metal prongs. The special camera was then inserted and just as images of adipose tissue and underlying tissues were showing up on the screen, everything was shut down abruptly. I asked Dr. Do what was going on, and she said that the nature of the cyst made laparoscopic surgery too risky, and an open cystectomy had to be performed. It turns out that the cyst was an endometrioma, or “chocolate cyst.” This occurs when the endometrial lining that is normally in the uterine wall and sloughs off during menses forms an outpocketing elsewhere, and thus the blood pools within in a membrane without being drained. The result is a dark brown-colored fluid-filled cyst.
A longincision was made in above the pubic line, and a circular metal retractor was used to hold open a space of about six inches in diameter. The plan was to drain and excise the cyst without touching the ovaries. Eventually 300 mL of brownish fluid was drained and its jellylike membrane was removed. Occasionally, Dr. Do would ask the anesthesiologist if the urine was clear or not--this was because the area of interest is very close to the bladder and ureters, and if it were disrupted, blood would appear in the urine. Luckily, there were no complications at this point. Two hours later, the uterus had been carefully sutured around and removed as well. It came out in three pieces--the apple-sized fundus (body), the smaller neck, and the cervix, a coin-sized, whitish donut of a specimen. The left fallopian tube was also removed, as were many little cysts that looked like clear yellow vitamin E tablets. Dr. Do later had me put on gloves to palpate the pieces in formaldehyde solution before they got sent to pathology lab, and it was neat.
Dental Extraction
I
followed Jackson to the dental extraction performed by Dr.
Garvin and Dr.Wu. Dr. Garvin explained that on Tuesdays,
they perform surgeries for people with special needs. Having worked with
special needs students in college, I was touched by this fact. The patient needed to have teeth 1, 16, 29, 28, 27, 26, and 22--all of the rest of
his teeth!--extracted because they were decayed. Due to his history of
seizures and treatment history, this more challenging case was done in
Surgery and not in the Dental Clinic in the Old Building. The procedure
itself was reminiscent of going to the dentist office, with gum scraping
and forceful pliers rotation. Since the mouth is a small space to work
in, Dr. Garvin would tell me to come closer, and even moved out of
the way to show me the exposed jawbone! They needed to smooth the jaw
bone down, remove excess gum tissue, and suture up the gaping holes.
Special needs patients don’t do well with dentures, Dr. Wu told me.
Thus, the patient will probably have to chew with his gums from now on.
I followed my curiosity and went to OR 5, which the white board had listed simply as a “wound debridement,” which in my experience, wasn’t a particularly interesting procedure. But I peeked in, and was immediately intrigued by the sight of a young Asian girl was sedated on her side with her left leg up to her hip entirely eaten away by necrosis. The fat and muscle on her buttock was putrefied and left the area concave. There appeared to be no healthy skin left on her leg; only exposed muscle with blotches of black skin and pus. My immediate thought was, “How in the world does this happen?”
It turns out that this 18
year-old girl was hit by a bus two weeks ago, and was rushed as a Level 1
Trauma to The Hospital ED. She has been in and out of consciousness in the
ICU for the last two weeks, and doesn’t know the state of her leg, which
became infected from a hip fracture. The doctors said that they’ve
never seen anyone survive an injury of this magnitude.
The
worst part is, the doctors had wanted to amputate for some time now,
but the family had refused it. The only consent the
surgeons received was to clean the wound and debride it. Perhaps the
family still hoped that the leg could be saved. “If not amputated soon,
the girl will die of uncontrollable sepsis. The only reason her body is
holding on is because she’s young,” a nurse told me. It was all very sad
to see the nine doctors and nurses crowd the table, sullenly stripping
away some of the necrotic fat and tissues while murmuring about the
tragedy at hand. After some whirring of the microdebrider, the procedure
ended anticlimactically with bandaging up the bloody slab of a leg.
Since the infection had spread up her hip and lower back, her entire
pubic area was agape as well and her lower abdomen had to be packed with
several packages of acrylic gauze. Joan had said that because most of
the buttocks was gone, the anus may become a freestanding protrusion of
the intestine--if the girl survives.
It shocked me that a pelvic fracture is one of the most life-threatening fractures a person can sustain, because the pelvic region is so highly vascularized. It also shocked me that bacteria can eat away at an entire leg in a matter of days. I’ve read Atul Gawande’s book, Complications, in which a case of necrotizing fasciitis was destroying tissue before the surgeon’s eyes. (I highly recommend reading the book if you haven’t already, and also Better.) The images stay with you. But perhaps one of you OREX-ers in the next coming days will be able to witness the follow-up amputation surgery and share some good news.
It shocked me that a pelvic fracture is one of the most life-threatening fractures a person can sustain, because the pelvic region is so highly vascularized. It also shocked me that bacteria can eat away at an entire leg in a matter of days. I’ve read Atul Gawande’s book, Complications, in which a case of necrotizing fasciitis was destroying tissue before the surgeon’s eyes. (I highly recommend reading the book if you haven’t already, and also Better.) The images stay with you. But perhaps one of you OREX-ers in the next coming days will be able to witness the follow-up amputation surgery and share some good news.
..........
These were just a few of many things that I saw over a period of one year. I'm incredibly grateful that God has opened my eyes to this type of work, and for the restorative nature of surgery.
Friday, August 10, 2012
Two stories from The Hospital
"Hey the red light is on, can you check the back door?"
The shuttle driver had just strapped in a wheelchair-bound patient in the back, and was starting to pull away from The Hospital. The woman who asked about the light is concerned that the back door isn't properly closed.
"Naw, that's so it'll be easier for you to jump out during a fire," the driver jokes. The whole shuttle, filled with patients and health care personnel, laughs. Except for me. I don't joke about safety. We drive down the hill, and then the back door flings open. I roll my eyes and count the people in the shuttle. In case you were wondering, no one was hurt.
Today at the Pain Clinic, I sat with Dr. K on six different cases. To give you an idea of what the clinic is like, the patients that we see have some sort of chronic pain. To qualify for acceptance to this program, the pain must be non-cancer-related, and must be inoperable. Patients must sign a pledge to give up illicit street drugs, and commit to a 12-week group psychoeducation program. They also have the option of physical therapy at The Hospital. Most patients are prescribed opiates. Dr. K strongly believes in buprenorphine, and has invited me to join in his clinical research on its effects. I would have to commute to his other office in Mill Valley though, so I'm not entirely on board with the idea yet. And plus, I don't even know much about it myself.
My only job as a volunteer is to bring the patient in from the waiting room. That's it. Totally different from volunteering in the ED. Then I sit and listen to the visit, and bring the patient back out when Dr. K is done.
Each case was more depressing than the last. Patients hobbled in, heavily dependent on canes and railing support because walking is too painful for them. Patients told me about their pending lawsuits against their workplaces that caused their injuries. They talked about staying in bed for two days because they just can't move, work, walk, or eat. Two patients cried today, partly because they ran out of antidepressants, and partly because they can't afford to refill them. One patient said she almost ended her life yesterday because the pain was too unbearable.
It really makes me think, is there anything happy in medicine, or is it just suffering, all the time?
Dr. K just nods and says "Okay" a lot. Then he makes me count their pills, re-evaluates their medications, adjusts them to a higher dosage, and off the patients go. Six pills instead of four, a whole patch instead of a half, cut those tablets in half if you feel too jittery, decrease the medication if you are too drowsy. It's an entirely different type of intervention from what I've experienced before, and I've been in many many different clinical settings. I guess I'd never realized how fluid medicine can be, and how yes, in the end, treatments are experimental and not an exact science. Fancy that, medicine isn't a science. Also, Dr. K wears an iPod earbud in one ear, and so I get the distinct impression that he isn't listening. But I'm sure he is.
When I brought the last patient into the room, I thought that maybe it would be prudent if I left. Sometimes patients don't like volunteers being in the room, which I completely understand--I wouldn't want me sitting in on my doctor visit either, even if no clothes are being removed. But then the patient started talking about her kids' back to school expenses, her weight loss (now she's 198 lbs), and her trip to Memphis. We bonded over that--I've been to Memphis before, also. She said that the medications that she was on were aiding in her life greatly. She testified to the miracle healing powers of epson salt baths (well okay, mixed with Flexeril, a muscle relaxant), and said that her life is starting to look up. That made today worth it. I wanted to tell her that given all she's been through, that she was an amazing woman.
Another heartwarming tidbit: whenever I visit Boss Man at the volunteer office, he always throws up his arms and says, "Connie!" like he's really excited to see me. Today, he handed me a Hospital lanyard with one of those retractable badge holders with a post-it that said "For Connie." I had mentioned a couple of weeks ago that I wanted one, and now I have one. Yay!
The shuttle driver had just strapped in a wheelchair-bound patient in the back, and was starting to pull away from The Hospital. The woman who asked about the light is concerned that the back door isn't properly closed.
