In-hale, Ex-hale.
That’s the Anthem-Get Your Damn Hands Up.
We go out and examine the patient. She’s leaning forward with pursed lips, able to speak in short sentences without much difficulty. She’s so thin I can nearly see her first rib in the space between her clavicle and sternocleidomastoid when she inhales. On auscultation she doesn’t move much air through her lungs. Her toes were not cyanotic or cold, which was about the only good sign I could see on her.
I ask her if I can sit on the side of her bed and talk to her. I ask her if she had ever needed to be put on a ventilator. She nods.
‘I hope that never happens again,’ she says.
‘That’s what I am asking you, Ma’am. If it comes to the point that we think you need it,’ I ask her, ‘do you want us to put that tube down your throat and put you on the breathing machine again?’
‘Only if you thought I was going to die without it.’
That’s what I needed to hear. We went back in the consult room and I had my intern page the MICU resident while I ask the ED senior to move the patient to the Resus area, adjacent to the trauma bay.
I look at Resus, which has room for 4 stretchers. Five patients are there already. Three are already on vents. I look at the other two. Admittedly, they look sicker than my lady. As I’m presenting the patient, a stroke alert goes off. The stroke alert trumps her also.
‘She’s going to need intubation soon,’ I concede, ‘but not at this moment. Move her closer to the nursing station so you can keep your eye on her and I’ll be happy.’
She agrees. My intern has informed the MICU. Everything seems to be under control.
‘Erik, I have one for you.’ I look over and see another resident calling me. He’s telling me he is consulting me on a patient. I look at the bed number on the outside of the chart in his hands. I match it to the stretcher and see the thin man surrounded by his gaggle of plump women.
I was about to meet him.
Bonus Two-for-One Post in the comments section
Posted @ 4:43 PM
7 Comments:
1/12/2006
Erik writes:
dan writes:
Erik writes:
dan writes:
Erik writes:
dan writes:
Anonymous writes:
Two things:
One
I took Step Three of my Licensure Exam today. Yay, me! I’m now drinking beer and relaxing. With the exam done, this site should be like a patient with a fiber-added diet: much more regular.
Two
I got paged by the clinic administrator yesterday. When I called, she told me a package had arrived for me.
‘Is it ticking?’ I asked.
‘No,’ she laughed, ‘it’s not ticking.’
‘Does it smell like a dead rabbit?’ I asked.
‘No, doctor. It looks like a care package.’
‘Can you bring it up to respiratory isolation so I can open it?’
‘Doctor, why don’t you come down here and I can open it for you, if you’re really nervous about it.’
‘Well, if you’re so confident it’s safe, why do you even need me there?’
We argued about it for a while, eventually she convinced me to come down and open it, with just a quick run though the X-ray machine first.
It was a large box (14” x 11” x 14”) but not overly heavy. It did not, in fact, smell like a dead rabbit. It didn’t have any white residue. (which would have been so 2001 anyway)
It was tightly sealed, which—again—increased my suspicion, but the administrator grabbed her scissors and opened it with me looking on from the corner by the door.
Inside was a card, accusing me of being ‘sweet… and intoxicating!’ it was from, allegedly, ‘one of your many secret admirers.’
It contained a recipe for Rum Cake and—here’s where it gets good—everything you need to make a rum cake, even the Bundt pan, and a nice one at that. (To be technically correct, the eggs were not included)
I checked the postmark. Madison, Wisconsin.
I did a quick mental scan of the residents and nurses who were from Wisconsin and might have sent me the package over the holidays from home, but it was sent before the holidays—the date on the postmark was December 20th. (Great job, US Mail! Good thing it wasn’t a dead rabbit.)
I picked up the box and left the clinic as the administrator said, ‘Must be nice to have a secret admirer.’
‘Yes,’ I said, ‘but open admirers are better.’
And open admirers within a drunken walks distance from my house are best of all.
Madison, Wisconsin: a fat load of good that was going to do me.
But, seriously, thank you mysterious Rum Cake Maker, very generous and thoughtful. I will make it tomorrow.
And no, none of you can have a piece. This is my goddamn rum cake.
1/14/2006
So you're sweet and intoxicating like rum cake. I'm bitter and sobering. I wonder what kind of dessert-themed care package I would get.
Maybe if I play myself off as sweet and fruity, then somebody will send me some strawberry shortcake. Wait, I just set myself up there, didn't I.
1/14/2006
Bitter and Sobering? I can send you an Ammonia Inhaler.
If I was in a contest starting mood, I'd suggest we try to decide what dessert PlanetDan most resembles.
My first instinct would be to say an Apfelpfannkuchen.
1/14/2006
Apple Pannekoekens are ugly little desserts. They are the elephant men of the dessert world.
On a barely related note, we got a chain email at work a while back that listed out desserts of which you were supposed to choose your favorite. Then it would describe your personality based on your dessert choice. They were reading me the dessert list so that I could make my choice and when they got to "fudge cake with chocolate frosting" I yelled, maybe a little too enthusiastically, "That's it! That's what I want! Chocolate on chocolate!" which they all decided was clearly a freudian allusion to some latent sexual tendency toward ethnicity-based fetishism. I haven't lived it down since, and now whenever someone references any type of suggestive innuendo in my presence, someone inevitably shouts, "Chocolate on chocolate!" and everyone giggles derisively in my direction.
1/14/2006
Who do you think you are fooling? You had to look high and low for such an unattractive apfelpfannkuchen.
They are sweet but not cloying. A bit tart from the apple, but wrapped in the warmth of a comforting pancake.
Just look.
1/14/2006
Plus they taste so fuckin good.
2/25/2006
Got one for dan... lutefisk!
It smells horrible, but the taste actually isn't that bad... so for someone with taste whose attitude stinks, would that work? ;-)
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