Thursday, August 11, 2011

All in a day's work

3M Littmann 3128 Cardiology III Stethoscope, Black, 27 inchWe are humans with animal instincts routed in our subconscious minds.
A couple of days back I asked a colleague of mine, Dr.Shaal “ Is this normal”.
He stood in front of me and cocked his head on one side thinking for 30 seconds before saying “No its not”.
It all started just like any other day in my department. We had the usual patients with abdominal problems and trauma, but no hectic red code. I had just finished checking a patient and was busy writing a plan of treatment for the patient and ordering some bloods when I was called for a patient who had collapsed after being assaulted. I saw the nurses hooking up the monitor to this new patient and saw she was frothing at the mouth and seemed unconscious. She had a bandage on her right forearm. My experience and gut told me she was suffering from hysteria but given the fact she seemed to be unconscious and was frothing and spitting I had to rule out other causes of her condition. I tried calling her and informing her where she was but with no response. I tried shaking her shoulder and still no response. By then Dr.Shaal had joined me and I applied pressure on her sternum with my knuckle once and she moved a bit. I gave a history of the patient to him while I tried again putting pressure with my knuckle on her sternum. All I can say is that one minute I am standing next to her the next she is sitting up and screaming and holding my left arm in a tight grip and her other hand is pulling on my jacket collar . The zip of my jacket digs into my neck and slowly I find myself struggling to breath , my head turned away from patient but too late as her spittle makes a beeline for my right eye.I remind myself that this a patient and I cannot be offensive with her. Soon I start seeing stars in front of me and by now I hear voices in a distance. Someone is trying to unzip my jacket but its zipper is stuck, finally I manage to get out of my jacket thanks to my colleague , the intern and my nurses. Dr Shaal asks me if I am fine and I tell him I am absolutely fine only to feel a burning sensation on the left side of my neck where a wound is beaded with my blood. By now the patient is fully awake and doesn’t remember anything of the incident. I inform her that she is fine now and she is in the hospital. By now Dr. Shaal has got an iv in her left arm and we open her bandage on her right forearm to find 3 scratch marks on her forearm! The nurses laugh it out trying to lighten the mood. I decide not to inform the patient about her actions as I can see she was also a victim of an attack and needs reassurance. I carry on checking other patients. Then take a break to send a message to the hospital manager informing him about the incident as per protocol. As the day goes by I feel tired , all my adrenaline spent. I go to the doctors room and splash my face with cool water . I stare at myself in the mirror and am shocked to see two tears escaping my eyes. I stand there taking deep breaths and cannot understand my reaction. This has never happened to me before.Apart from the foul language from an intoxicated patient, I have been shoved against a wall in the ER, I have been slapped on my arms and my bum at work and my eyes have never betrayed me before. I have held the hands of patients as they slipped away from severe trauma, I have seen children and adults with traumatic amputations and GSW to heads with brains oozing out and GSW to face with face split open …..and many many why now!I remember another colleague of my mine who was slapped on the face by a relative and how he too remained passive due to the Hippocratic oath. I clean myself up and get my file and go to occupational health to fill in forms. As I sit there doing paper work I see the same patient walking arm in arm with a friend to the pharmacy. Ironic I think. I sign the last form and stand up to leave when I see my husband standing at the door. Then I remember he had Imed me to see how I was and I had told him I would talk to him later. I can see he is concerned and angry. This is the last thing I need right now. I know its going to be a looong day for me. On route I bump into my Chief and I am touched with the concern in his eyes. I know he is wondering the same thing as I am...what is my husband doing here. I tell him that I had missed his phone calls and he got concerned and came to check on me. I didn't think he would understand if I told him that my husband had a bad feeling about me the whole morning and after my message just rushed to see me. At that time I couldn't understand my husbands reaction towards this patient. I just kept on evading him from the patient as I could see the blood in his eyes. Thats when I asked Dr.Shaal if it was normal what had happened to me....and he said no. It was then that I realised the wide gap between doctors and normal human beings. We as doctors are so used to detaching our emotions from ourselves at work that some of us forget the off doctor switch. We start to think our spouses are like us and hence cannot fathom why they show such intense emotions.We become handicapped without emotions. We forget to be humans. I thank God that my better half is always there to anchor me during the worst storms at work. I thank my colleague for being there and more importantly for saying that one word that reminded me about my off switch.
After this incident I sat at home looking at my arm which still bore the bruises from the patients hand grip. I sat and thought about how my life would have been if I had stuck to being a computer programmer and not a doctor. I would have had more kids and more time on my hands, maybe work as a freelance from home. Would I have been happier? I found myself reaching for my phone to check out when was my next shift. Thats when it hit me...I had my dream kept me on my toes and everyday is like going on a new adventure.