"Naw, that's so it'll be easier for you to jump out during a fire," the driver jokes. The whole shuttle, filled with patients and health care personnel, laughs. Except for me. I don't joke about safety. We drive down the hill, and then the back door flings open. I roll my eyes and count the people in the shuttle. In case you were wondering, no one was hurt.
Today at the Pain Clinic, I sat with Dr. K on six different cases. To give you an idea of what the clinic is like, the patients that we see have some sort of chronic pain. To qualify for acceptance to this program, the pain must be non-cancer-related, and must be inoperable. Patients must sign a pledge to give up illicit street drugs, and commit to a 12-week group psychoeducation program. They also have the option of physical therapy at The Hospital. Most patients are prescribed opiates. Dr. K strongly believes in buprenorphine, and has invited me to join in his clinical research on its effects. I would have to commute to his other office in Mill Valley though, so I'm not entirely on board with the idea yet. And plus, I don't even know much about it myself.
My only job as a volunteer is to bring the patient in from the waiting room. That's it. Totally different from volunteering in the ED. Then I sit and listen to the visit, and bring the patient back out when Dr. K is done.
Each case was more depressing than the last. Patients hobbled in, heavily dependent on canes and railing support because walking is too painful for them. Patients told me about their pending lawsuits against their workplaces that caused their injuries. They talked about staying in bed for two days because they just can't move, work, walk, or eat. Two patients cried today, partly because they ran out of antidepressants, and partly because they can't afford to refill them. One patient said she almost ended her life yesterday because the pain was too unbearable.
It really makes me think, is there anything happy in medicine, or is it just suffering, all the time?
Dr. K just nods and says "Okay" a lot. Then he makes me count their pills, re-evaluates their medications, adjusts them to a higher dosage, and off the patients go. Six pills instead of four, a whole patch instead of a half, cut those tablets in half if you feel too jittery, decrease the medication if you are too drowsy. It's an entirely different type of intervention from what I've experienced before, and I've been in many many different clinical settings. I guess I'd never realized how fluid medicine can be, and how yes, in the end, treatments are experimental and not an exact science. Fancy that, medicine isn't a science. Also, Dr. K wears an iPod earbud in one ear, and so I get the distinct impression that he isn't listening. But I'm sure he is.
When I brought the last patient into the room, I thought that maybe it would be prudent if I left. Sometimes patients don't like volunteers being in the room, which I completely understand--I wouldn't want me sitting in on my doctor visit either, even if no clothes are being removed. But then the patient started talking about her kids' back to school expenses, her weight loss (now she's 198 lbs), and her trip to Memphis. We bonded over that--I've been to Memphis before, also. She said that the medications that she was on were aiding in her life greatly. She testified to the miracle healing powers of epson salt baths (well okay, mixed with Flexeril, a muscle relaxant), and said that her life is starting to look up. That made today worth it. I wanted to tell her that given all she's been through, that she was an amazing woman.
Another heartwarming tidbit: whenever I visit Boss Man at the volunteer office, he always throws up his arms and says, "Connie!" like he's really excited to see me. Today, he handed me a Hospital lanyard with one of those retractable badge holders with a post-it that said "For Connie." I had mentioned a couple of weeks ago that I wanted one, and now I have one. Yay!
Wednesday, July 11, 2012
On the contrary
I have a secret to share. On this blog, I have written a bunch of stock posts (such as the previous one) that really have nothing to do with my current life. When things on my end feel uninteresting or I'm stuck in a rut, out come the random topics, elaborated on in more-than-you-care details. Stay tuned for thoughts on laundry, graduation gifts, ever-changing book lists, even a post titled "Things People Said That Have Stuck With Me #2." It keeps things spicy, I know. Hah.
In the last weeks, I've plunged into the dreariness of working nearly full-time at a high-stress job and the emotional drain that followed certain recent events. In short, I've decided to take a leave from the emergency department and instead, shadow at the pain management clinic at The Hospital. When contacting my department lead friends, I decided that pain management sounds pretty good to me right now. Since it's an integrative treatment clinic, maybe I'll even get to sit in on some psychiatry sessions for my own mental well-being tomorrow. Fingers crossed.
But this all sounds like I'm spiraling into some miserable abyss. I'm not! I've been able to find simple joys in the everyday. Here is photographic proof of such joy:
See? We are able-bodied, healthy, young friends enjoying the sunshine! Which is at least four things more than I can say for most people I interact with on a daily basis. What a blessing that is.
I've been realizing more and more that everything is about posture. Posture before people, posture before self, posture before God.The sooner I accept grace, the better I can reflect it.
In the last weeks, I've plunged into the dreariness of working nearly full-time at a high-stress job and the emotional drain that followed certain recent events. In short, I've decided to take a leave from the emergency department and instead, shadow at the pain management clinic at The Hospital. When contacting my department lead friends, I decided that pain management sounds pretty good to me right now. Since it's an integrative treatment clinic, maybe I'll even get to sit in on some psychiatry sessions for my own mental well-being tomorrow. Fingers crossed.
But this all sounds like I'm spiraling into some miserable abyss. I'm not! I've been able to find simple joys in the everyday. Here is photographic proof of such joy:
See? We are able-bodied, healthy, young friends enjoying the sunshine! Which is at least four things more than I can say for most people I interact with on a daily basis. What a blessing that is.
I've been realizing more and more that everything is about posture. Posture before people, posture before self, posture before God.The sooner I accept grace, the better I can reflect it.
Sunday, June 24, 2012
Better than TV
I decide to put on another piece of clothing before leaving for dinner with my mother. It's chilly out, and we are walking to a Korean restaurant nearby my house. After a minute of contemplation, I decide to wear my Hospital sweatshirt, which I hadn't worn for months. On the front, it says "Emergency," and on the back, it says, "Hospital ER, Better Than TV."
My mother and I walk to the restaurant, and are seated at a table for four. We order the combination tofu soup and bulgogi, which is a better deal than if you were to order them separately.
As we wait for our banchan to come, my mother waves hello to someone at the table behind me. "My students," she smiles. My mom is very popular. I think that if she had a Facebook, she'd have more friends than I do. I turn and look.
At that moment, a peculiar scene catches my eye: seated at the head of that table, an old woman in a wheelchair. Her back is facing me, but it's apparent that she has choked on something. The uncles are prying into her mouth and patting her back. I turn back to my mother and we continue talking.
I tell my mom a story in which one of the doctors at the office told me that in an emergency situation (like for example, a birth on an airplane) if someone asked, "Is there a doctor here?" she would not volunteer. Ophthalmology is a very specific field, and she said she would not be useful in any emergency. My mother chuckles.
A minute or two later, there is commotion at the table behind me. "She's turning purple!" a waitress exclaims. The old woman who choked is apparently not breathing. The waitress hoists the old woman upright in her wheelchair and tries the heimlich unsuccessfully. At this point, the entire restaurant (which happened to be full) turns to watch. One of the grandchildren starts to cry. An aunt calls 911. The uncles lift her out of the wheelchair and lays her down on the floor.
At this point, a waitstaff starts CPR. I get up from our table, and tell her that I am also trained, and roll up my sleeves. I instruct the uncle to take the chopstick out of her mouth (what the heck?) and tilt back her chin, and take over the chest compressions.
The old woman was completely purple. How did no one notice at the table? Perhaps she wasn't very verbal to begin with. I actually feel the sternum crack as I compress, but I don't stop. There is no stopping. Not until the paramedics get here.
The paramedics arrived with their fancy equipment and take over CPR. I stand up awkwardly, slightly sweaty, and avoid the eyes of all of the diners. I look at my mother. Her face is stern but relieved. What should I do? Sit back at my table? The waitress who brought our food is standing and sobbing with the tray of banchan.
I decide to just stand by and pray. I tie my hair back, since it flounced back and forth into my face while I did compressions. I really hope no one is looking at the words on my sweatshirt. Oh, the irony. A paramedic interrupted my selfish thoughts and asked me to do CPR again. They cut away the old woman's clothing and suction out food to try to intubate her. I pump, pump, pump.
I'm not sure what happened after. At some point, I was told to stop so the woman could be strapped into a gurney and whisked away. I straighten up. One of the uncles thanks me for helping his mother. I nod. The entire family of perhaps twelve people leave the restaurant in tears. My mother waves a sad goodbye to her students.
I sit down next to my mother. We stare at the food, now cold. Neither of us really wants to eat. A woman at the adjacent table asks me if I'm a nurse, and I mumble something about volunteering at an ER. She said, "It was good that you are here!"
Was it really?
Earlier in the day, D and I talked about the cost of pursuing medicine. I prayed in that moment that I would receive affirmation from God that this is the way that He wants me to live. Was this it? What makes the pursuit worth it? A life saved (or not)? Or is it the purposefulness of being able to stand up, and take action when everyone else watches helplessly?
