My Precious

Back when I worked in the Big City ED, we had a nurse named Bob. Now I'm sure Bob was a perfectly wonderful human being, but he was not a great ER nurse. Bob didn't like commotion. He didn't like multi-tasking. He was no fan of confrontation. More than anything else though, Bob hated, and I mean truly and completely despised, when someone moved his charts.

Finding a chart lying on the counter rather than stacked neatly in the rack put Bob over the edge, so much so that he once famously kidnapped all the charts, relocating them to the med room and hiding them among the lidocaine vials behind the safety of a locked door. Any attempts to access the abducted charts by another member of the team was rebuked. There, safe from greedy grubby hands grabbing his precious charts, Bob remained holed up to jealously document on his well-organized beauties. (His tenure in the ED was short.)

Sitting around the Christmas tree this weekend, I was reminded of this humorous episode by noticing the same possessive leer in the eyes of one of my younger cousins. Still a few years shy of truly appreciating the whole "giving is better than receiving" tenet of the season, the little rascal wolfishly gathered his presents from under the tree and arranged them in a neat pile at his feet. Positioned out of reach from the rest of the family, he was poised to start shredding the wrapping paper at the earliest acceptable moment.

Recognizing that look which screamed "Mine!" and smiling, I hoped at that moment my cousin would never choose a career as an ER nurse.

Around the Blogosphere

I'm sure most of you read Movin' Meat already, but if not, take a minute to stop by and leave some kind words for Shadowfax. His wife was recently diagnosed with breast cancer. Between several years of working with kids with cancer, and losing a couple family members to the disease, I can honestly say cancer sucks.

On a happier note, Nurse K is back! Brace yourself for more hilarity and snark.

Med Student Heal Thyself

For the record, I probably do not have an abdominal aortic anneursym.

I do, however, have a funny, recurring, pusatile sensation in my left lower quadrant.

Combine that with a a heightened sense of medical curiosity secondary to the elevated ignorance of a first year medical student, and you get several intriguing, bizarre, and universally fatal self-diagnoses.

It's kinda fun.

The Tables Have Turned

For the first time in several years, I experienced a visit to the ER on the opposite side of the stethoscope. Now back home for winter break, I accompanied my father to the Local Hospital this weekend after an icy sidewalk led him to experience to a sudden and unexpected burst of gravity. After countless encounters with family members in the ER, I decided to employ several of their techniques to ensure we received high quality care:

*Upon arriving at triage, I spoke over my father to answer all the RN's questions. When she asked his pain, I replied "20/10!" while waving my arms emphatically. When his temperature was measured as 97.6˚, I informed the RN that it was "high for him."

*As our time in the waiting room approached an unbearable 10 minutes, I interrupted the RN while she was triaging another patient to ask if she was trying to let my father die. I also asked to speak to a manager.

*Once brought back, I explained to everyone that I worked in an ER, pointing to my Big City Hospital ID badge that I carry with me at all times. I also mentioned that I'm a first year medical student, so I basically know everything.

*While my father waited for X-ray results, I decided to wander the halls of the department, peering into other patient rooms and trying to decipher chief complaints while reading the board.

*Since my father hadn't eaten in at least 3 hours, I demanded two box lunches - one for him, one for me.

*When the doctor explained that X-ray showed no broken bones, I hastily began packing up our belongings and accused the stupid doctor of wasting our time and money on those pointless tests before storming out.

All in all, it was a very successful trip.

Extreme EM

From the New York Times, another account of front line medicine in Afghanistan. Transporting a pregnant woman is stressful enough, but flying her in a Blackhawk helicopter over a war zone?

The Robot Will See You Now

Blood pressure 220/110? Warning! Danger Will Robinson!

So it looks like years of education, hundreds of thousands of dollars in student loans, and a small forest's worth of lecture notes will all be for naught.

That's right, doctors are out, robots are in. At least in triage, that is. Vanderbilt University is working on the TriageBot, a machine that will take patients vitals, solicit their chief complaint, even wander the waiting room to make sure patients are still breathing.

Maybe I should start focusing on learning what R2D2's bowel sounds sound like?

Law and Order: Organ Preservation Unit

We'd like to see your organs.

A patient having a heart attack calls 911, and an ambulance rushes to the scene to save a life. A second ambulance, with the words "Organ Preservation Unit" stenciled on the side, arrives a little later in case the first crew is unsuccessful. Like anything with organ transplantation, it's a concept with complicated ethical, logistical, and public relations considerations, but an interesting plan nonetheless. I still vote for a national opt-out policy instead.