Sunday, January 30, 2011

Another rainy day ….

I love the rain. I don’t know why but I do .the heavier, the better …yesterday, I woke up quite early. Checked my watch still about half an hour to Fajir … I can hear the sound of rain outside, it's gonna be great, I thought-lame I know-.  It's my first day as a surgical ward resident. The hours are longer but it's less stressful than the emergency and the best part is, I'll have my own office!
Gosh I should change this tone….
'If I say yes or no, that won't change your decision. You still gonna do what you think should be done ….'  That was from a friend I asked for advice… the guy was in an 'unfriendly mode' I thought or ….or am I that stubborn?! Naaaaaah
'Busy, doctor?'
That was the nurse of the urology ward
'Please come in'
'I gave shyma only half the dose of pethidine and she starts feeling dizzy ….'
'Shyma who ?'
'Uro ward 3'
'When was she admitted? '
'Few minutes ago , the senior 's already ordered the tests and the treatment '
'And the guy didn’t even bother to tell me I have another patient under my watch …..those seniors' I thought
'Her records?' I asked   
'Its still empty, I was about to hand it to you after giving her pethidine '
'Ok, let's go check on her'
'Good morning shyma ,how are you doing?' I asked
no response
'shyma,I know you are in pain ..please nod if you are feeling dizzy?'
'Gosh, if she was anybody's patient in the exam they'll definitely fail' I thought
'Shyma please help me help you …..'
Half an hour later ….
'What's wrong with her, doctor?' the nurse asked
'She had right nephrectomy after an RTA and now she is presented with left ureteric stone, a big one obstructing her ureter'
'And …and what does that mean?'
Come on!! I hate it when I have to translate … not because I don’t want to, but I just can't find the right words for it plus I hate the things that I usually suck at ….
'Means ,nurse, she has only one kidney and its shutting down, give her the rest of the dose add metoclopramide to the treatment'
'salam alakum you are ..?'
'I'm Doctor … the resident on call today '
'Why aren’t you wearing your badge?'
'I am'
'Oh…. then come see this patient with me'
That was Dr.Zala the chief of residents, aka my boss, which happens to be a urologist too
'Sure, doctor ' just to be clear that wasn’t sucking asses…Although I think the latter is part of my job description!
'Would you mind if we use your office?'  It was dr.zala again
Man take over the office, you rule, just stop adding more working hours!!
'Not at all, do you want me to leave?'  I said
'No, stay. Its an interesting case'
'Why is this patient here? He's a shell in his abdomen; he might need an operation anytime? ' one of the surgical team on call that day asked me like I'm the one who planted the explosives in this guy's car
'I'm following him up closely, he's stable so far… plus I don’t assign the wards in which patients are staying, you do'
He didn’t comment .victory!
'Move him the ward closest to the OR'
'And next time, ask one of the nurses to escort you when you go to the male wards…'
Apparently my face was expressionless
 'It's late, rainy u know …as a safety measure'
'I…I will !! '

Friday, January 28, 2011

Just another day at work...

'Where have you been doctor, leaving me doing what a resident supposed to do ''''meaning doing your job''''?
'I …I was at the surgical mini OR with the gunshot victim. I was just… '
Well she didn’t let me finish which is really so typical of her and all other permanents ... I was a bit annoyed by her tone... I always think that it would've been great if permanents stop pushing residents' buttons  and focus on their patients instead...but it's easier said than done ... I sometimes  relate to my seniors …I mean it's not easy to keep on a positive attitude when you're working at a surgical emergency in Baghdad …with at least one blast victim during a shift , less than optimum hospital supplies and sub staff ,it's really a challenge to 'see the trees so green , red roses too and think to myself what a wonderful world' ….gosh I love this song J
I didn’t have time to reflect on it anyways...I was busy doing  the paper work of the blast victims we managed earlier when another gush of injured victims reached  the ER ' same blast ? 'I asked ' No it's another one'
'How many patients? 'the permanent asked
'Two arrived, a third one on the way'
'Doctor, call the surgical team'
'On it' I answered
By the time I came back – I had to go outside to make the call because of low signal reception inside the ER! ' the permanent was dealing with one patient  ,one of the nurses was cleaning the other victim,  but the patient had no IV line yet ,no cross match, nothing  
'Marwan don’t move his neck!! What are you doing?clean him later… secure an IV line first, put him on a monitor stat ' I totally forgot that Marwan and Alya, the sub staff for the evening shift that day,  are both new nurses meaning  zero experience. They don’t know the crush protocol so it's my responsibility to guide them through it, which didn’t ease my job at all …
'You said three patients, where is the third one?' and before I even had time to answer
'Doctor, where is the third patient?' another member of the surgical team shouted
'First bed left ,doctor he's not critical '
'Call vascular team and orthopedics too'
'I've already done that '
'Cross match? '
'Done  '
Go get 4 pints of blood for 'Abdulla '
'Which Abdulla ? both victims have the same first name '
'This Abdulla'
'His name is A. Ibrahim'
'Yes whatever ..get the blood stat'
'Where have you been? '
'I was getting ….'
'call the maxillo-facial and the RCU ..we'll intubate'
'I've already done that no one is picking up'
Then you should've send someone to the RCU, its urgent '
'An ambulance arrived '
An other victim, he's dead
'There a heart beat doctor' I said
'3 bullets in the chest, 2 in the head, bilaterally dilated pupils ,negative  pulse, no breath sound ..HES DEAD '
'ok Im sorry, I never said he's alive'
'I wanna talk to you'
' you almost drag yourself into a big problem don’t announce time of death a senior doctor does …'
I was trying to …
Don’t ever speak in Arabic in front of the relatives ,ok.. you gave the family false hope ..if they weren’t educated -lucky you- they would've thought that we didn’t do enough ..bla bla bla
'doctor , x-ray's back.. Fractures at two sites , I was told by ..' a patient's dad is talking to me thank god J ,the perfect excuse to ditch this totally unbalanced conversation  , like I needed nerve racking nutjob surgeons to tell me I screwed , or so I thought .
'Ok doctor I have to ..'
'Go' he mumbled

I got busy with the usual ER patients afterwards(and by that I mean the non-blast patients) somehow the time flew by ...
'have you finished the police report yet? …
'I'm doing my best officer..'I answered
'No do it faster '
' Sigh I'm so tired ,its 10:10 my shift finished 10 min ago' I was a bit irritable by then
'Please do it'
'How was your day? ' my brother asked
'The usual ' I answered
'I take it as shut up I don’t wanna talk about it ' he mumbled
'not now Doda , not now'…