How different it is to do CPR in an emergency room, than to do CPR at a restaurant. My mother and I tried to eat our dinner in peace, which is hard to do after that ordeal. My arms are quivering from the compressions, and I can't quite use chopsticks correctly. We eat slowly and sullenly, ruminating on life and purpose. I pray that the old woman made it, and for the family to remember to love each other more.
My mother and I walk to the restaurant, and are seated at a table for four. We order the combination tofu soup and bulgogi, which is a better deal than if you were to order them separately.
As we wait for our banchan to come, my mother waves hello to someone at the table behind me. "My students," she smiles. My mom is very popular. I think that if she had a Facebook, she'd have more friends than I do. I turn and look.
At that moment, a peculiar scene catches my eye: seated at the head of that table, an old woman in a wheelchair. Her back is facing me, but it's apparent that she has choked on something. The uncles are prying into her mouth and patting her back. I turn back to my mother and we continue talking.
I tell my mom a story in which one of the doctors at the office told me that in an emergency situation (like for example, a birth on an airplane) if someone asked, "Is there a doctor here?" she would not volunteer. Ophthalmology is a very specific field, and she said she would not be useful in any emergency. My mother chuckles.
A minute or two later, there is commotion at the table behind me. "She's turning purple!" a waitress exclaims. The old woman who choked is apparently not breathing. The waitress hoists the old woman upright in her wheelchair and tries the heimlich unsuccessfully. At this point, the entire restaurant (which happened to be full) turns to watch. One of the grandchildren starts to cry. An aunt calls 911. The uncles lift her out of the wheelchair and lays her down on the floor.
At this point, a waitstaff starts CPR. I get up from our table, and tell her that I am also trained, and roll up my sleeves. I instruct the uncle to take the chopstick out of her mouth (what the heck?) and tilt back her chin, and take over the chest compressions.
The old woman was completely purple. How did no one notice at the table? Perhaps she wasn't very verbal to begin with. I actually feel the sternum crack as I compress, but I don't stop. There is no stopping. Not until the paramedics get here.
The paramedics arrived with their fancy equipment and take over CPR. I stand up awkwardly, slightly sweaty, and avoid the eyes of all of the diners. I look at my mother. Her face is stern but relieved. What should I do? Sit back at my table? The waitress who brought our food is standing and sobbing with the tray of banchan.
I decide to just stand by and pray. I tie my hair back, since it flounced back and forth into my face while I did compressions. I really hope no one is looking at the words on my sweatshirt. Oh, the irony. A paramedic interrupted my selfish thoughts and asked me to do CPR again. They cut away the old woman's clothing and suction out food to try to intubate her. I pump, pump, pump.
I'm not sure what happened after. At some point, I was told to stop so the woman could be strapped into a gurney and whisked away. I straighten up. One of the uncles thanks me for helping his mother. I nod. The entire family of perhaps twelve people leave the restaurant in tears. My mother waves a sad goodbye to her students.
I sit down next to my mother. We stare at the food, now cold. Neither of us really wants to eat. A woman at the adjacent table asks me if I'm a nurse, and I mumble something about volunteering at an ER. She said, "It was good that you are here!"
Was it really?
Earlier in the day, D and I talked about the cost of pursuing medicine. I prayed in that moment that I would receive affirmation from God that this is the way that He wants me to live. Was this it? What makes the pursuit worth it? A life saved (or not)? Or is it the purposefulness of being able to stand up, and take action when everyone else watches helplessly?
How different it is to do CPR in an emergency room, than to do CPR at a restaurant. My mother and I tried to eat our dinner in peace, which is hard to do after that ordeal. My arms are quivering from the compressions, and I can't quite use chopsticks correctly. We eat slowly and sullenly, ruminating on life and purpose. I pray that the old woman made it, and for the family to remember to love each other more.
Friday, April 20, 2012
Think about these things
I've been tremendously guilty of being a downer when it comes to recounting my emergency department experiences without being aware of it. For anyone who's felt heavy and depressed after reading my posts, I sincerely apologize. It is my nature to gravitate toward the less appealing side of whatever it is I'm doing, although that tends to be draining in more ways than I know.
Let's be clear; the emergency department is not a place that happy people go to. It's not like a newborn infant ward, or even a dermatology clinic. There are issues that I felt important to recount from a perspective that I personally have never heard others share about. But, even so, I will do my best to be more positive both in the ED, and to share with you more uplifting stories!
Let's be clear; the emergency department is not a place that happy people go to. It's not like a newborn infant ward, or even a dermatology clinic. There are issues that I felt important to recount from a perspective that I personally have never heard others share about. But, even so, I will do my best to be more positive both in the ED, and to share with you more uplifting stories!
Finally, brothers, whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable, if there is any excellence, if there is anything worthy of praise, think about these things. What you have learned and received and heard and seen in me—practice these things, and the God of peace will be with you. -Philippians 4:8-9
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| Oh, look! Here's a photo of our surgery observation members. It's not really related, but....eh. |
Wednesday, April 04, 2012
Some things you can't unsee
There is frenzied movement in the ED. Patients are moved to free up trauma beds. Machines are wheeled and positioned. Thick absorbent bedding is laid down. Blue gowns and splash guard visors are put on.
All in anticipation of a horrific event. The paramedic radios tell us that multiple victims are wounded, but everything else is speculation. A Code Triage External is sounded while rumors are whispered. It's a college. No, I heard it's a nursing home. No, I heard it's an adult school. Everyone is on edge until that first victim comes through the ambulance bay doors.
It's loud in the ER. Twenty-five people are swarming around one bed--ED doctors, nurses, the surgical team from the 5th floor, blood bank techs, ultrasound techs, x-ray techs, EMTs, police officials, heck, even social workers and us, the lowly volunteers.
L and I clutch a Patient Belongings List, hoping that it won't be switched to an Items Sent To Morgue List. We stand by in gloves and wait our turn at CPR. It doesn't come. Instead, the victim's chest cavity is cut open and the heart is manually pumped by a doctor's hand. This is the last-ditch effort when all else fails.
I remember being fixated on the yellow glistening fat that bled surprisingly little when cut, ten inches slashed across to expose the chest cavity. It was a hasty cut. A this-is-no-time-for-aesthetics cut, a this-might-hurt-but-you'll-thank-me-later-if-at-all cut.
....
"Does anyone object to calling the time?"
I object. I object. Because it's never the time to die such a horrible death. These are people who had put their faith in God, but where was God in any of this? These people had families, friends, people who depended on them to provide for them. And yet, in a senseless act of violence, their time came too soon. Where was God in any of this?
L and I finally hug each other and weep after our last trip to the morgue. As we left, a tuft of dark hair sticking out from under the white sheet catches my eye.
These experiences affect me. Haunt me, even.
I don't know what to do with them. I don't know where to shelve "watch people die horrible deaths, fail to save them." With every week's reality checks, I grow a little more bitter at the world and its injustices that I see every single week.
I cry to you, LORD;
I say, “You are my refuge,
my portion in the land of the living.”
But what about the land of the dead? Surely your plan extends to provide some comfort over those who mourn. Surely you are still good, always and forevermore.
I don't know why I go back to the emergency department, other than this is a city that cries out for restoration that I am powerless to provide.
All in anticipation of a horrific event. The paramedic radios tell us that multiple victims are wounded, but everything else is speculation. A Code Triage External is sounded while rumors are whispered. It's a college. No, I heard it's a nursing home. No, I heard it's an adult school. Everyone is on edge until that first victim comes through the ambulance bay doors.
It's loud in the ER. Twenty-five people are swarming around one bed--ED doctors, nurses, the surgical team from the 5th floor, blood bank techs, ultrasound techs, x-ray techs, EMTs, police officials, heck, even social workers and us, the lowly volunteers.
L and I clutch a Patient Belongings List, hoping that it won't be switched to an Items Sent To Morgue List. We stand by in gloves and wait our turn at CPR. It doesn't come. Instead, the victim's chest cavity is cut open and the heart is manually pumped by a doctor's hand. This is the last-ditch effort when all else fails.
I remember being fixated on the yellow glistening fat that bled surprisingly little when cut, ten inches slashed across to expose the chest cavity. It was a hasty cut. A this-is-no-time-for-aesthetics cut, a this-might-hurt-but-you'll-thank-me-later-if-at-all cut.
....
"Does anyone object to calling the time?"
I object. I object. Because it's never the time to die such a horrible death. These are people who had put their faith in God, but where was God in any of this? These people had families, friends, people who depended on them to provide for them. And yet, in a senseless act of violence, their time came too soon. Where was God in any of this?
L and I finally hug each other and weep after our last trip to the morgue. As we left, a tuft of dark hair sticking out from under the white sheet catches my eye.
These experiences affect me. Haunt me, even.
I don't know what to do with them. I don't know where to shelve "watch people die horrible deaths, fail to save them." With every week's reality checks, I grow a little more bitter at the world and its injustices that I see every single week.
I cry to you, LORD;
I say, “You are my refuge,
my portion in the land of the living.”
But what about the land of the dead? Surely your plan extends to provide some comfort over those who mourn. Surely you are still good, always and forevermore.
I don't know why I go back to the emergency department, other than this is a city that cries out for restoration that I am powerless to provide.
Wednesday, March 28, 2012
Shower in the ED (Rated PG-13)
A social worker led us out into the lobby area, to where an elderly man was sitting with a radius of empty chairs surrounding him. It didn't take long to figure out why--the man was homeless and he reeked of urine from yards away.
"Bless your hearts, girls! Here you are. These nice girls are going to take care of you!"
F and I looked at one another. We were supposed to help this man to the shower in the back room of the emergency department. He looked to be about 60 or 70 years old, with a head full of graying matted dreads. He wobbled on his cane as we held open doors and inched along next to him. I tried to stay upwind from him.
"Ohh, you ladies so nice!"
Even the security guards gawked as we walked by. Well, first stared, and then quickly turned their heads to gasp audibly for air. You'd think they would be used to it by now. It is a county hospital, after all.
I figured that once we unlocked the shower door, we could sit the man in a chair, and leave him with some new clothes from the clothing closet. Surely he could operate the shower on his own, right? It's just a hand-held shower head, for crying out loud.
I couldn't have been more wrong.
The instant F and I sat him down and piled his belongings in the corner, he mumbled something about needing a cup. I thought he meant a urinal, but he meant exactly that--a cup. For spitting out his chewing tobacco juice.
Between the smell of his body and the smell of his messy brown hacking, there was nothing that I wanted more than to leave that grungy little shower room. I had already been at the hospital for 7 hours by then. I looked at F with eyes that pleaded, "Get me out of here. Now."
But F was calmly sorting through his belongings--Sir, did you want to keep those dirty socks? Let's get him new, clean ones. What about that wad of soiled napkins? Surely we can give him a tissue box. The man just nodded and mumbled incoherently.
I sighed and put on a pair of gloves as "WWJD" flashed in front of my eyes. He obviously couldn't wash himself. So we were going to do it for him.
Ugh. I hate when conviction stabs me in the gut, or makes me wash naked old homeless men. I wasn't about to let F (a tiny Asian girl) do it herself.
The worst part was removing his underwear. And by underwear, I mean the hospital-issued blue scrubs so heavily soiled that they appeared dyed brown. The steamy stench hit me so hard that my eyes actually watered behind my glasses. The dreads in his hair told me that he hadn't seen a shower in months.
F and I murmured soothing words as we undressed the man. Probably more for our sake than for his. And then he was nakedly vulnerable, spotted wrinkles piled in a chair for us to scrub with soapy washcloths.
The second worst part was when he scrubbed his genitals so vigorously that he splashed the dirty wash water all over our clothes. There was nowhere to escape to in that little locked room. At first I was horrified. (And not because I'm prudish. Believe me, working in health care means seeing more genitals than you ever care to.) Then F and I shrugged. At least it didn't get in our mouths.
You know your life is charmed when you don't have to worry about dirty penis wash water getting into your mouth. Cough. Just saying.
An hour and six gray washcloths later, we were drenched from the knee down. We finally wiped the man down with a blanket (ED blankets are so rough, they can easily pass as towels). He started to smell better, and I was no longer dizzy from the stench. We put on his new, clean clothes.
As we walked out of the ED slowly, an EMT said pityingly, "That's the life of a volunteer, eh?"
The security guard said, "Lookin' good! Y'all miracle workers!"
F said, "I'm really glad you came down from OREX. Thanks for having my back."
I said, "Next time M (our male volunteer friend) better be here, because there's no way I'm doing that again."
"Bless your hearts, girls! Here you are. These nice girls are going to take care of you!"
F and I looked at one another. We were supposed to help this man to the shower in the back room of the emergency department. He looked to be about 60 or 70 years old, with a head full of graying matted dreads. He wobbled on his cane as we held open doors and inched along next to him. I tried to stay upwind from him.
"Ohh, you ladies so nice!"
Even the security guards gawked as we walked by. Well, first stared, and then quickly turned their heads to gasp audibly for air. You'd think they would be used to it by now. It is a county hospital, after all.
I figured that once we unlocked the shower door, we could sit the man in a chair, and leave him with some new clothes from the clothing closet. Surely he could operate the shower on his own, right? It's just a hand-held shower head, for crying out loud.
I couldn't have been more wrong.
The instant F and I sat him down and piled his belongings in the corner, he mumbled something about needing a cup. I thought he meant a urinal, but he meant exactly that--a cup. For spitting out his chewing tobacco juice.
Between the smell of his body and the smell of his messy brown hacking, there was nothing that I wanted more than to leave that grungy little shower room. I had already been at the hospital for 7 hours by then. I looked at F with eyes that pleaded, "Get me out of here. Now."
But F was calmly sorting through his belongings--Sir, did you want to keep those dirty socks? Let's get him new, clean ones. What about that wad of soiled napkins? Surely we can give him a tissue box. The man just nodded and mumbled incoherently.
I sighed and put on a pair of gloves as "WWJD" flashed in front of my eyes. He obviously couldn't wash himself. So we were going to do it for him.
Ugh. I hate when conviction stabs me in the gut, or makes me wash naked old homeless men. I wasn't about to let F (a tiny Asian girl) do it herself.
The worst part was removing his underwear. And by underwear, I mean the hospital-issued blue scrubs so heavily soiled that they appeared dyed brown. The steamy stench hit me so hard that my eyes actually watered behind my glasses. The dreads in his hair told me that he hadn't seen a shower in months.
F and I murmured soothing words as we undressed the man. Probably more for our sake than for his. And then he was nakedly vulnerable, spotted wrinkles piled in a chair for us to scrub with soapy washcloths.
The second worst part was when he scrubbed his genitals so vigorously that he splashed the dirty wash water all over our clothes. There was nowhere to escape to in that little locked room. At first I was horrified. (And not because I'm prudish. Believe me, working in health care means seeing more genitals than you ever care to.) Then F and I shrugged. At least it didn't get in our mouths.
You know your life is charmed when you don't have to worry about dirty penis wash water getting into your mouth. Cough. Just saying.
An hour and six gray washcloths later, we were drenched from the knee down. We finally wiped the man down with a blanket (ED blankets are so rough, they can easily pass as towels). He started to smell better, and I was no longer dizzy from the stench. We put on his new, clean clothes.
As we walked out of the ED slowly, an EMT said pityingly, "That's the life of a volunteer, eh?"
The security guard said, "Lookin' good! Y'all miracle workers!"
F said, "I'm really glad you came down from OREX. Thanks for having my back."
I said, "Next time M (our male volunteer friend) better be here, because there's no way I'm doing that again."
Tuesday, March 20, 2012
Tidbits
D and I witnessed a rear-end car crash today at an intersection near The Hospital, when he picked me up from my shift. It didn't seem like anyone was hurt.
I've been wanting to check out the campus swimming pool. But I had some weird health issues two weeks ago. Last week it raining. This week, campus is closed. And next week, I'm crazy busy. Sigh.
I haven't eaten a single peanut butter sandwich since moving home last summer. In fact, they don't sound appealing to me at all. (In case you didn't know, I ate 1-2 peanut butter sandwiches per day, every day in college--you do the math).
Today a hostile male patient threatened to kill the security guard and the security guard's family, and nurses, doctors, and whoever was around. Tensions flared and fingers hovered near gun holsters.
Sometimes I ponder what the heck health care involves, and what I am getting myself into.
My guilty pleasures are Desperate Housewives and Dear Prudence on Slate Magazine. Some people have some really intriguing issues.
I would really like a week away from technology. Camping in the woods is a good solution to this. When I proposed this as a senior trip last year, it was as if I had suggested a dive into a sleeping bag filled with beetles and spiderwebs.
Home is nice, and probably five times more spacious, but I miss living in an apartment.
And because I get asked this question sometimes, no, I'm not in med school yet. I haven't even applied. But I am going to apply in approximately two months. The cycle lasts about a year. Therefore, I'd be applying for the class of 2017--far, far into the future.
I've been wanting to check out the campus swimming pool. But I had some weird health issues two weeks ago. Last week it raining. This week, campus is closed. And next week, I'm crazy busy. Sigh.
I haven't eaten a single peanut butter sandwich since moving home last summer. In fact, they don't sound appealing to me at all. (In case you didn't know, I ate 1-2 peanut butter sandwiches per day, every day in college--you do the math).
Today a hostile male patient threatened to kill the security guard and the security guard's family, and nurses, doctors, and whoever was around. Tensions flared and fingers hovered near gun holsters.
Sometimes I ponder what the heck health care involves, and what I am getting myself into.
My guilty pleasures are Desperate Housewives and Dear Prudence on Slate Magazine. Some people have some really intriguing issues.
I would really like a week away from technology. Camping in the woods is a good solution to this. When I proposed this as a senior trip last year, it was as if I had suggested a dive into a sleeping bag filled with beetles and spiderwebs.
Home is nice, and probably five times more spacious, but I miss living in an apartment.
And because I get asked this question sometimes, no, I'm not in med school yet. I haven't even applied. But I am going to apply in approximately two months. The cycle lasts about a year. Therefore, I'd be applying for the class of 2017--far, far into the future.
Monday, February 20, 2012
I just wanted to hide under covers today
I was about forty minutes late to my volunteer shift in the emergency department today. My boss eventually picked me up from the BART station because the shuttle wasn't running and I didn't have cash to ride the bus. I had contemplated just turning around, swiping my Clipper card into the turnstile and making up some excuse about it being a holiday, and going back to bed. Well, it is a holiday, but hospitals don't take vacations, do they?
My boss showed up in the parking lot in his car from the 1970s. It has vinyl seats with no seat belts ("That won't be a problem, will it?" my boss asks. I hang onto the door, which he also advises against). The gear shift is a straight metal rod with an 8 ball at the end and the dashboard has five square buttons on it, I'm guessing as some sort of use-to-be radio. The speedometer only goes up to 50 mph. His four-year-old son is strapped in a car seat in the back (at least he's secure!) and shyly looks away when I say hi. It was actually a pretty fun ride. I was grateful that my boss just happened to be heading to work at 11:20am.
It starts to drizzle when we walk into the building.
I apologize profusely to the trainee whose time I've wasted, and promise that things will go more smoothly now that I'm here. But I can't really say that for sure, the emergency department is a chaotic melange of emotions and attitudes and blood and injuries and smells and things.
It's one of those days that I have a hard time dealing with the messiness of other people. I hold my breath as I stooped to help an elderly homeless patient change out of his soiled pant bottoms and coax a clean pair of hospital-issued scrubs over his underwear-less crotch. A resident who passes by said, "Mmm it smells great in here," and then gave me a sympathetic look as I finally got one foot into the pant leg. Halfway through I wonder why in the world the nurse hadn't asked my male counterpart to do this instead. I tell myself, this is what Jesus did, right--wash people's dirty feet? Clothe people's naked bottoms? These are the sort of feel-good things that people in clean, safe, comfortable situations say. But I'm pretty sure those people have never had their heads perilously close to a homeless person's gnarled, foul-smelling genitalia before.
I roll my eyes when a nurse I'd never even met before snatched a patient's food tray out of my hands and told me to hurry up and take her patient upstairs which was so urgent I'm not sure what was keeping her capable, payroll-enjoying self from doing it pronto. On any other day, I would have cheerfully smiled and said, I'd be happy to! But today I had to bite my tongue to swallow my fighting words, which would have been spat out so viciously that I probably would have also burst out in tears afterward. Good thing I had a trainee next to me, observing my every move.
My boss showed up in the parking lot in his car from the 1970s. It has vinyl seats with no seat belts ("That won't be a problem, will it?" my boss asks. I hang onto the door, which he also advises against). The gear shift is a straight metal rod with an 8 ball at the end and the dashboard has five square buttons on it, I'm guessing as some sort of use-to-be radio. The speedometer only goes up to 50 mph. His four-year-old son is strapped in a car seat in the back (at least he's secure!) and shyly looks away when I say hi. It was actually a pretty fun ride. I was grateful that my boss just happened to be heading to work at 11:20am.
It starts to drizzle when we walk into the building.
I apologize profusely to the trainee whose time I've wasted, and promise that things will go more smoothly now that I'm here. But I can't really say that for sure, the emergency department is a chaotic melange of emotions and attitudes and blood and injuries and smells and things.
It's one of those days that I have a hard time dealing with the messiness of other people. I hold my breath as I stooped to help an elderly homeless patient change out of his soiled pant bottoms and coax a clean pair of hospital-issued scrubs over his underwear-less crotch. A resident who passes by said, "Mmm it smells great in here," and then gave me a sympathetic look as I finally got one foot into the pant leg. Halfway through I wonder why in the world the nurse hadn't asked my male counterpart to do this instead. I tell myself, this is what Jesus did, right--wash people's dirty feet? Clothe people's naked bottoms? These are the sort of feel-good things that people in clean, safe, comfortable situations say. But I'm pretty sure those people have never had their heads perilously close to a homeless person's gnarled, foul-smelling genitalia before.
I roll my eyes when a nurse I'd never even met before snatched a patient's food tray out of my hands and told me to hurry up and take her patient upstairs which was so urgent I'm not sure what was keeping her capable, payroll-enjoying self from doing it pronto. On any other day, I would have cheerfully smiled and said, I'd be happy to! But today I had to bite my tongue to swallow my fighting words, which would have been spat out so viciously that I probably would have also burst out in tears afterward. Good thing I had a trainee next to me, observing my every move.
Tuesday, February 07, 2012
Quit cryin'
She asks to use the phone. "My cousin works in this hospital. I need to call my cousin."
I wheel her gurney to the hallway telephone and dial the number for her. Then I linger nearby without infringing on her privacy. Just in case. From down the hall, I can hear her sobbing and afraid. When she strains to hang the phone back up, I spring to her side and take the phone, urging her to sit back and relax. A heart attack isn't something you can just walk away from easily. I grab a box of tissues on the way in, and offer it to the woman.
A man waits in the room when we get back. He might be her husband, I don't know. He isn't happy to see her.
"Quit cryin', baby," he says sternly. "You ain't solving anything by crying. I should be the one cryin', cuz you done get yourself in a damned mess. Quit it, now."
I don't like the tone of his voice. She cries harder. I ask him to step outside so I can give her another EKG. Post heart-attack patients need to have them done and re-done pretty much every hour to monitor their progress closely.
"I can ask him to leave, if you'd like. Or I can call the social worker, if you'd rather," I whisper to her. Her eyes are scrunched together, tears leaking out. She just shakes her head and I finish the EKG while talking to her in a quiet, soothing voice.
When I finish, he comes back into the room. She's forty years old, but he calls her old. She's not very large, but he calls her fat. I try to imagine her home life and stop myself. Watching someone be verbally abused, even someone I do not know, is gut-wrenching and horrible. Her nurse notices it too, and feels it is her obligation to call the social worker.
A good thing too, because as he gets up, he says, "I left the house keys on the bus. Looks like you just gon' have to stay here. Oh well."
She looks as if she's going to have another heart attack. It's all I can do to stop myself from calling my big, tall security guard friends over to throw him out.
I wheel her gurney to the hallway telephone and dial the number for her. Then I linger nearby without infringing on her privacy. Just in case. From down the hall, I can hear her sobbing and afraid. When she strains to hang the phone back up, I spring to her side and take the phone, urging her to sit back and relax. A heart attack isn't something you can just walk away from easily. I grab a box of tissues on the way in, and offer it to the woman.
A man waits in the room when we get back. He might be her husband, I don't know. He isn't happy to see her.
"Quit cryin', baby," he says sternly. "You ain't solving anything by crying. I should be the one cryin', cuz you done get yourself in a damned mess. Quit it, now."
I don't like the tone of his voice. She cries harder. I ask him to step outside so I can give her another EKG. Post heart-attack patients need to have them done and re-done pretty much every hour to monitor their progress closely.
"I can ask him to leave, if you'd like. Or I can call the social worker, if you'd rather," I whisper to her. Her eyes are scrunched together, tears leaking out. She just shakes her head and I finish the EKG while talking to her in a quiet, soothing voice.
When I finish, he comes back into the room. She's forty years old, but he calls her old. She's not very large, but he calls her fat. I try to imagine her home life and stop myself. Watching someone be verbally abused, even someone I do not know, is gut-wrenching and horrible. Her nurse notices it too, and feels it is her obligation to call the social worker.
A good thing too, because as he gets up, he says, "I left the house keys on the bus. Looks like you just gon' have to stay here. Oh well."
She looks as if she's going to have another heart attack. It's all I can do to stop myself from calling my big, tall security guard friends over to throw him out.
Saturday, December 31, 2011
Pumpkin Cheesecake
I've been up since 5:45am and had to take a long recuperation nap when I got home. I admit that I only woke up from my delicious nap because I had thoughts about the pumpkin cheesecake I made last night, which was cooling in the refrigerator. There's something about standing on my feet for seven or eight hours that just makes me crave cheesecake. Halfway through my OREX shift today (at about noon) I stepped outside into the lobby and texted my little brother that I wanted to eat it. It was apparently more important to me than watching surgeons cut open body parts and suture them back together.
Is it weird that I'm talking about cheesecake and surgery at the same time? Sorry that it's probably not appetizing to you. Having worked in the Emergency Department for over a year now, sometimes you just throw up your hands during a chaotic, gory shift and say, "Let's go eat lunch!" Or in this case, pumpkin cheesecake.
I've made a lot of desserts in my life, but this pumpkin cheesecake from America's Test Kitchen is pretty darned fantastic. It's as if fluffy and luscious cheesecake meets pumpkin pie spiced with cinnamon, nutmeg and ginger and then lived happily ever after...in my tummy. I dropped a little on the kitchen counter while cutting slices and my germaphobic little brother scooped it up and licked his fingers. If that's not a testimonial, I'm not sure what is.
PS. Thanks R, for the springform pan! I'm going to drive to your house and deliver you a slice, right...about....now.
Is it weird that I'm talking about cheesecake and surgery at the same time? Sorry that it's probably not appetizing to you. Having worked in the Emergency Department for over a year now, sometimes you just throw up your hands during a chaotic, gory shift and say, "Let's go eat lunch!" Or in this case, pumpkin cheesecake.
 |
| Have you ever tried to cut a soft, custardy cake with dental floss? Well, don't with this one. There's a graham cracker crust, after all. |
I've made a lot of desserts in my life, but this pumpkin cheesecake from America's Test Kitchen is pretty darned fantastic. It's as if fluffy and luscious cheesecake meets pumpkin pie spiced with cinnamon, nutmeg and ginger and then lived happily ever after...in my tummy. I dropped a little on the kitchen counter while cutting slices and my germaphobic little brother scooped it up and licked his fingers. If that's not a testimonial, I'm not sure what is.
PS. Thanks R, for the springform pan! I'm going to drive to your house and deliver you a slice, right...about....now.
Thursday, December 15, 2011
Cardiopulmonary Resuscitation (CPR)
All Emergency Department Volunteers are required to have CPR certification. Today was my first time putting that into practice.
With the trauma team hovering over the patient, a nurse looked at me and said, "You! Can you do CPR?" I elbowed M, a middle-aged male volunteer who has far more upper body strength than I. He hurried to the bed to relieve a sweat-drenched nurse who had compressing for five minutes. The patient's chest rose and fell with frantic speed. CPR, against popular belief, does not restart the heart. With no pulse, we were fighting against brain tissue death for a chance at life support-assisted survival.
Minutes later, M was running out of steam. I had been mesmerized by all of the different procedures the doctors were running on the patient. Scalpels were used. Tubes were everywhere. The trauma room floor was littered with the empty packaging of syringes, bloodied cloths, empty IV bags. M called my name. I put on a face shield and stepped up on the stool for leverage. We exchanged positions without missing too many beats.
Pump, pump, pump.
It had felt so easy on the mannequins. Part of my CPR training was kneeling over a half-torso dummy on the ground and giving halfhearted compressions. This was different. This was a real life emergency. I wasn't prepared for how slippery and cold bare skin is. No one told me how awkward of an angle my arms would be with straight elbows, or how much of my entire body weight I had to throw onto the chest just to compress it a few centimeters. No one told me that looking into the patient's face would return a glazed stare and a half-opened mouth. I prayed with every forceful thrust of my stiffened arms.
Live. Live. Live.
The general rule for giving CPR is to keep going until you can't anymore. I had thought that was peculiar. What does it mean if you can't anymore? Do you just give up and walk away? Or do you succumb to exhaustion yourself, and then there would be two victims, total?
I think I am a relatively fit individual, but my upper body strength is lacking. After about just one minute of fast, hard compressions, I became exhausted. My palm was slipping on top of freshly applied ultrasound gel and squirming in my glove. My forehead was sweaty. My compressions became shallower and slower, and I wanted desperately to stop. Fortunately, A, my favorite nurse, was ready to take over behind me.
"Good job, buddy," he said as he patted my shoulder and positioned for takeover. I'm convinced that he calls me buddy because he doesn't know if he should call me Connie or Constance (my badge says the latter). He gave the patient many good, deep compressions as I wiped my brow and stood bedside with M, waiting for our next turn.
A CPR-giving queue had been summoned over the Emergency Department PA system, but the nurses kicked off some people who weren't doing it correctly, and other people had their own patients to attend to. It was just the three of us eventually. Ten minutes elapsed. Then twenty five. Then one hour. My arms felt like they were going to detach from my shoulders, and my scrubs were soaked with seawater mingled with sweat. A and M would compress for minutes, while I took a much shorter turn. I worried that sometime during my turn, the attending doctor would say, "Stop! Time of death.." and I would back away from the bed, knowing that maybe there was something that I could have done. I'd never felt more useful or useless in my life.
With the trauma team hovering over the patient, a nurse looked at me and said, "You! Can you do CPR?" I elbowed M, a middle-aged male volunteer who has far more upper body strength than I. He hurried to the bed to relieve a sweat-drenched nurse who had compressing for five minutes. The patient's chest rose and fell with frantic speed. CPR, against popular belief, does not restart the heart. With no pulse, we were fighting against brain tissue death for a chance at life support-assisted survival.
Minutes later, M was running out of steam. I had been mesmerized by all of the different procedures the doctors were running on the patient. Scalpels were used. Tubes were everywhere. The trauma room floor was littered with the empty packaging of syringes, bloodied cloths, empty IV bags. M called my name. I put on a face shield and stepped up on the stool for leverage. We exchanged positions without missing too many beats.
Pump, pump, pump.
It had felt so easy on the mannequins. Part of my CPR training was kneeling over a half-torso dummy on the ground and giving halfhearted compressions. This was different. This was a real life emergency. I wasn't prepared for how slippery and cold bare skin is. No one told me how awkward of an angle my arms would be with straight elbows, or how much of my entire body weight I had to throw onto the chest just to compress it a few centimeters. No one told me that looking into the patient's face would return a glazed stare and a half-opened mouth. I prayed with every forceful thrust of my stiffened arms.
Live. Live. Live.
The general rule for giving CPR is to keep going until you can't anymore. I had thought that was peculiar. What does it mean if you can't anymore? Do you just give up and walk away? Or do you succumb to exhaustion yourself, and then there would be two victims, total?
I think I am a relatively fit individual, but my upper body strength is lacking. After about just one minute of fast, hard compressions, I became exhausted. My palm was slipping on top of freshly applied ultrasound gel and squirming in my glove. My forehead was sweaty. My compressions became shallower and slower, and I wanted desperately to stop. Fortunately, A, my favorite nurse, was ready to take over behind me.
"Good job, buddy," he said as he patted my shoulder and positioned for takeover. I'm convinced that he calls me buddy because he doesn't know if he should call me Connie or Constance (my badge says the latter). He gave the patient many good, deep compressions as I wiped my brow and stood bedside with M, waiting for our next turn.
A CPR-giving queue had been summoned over the Emergency Department PA system, but the nurses kicked off some people who weren't doing it correctly, and other people had their own patients to attend to. It was just the three of us eventually. Ten minutes elapsed. Then twenty five. Then one hour. My arms felt like they were going to detach from my shoulders, and my scrubs were soaked with seawater mingled with sweat. A and M would compress for minutes, while I took a much shorter turn. I worried that sometime during my turn, the attending doctor would say, "Stop! Time of death.." and I would back away from the bed, knowing that maybe there was something that I could have done. I'd never felt more useful or useless in my life.
Wednesday, December 07, 2011
ED Lesson #3: It's All About the Attitude
As I was riding the shuttle to The Hospital today, I was consumed with my own melancholy thoughts about how emotionally draining these last months have been. But of course, there's nothing quite like riding a rickety shuttle bus with people who have more apparent problems (drug abuse! Broken limbs! Unfilled prescriptions! No insurance!) to give me an attitude check. When I finally smiled at the thought of my own ridiculousness, a man who sat in the row across from me said, "With a pretty smile like yo's, you can make the world go 'round." Thank you, sir. I tried to be as gracious, patient, and accommodating as I possibly could my entire shift. It was exhausting, but I'm better for it.
These three weeks, I'm training volunteers in the Emergency Department. You'd think that after five trainees already, I would have mastered the art of imparting technical knowledge to new volunteers. Wrong! Things are unpredictable in the ED every single shift, so I've never trained the same way twice. It's inevitable that when I'm explaining the pneumatic tube system, I'll get interrupted by a nurse to do a patient transport, or that when I'm showing my trainee the orthopedic supply room, a trauma will get called in. It's really quite exciting. I've made it a point to teach my trainees things beyond the official training checklist because I always hate getting caught in situations that caused me to fumble. While it's inevitable for unexpected things to come up, I feel slightly protective of (or at least responsible for) whoever I train, and want my trainees to do well on their own. One of my trainees today was really sweet and bought me a balloon from the gift shop as a thank-you. What the! It says "Congratulations on your baby boy!" Hahaha.
Today was a good day after all.
These three weeks, I'm training volunteers in the Emergency Department. You'd think that after five trainees already, I would have mastered the art of imparting technical knowledge to new volunteers. Wrong! Things are unpredictable in the ED every single shift, so I've never trained the same way twice. It's inevitable that when I'm explaining the pneumatic tube system, I'll get interrupted by a nurse to do a patient transport, or that when I'm showing my trainee the orthopedic supply room, a trauma will get called in. It's really quite exciting. I've made it a point to teach my trainees things beyond the official training checklist because I always hate getting caught in situations that caused me to fumble. While it's inevitable for unexpected things to come up, I feel slightly protective of (or at least responsible for) whoever I train, and want my trainees to do well on their own. One of my trainees today was really sweet and bought me a balloon from the gift shop as a thank-you. What the! It says "Congratulations on your baby boy!" Hahaha.
Today was a good day after all.
Wednesday, November 16, 2011
When the news comes to you
I paused from trying to fit a banged-up motorcyle helmet into a patient belongings bag to listen to the automated overhead voice announcing "Level One Trauma, ETA five minutes" three times in quick succession. This is the code that sends doctors and nurses running to the room next door while donning visors and protective equipment. In my one year in the emergency department, I've only seen three level 1 traumas on my shift. I quickly gathered the rest of the motorcycle accident patient's belongings and put on a fresh pair of gloves to join in on the commotion. Minutes later, the trauma room was noisily crammed to capacity with teams of doctors, nurses, X-ray technicians, paramedics, and oddly enough, half a dozen police officers. A thick trail of glossy, crimson blood followed the gurney.
Things in the ED had started off so relaxed and under control this morning that L, D, and I had nothing better to do than to have lunch at the hospital cafeteria, not at 1 or 2pm, but at noon! I had also invited a visiting EMT student, M, who I had taken under my wing for the morning. We toured all of the stations, peered into patient rooms to fluff their pillows, and joked around with nurses--especially A, who treats everyone with good-natured fist-bumping, shoulder-poking, and back-pounding. My left shoulder is still a little sore.
Then came one trauma. Then another. And another two. All unrelated, of course. It seemed that for the rest of the day, most of I did was to gather patient belongings take inventory of cut-up, bloody, foul-smelling garments and personal effects while doctors and nurses swarmed around me. You'd be surprised how many foul smells (and textures!) one can experience in a busy urban county emergency department.
And then, minutes before my shift was over, came the case that hit close to home. When the patient was rolled in, doctors and nurses scrambled to save that man's life. We didn't know the details of the case. To us, he was a patient in need. Health care practitioners are under the Hippocratic oath to do anything in their power to save lives, after all, right? It matters not if the patient is of questionable character, has committed any wrongdoings, or even the very reason he arrived at the hospital. That is not for us to judge. All that matters is there is a body that needs mending, and a life worth saving.
Things in the ED had started off so relaxed and under control this morning that L, D, and I had nothing better to do than to have lunch at the hospital cafeteria, not at 1 or 2pm, but at noon! I had also invited a visiting EMT student, M, who I had taken under my wing for the morning. We toured all of the stations, peered into patient rooms to fluff their pillows, and joked around with nurses--especially A, who treats everyone with good-natured fist-bumping, shoulder-poking, and back-pounding. My left shoulder is still a little sore.
Then came one trauma. Then another. And another two. All unrelated, of course. It seemed that for the rest of the day, most of I did was to gather patient belongings take inventory of cut-up, bloody, foul-smelling garments and personal effects while doctors and nurses swarmed around me. You'd be surprised how many foul smells (and textures!) one can experience in a busy urban county emergency department.
And then, minutes before my shift was over, came the case that hit close to home. When the patient was rolled in, doctors and nurses scrambled to save that man's life. We didn't know the details of the case. To us, he was a patient in need. Health care practitioners are under the Hippocratic oath to do anything in their power to save lives, after all, right? It matters not if the patient is of questionable character, has committed any wrongdoings, or even the very reason he arrived at the hospital. That is not for us to judge. All that matters is there is a body that needs mending, and a life worth saving.
Wednesday, November 09, 2011
OREX #2: Things I noticed
Going into something for the second time usually means that most of my nervousness has dissipated, and I have some semblance of confidence. Even if that means confidence in my ability to be a wallflower in the operating room. It also means that I notice things that I hadn't noticed the first time around.
For one, the process of a surgeon "scrubbing in" is really fascinating to me. I've rarely seen ED doctors wash their hands (you didn't hear it from me), but surgeons have a strict ritual from sterile soaps, pushing the OR door with their hips with hands dripping wet, waiting for the circulating nurse to hand them an autoclaved hand towel, being helped into their gowns and two sets of tight gloves...I just can't help but stare at the whole dance. Since I'm not allowed to touch or stand near anything blue--which includes sterile drapes, instrument tables, or surgeons themselves--I don't even have to wash my hands. But since I'm a germaphobe, I do anyway. Just not with the same rigor as a surgeon.
Dr. Harken treats all of his nurses and fellow doctors with grace and kindness. I am so glad that he is my mentor and I want to be like him. Even in tense situations, he doesn't raise his voice. Sutures by nervous medical students are praised, "Yes!"s of approval are heartily and frequently spoken, and he always thanks his team for their hard work and asks if I have questions. Not so with three of the four other doctors that I've observed today. During one case, an overworked circulating nurse was given five orders at once, from five different people. In a moment of chaos, B was forced to grab blood-soaked equipment from under the table with his bare hands because the surgeon barked, "I don't care what you're doing, stop it and get me the damned pedal!" The poor guy didn't even have time to put on gloves. When he finally sat down to record the chart, I whispered to him, "They should pay you more." But what I wanted to do was to yell at the doctors and help B out and maybe massage his shoulders....or not.
When I'm in the Emergency Department, I know how to do things without understanding why I am doing them. In the operating room, I understand what is happening without knowing how to do anything. It's quite the learning experience.
For one, the process of a surgeon "scrubbing in" is really fascinating to me. I've rarely seen ED doctors wash their hands (you didn't hear it from me), but surgeons have a strict ritual from sterile soaps, pushing the OR door with their hips with hands dripping wet, waiting for the circulating nurse to hand them an autoclaved hand towel, being helped into their gowns and two sets of tight gloves...I just can't help but stare at the whole dance. Since I'm not allowed to touch or stand near anything blue--which includes sterile drapes, instrument tables, or surgeons themselves--I don't even have to wash my hands. But since I'm a germaphobe, I do anyway. Just not with the same rigor as a surgeon.
Dr. Harken treats all of his nurses and fellow doctors with grace and kindness. I am so glad that he is my mentor and I want to be like him. Even in tense situations, he doesn't raise his voice. Sutures by nervous medical students are praised, "Yes!"s of approval are heartily and frequently spoken, and he always thanks his team for their hard work and asks if I have questions. Not so with three of the four other doctors that I've observed today. During one case, an overworked circulating nurse was given five orders at once, from five different people. In a moment of chaos, B was forced to grab blood-soaked equipment from under the table with his bare hands because the surgeon barked, "I don't care what you're doing, stop it and get me the damned pedal!" The poor guy didn't even have time to put on gloves. When he finally sat down to record the chart, I whispered to him, "They should pay you more." But what I wanted to do was to yell at the doctors and help B out and maybe massage his shoulders....or not.
When I'm in the Emergency Department, I know how to do things without understanding why I am doing them. In the operating room, I understand what is happening without knowing how to do anything. It's quite the learning experience.
Wednesday, October 26, 2011
One hour commute | Counting the cost
On the shuttle ride home after my ED shift, a little girl with beads in her hair sat down next to me. Her mother, visibly lethargic from hospital treatment, sat in the row in front of us. A youngish-looking man carrying a stroller also boarded the shuttle with them, and sat behind us. The man turned out to be her grandfather. As usual, I am the only Asian person on this bus. The demographic that The Hospital serves is largely African-American and Latino.
The little girl hummed and played with a biohazard bag of ice that someone at the hospital had given her. I smiled at her and she shyly said Hi. She looked very sweet.
Behind us, the grandfather was conversing casually with another man riding the shuttle about a recent neighborhood shooting. At one point, he laughed loudly and exclaimed, "BANG! BANG! Right there in fronta his house! BANG! He dead. Right in fronta plain view!" The men laughed for a while, repeated some BANG noises, and I smelled the weed and alcohol on his breath.
I've heard some disturbing things on this shuttle, but this bothered me tremendously. I wanted to put my hands over the little girl's ears to protect her from hearing these monstrous acts of violence. Yet everyone else on the shuttle stared forward disinterestedly, although I am quite sure the entire conversation was audible even to the driver. I wondered about the little girl's home life. I wondered if she was destined to grow up in an environment of gang warfare and poverty, someday becoming like the patients I see in the ED--destitute and angry.
I feel sick that circumstances like this exist at all.
Yes, one of the reasons I chose to volunteer at The Hospital was because there is great medical need in that urban zone of crisis. The first time a gun shot victim died during my shift (and I had to bring him to the morgue), I sent out text messages to my friends, urging them to pray for Oakland's brokenness. To clarify, the vast majority of patients are there for reasons not violence-related. Yet, I do not tell my parents of the frequent GSWs and violent traumas, because I know they will fear for my safety, disapprove, and tell me to volunteer somewhere less dangerous. When my dad drives me to The Hospital in the darkness of 6am and sees figures lurking around the street entrance, he calls me to make sure I've made it safely inside. I used to pray for protection under my breath while waiting for the shuttle to take me back to Berkeley, and to Large Group, more than one hour late. How can I love the people in this place if I am afraid of what will happen to me? It's a struggle that I have of wanting to delve into the ugliness of others while remaining relatively unscathed myself. I am realizing more and more that it may not be possible.
The little girl hummed and played with a biohazard bag of ice that someone at the hospital had given her. I smiled at her and she shyly said Hi. She looked very sweet.
Behind us, the grandfather was conversing casually with another man riding the shuttle about a recent neighborhood shooting. At one point, he laughed loudly and exclaimed, "BANG! BANG! Right there in fronta his house! BANG! He dead. Right in fronta plain view!" The men laughed for a while, repeated some BANG noises, and I smelled the weed and alcohol on his breath.
I've heard some disturbing things on this shuttle, but this bothered me tremendously. I wanted to put my hands over the little girl's ears to protect her from hearing these monstrous acts of violence. Yet everyone else on the shuttle stared forward disinterestedly, although I am quite sure the entire conversation was audible even to the driver. I wondered about the little girl's home life. I wondered if she was destined to grow up in an environment of gang warfare and poverty, someday becoming like the patients I see in the ED--destitute and angry.
I feel sick that circumstances like this exist at all.
Yes, one of the reasons I chose to volunteer at The Hospital was because there is great medical need in that urban zone of crisis. The first time a gun shot victim died during my shift (and I had to bring him to the morgue), I sent out text messages to my friends, urging them to pray for Oakland's brokenness. To clarify, the vast majority of patients are there for reasons not violence-related. Yet, I do not tell my parents of the frequent GSWs and violent traumas, because I know they will fear for my safety, disapprove, and tell me to volunteer somewhere less dangerous. When my dad drives me to The Hospital in the darkness of 6am and sees figures lurking around the street entrance, he calls me to make sure I've made it safely inside. I used to pray for protection under my breath while waiting for the shuttle to take me back to Berkeley, and to Large Group, more than one hour late. How can I love the people in this place if I am afraid of what will happen to me? It's a struggle that I have of wanting to delve into the ugliness of others while remaining relatively unscathed myself. I am realizing more and more that it may not be possible.
Wednesday, October 19, 2011
OREX #1: Even Doctors Sleep in Class
[Disclaimer: I have to write a jargon-y, technical journal entry as part of OREX, and so this post will be mostly HIPAA-happy thoughts from my brain!)
Every time I have an important order of business in the morning, I spring out of bed before my alarm rings. Today was no exception. My alarm was set for 5:30am for my first OREX day, but in the darkness of the night, I woke up at 4:31am and could not fall back asleep.
I made it to The Hospital by 6:35am, and walked into the surgery conference room 40 minutes early. There was a talk from a UCSF doctor that apparently began at 6:00am (that I wasn't required to go to) so there were already medical students and surgical residents gathered around the long table. Since no two OREX-ers are scheduled for the same day of surgery observation, it was obvious that I was the odd one out on my own.
I introduced myself to Dr. Harken, my new mentor, during a lull in the discussion. He heartily welcomed me to the program, and insisted with a firm sweep of his arm that I get some donuts and coffee at the table. "Just like visiting your grandma," a resident nearby laughed. After some protesting, I got up awkwardly and plunged my hand into a bag containing bagels, because I didn't want a sugar crash during my nine hours at The Hospital. Unfortunately, I was stuck with a really dry millet and grain bagel, which I munched on slowly for the next hour and a half.
Dr. Harken sat next to me for the remainder of the presentation, and explained to me the terms and procedures mentioned. At one point, he even drew a diagram of a colon for me--he was delighted by my meager anatomy vocabulary (take IB 131L, kids!). The lecture was over my head, and I noticed a resident nodding off. I don't blame him-- it was still dark outside. Another thing I noticed was that doctors put their food directly on table surfaces. You'd think with all that knowledge about sterility and germs, doctors would be the most paranoid about sanitation. Meh. At 7:40am, Dr. Harken whispered to me that he had to go to surgery, and then I was free from choking down the rest of that awful bagel.
Every time I have an important order of business in the morning, I spring out of bed before my alarm rings. Today was no exception. My alarm was set for 5:30am for my first OREX day, but in the darkness of the night, I woke up at 4:31am and could not fall back asleep.
I made it to The Hospital by 6:35am, and walked into the surgery conference room 40 minutes early. There was a talk from a UCSF doctor that apparently began at 6:00am (that I wasn't required to go to) so there were already medical students and surgical residents gathered around the long table. Since no two OREX-ers are scheduled for the same day of surgery observation, it was obvious that I was the odd one out on my own.
I introduced myself to Dr. Harken, my new mentor, during a lull in the discussion. He heartily welcomed me to the program, and insisted with a firm sweep of his arm that I get some donuts and coffee at the table. "Just like visiting your grandma," a resident nearby laughed. After some protesting, I got up awkwardly and plunged my hand into a bag containing bagels, because I didn't want a sugar crash during my nine hours at The Hospital. Unfortunately, I was stuck with a really dry millet and grain bagel, which I munched on slowly for the next hour and a half.
Dr. Harken sat next to me for the remainder of the presentation, and explained to me the terms and procedures mentioned. At one point, he even drew a diagram of a colon for me--he was delighted by my meager anatomy vocabulary (take IB 131L, kids!). The lecture was over my head, and I noticed a resident nodding off. I don't blame him-- it was still dark outside. Another thing I noticed was that doctors put their food directly on table surfaces. You'd think with all that knowledge about sterility and germs, doctors would be the most paranoid about sanitation. Meh. At 7:40am, Dr. Harken whispered to me that he had to go to surgery, and then I was free from choking down the rest of that awful bagel.
Tuesday, October 11, 2011
ED Lesson #1: Ask Questions
"I need a 24 gauge 11-inch suprapubic catheter, please." I was pleased that I had remembered what to tell the technicians at Central Supply on the first floor.
"You sure that's what you want?"
Huh? Why is she asking me that? I'm not a nurse. I was just reciting what I had been told by the nurse. I answered as confidently in the affirmative as I could, twiddled my thumbs, and waited for the order. The technician came back with a bag of what I had asked for, but the look on her face said that I was going to be sorry.
"You sure that's what you want?"
Huh? Why is she asking me that? I'm not a nurse. I was just reciting what I had been told by the nurse. I answered as confidently in the affirmative as I could, twiddled my thumbs, and waited for the order. The technician came back with a bag of what I had asked for, but the look on her face said that I was going to be sorry.
Monday, October 03, 2011
OREX
I was recently accepted to a surgery observation program called OREX (Operating Room Experience) at The Hospital. The website is a little outdated--this is now the fourth year of the program.
A year ago around this time, I had just started volunteering in the Emergency Department, and it was a dream come true. Now it gets better! God has opened so many doors for me on this path, and for that I am grateful.
Fifteen participants and I will be attending pre-operation lectures by Dr. Harken, the chief of surgery, once a month at 7:15am. This means I have to wake up at 5:30am to get to The Hospital on time via public transportation! We scrub in to observe a minimum of 4 hours of operations, and can stay as long as we like (one of last year's participants watched 6 surgeries in a day--sounds exhausting). I've never had to get surgery before, and I've never watched one before, either. It all sounds unreal to me.
A year ago around this time, I had just started volunteering in the Emergency Department, and it was a dream come true. Now it gets better! God has opened so many doors for me on this path, and for that I am grateful.
Fifteen participants and I will be attending pre-operation lectures by Dr. Harken, the chief of surgery, once a month at 7:15am. This means I have to wake up at 5:30am to get to The Hospital on time via public transportation! We scrub in to observe a minimum of 4 hours of operations, and can stay as long as we like (one of last year's participants watched 6 surgeries in a day--sounds exhausting). I've never had to get surgery before, and I've never watched one before, either. It all sounds unreal to me.
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