I spent my first vacation day in the Emergency Room at Maimonedes Hospital. My stomach felt as if someone had stuck a balloon inside it and was blowing it up at will, and nothing was working (not water, not pepto, no food going down), so I found myself moaning in a bed next to a man who couldn't breathe, at about 12:30pm. The doctors were pretty swift with me and decided pretty early that I had one of the many viruses going around, and once my bloodwork proved mostly normal (my white count was up, of course), I was handed an elixir of phenobarbytol and maalox which knocked out the pain and sent me a-slumbering for about an hour. When I awoke, the guy next to me sounded like he was breathing under-water, and the amazing nurse who was working on him noticed quickly that there was no suction device near his bed. She called for one and a chaotic group of nurses and doctors surrounded her while the device was set up (no more than an ordinary suction bag and a plastic jar). She had to ask the guy questions and get him to move while she did some of this -- and I heard her call out, "Not yet!" Then a voice behind her said, "He's got a DNR." The nurse said crisply, "I don't think we're at that point," and proceeded to suction out fluid from the guy's lungs. Fifteen minutes later, he was talking to his teenage son.
When I was preparing to leave, about 45 minutes later, the doctors -- most of the respiratory team available on a Saturday -- were deciding how to replace the man's trachial tube -- what size to use, what to do about a blood clot which seemed to be at the bottom of the one he was currently using, and questions were repeated over and over by each group that was added to the case. "Did we put this in? Has he been x-rayed?" In a lot of the questions, you could hear the underlying wonder of how much should be done. I wanted the people with questions to go away and simply let the smart-mouthed, but excellent respiratory doctor who was at the center of the circle and now testing a smaller sized tube, do his work. He was explaining everything non-chalantly and then deciding what size to go with. "I understand," he said to the man as he worked on him, "It feels like the tumor is bumping up against the tube." The doctor didn't say if it was or wasn't -- I don't think he knew. He was certain about the clot. He continued to work. I couldn't see him, but I felt as if I could picture what he was doing. "You see, I just put this [smaller tube] down and he says he feels better so we must've moved the clot or whatever was at the base of the other one." "This is a size..." His words became muffled by the movement -- he was getting ready to replace the tube and he swiftly left the circle to get what he needed.
My nurse took my blood pressure just before I signed my paperwork, and it was 139/90 -- higher than it had ever been in my life, but we took this to be from my involvement in the drama next to me. I was telling her about how frustrating it was to hear the same questions repeated while this guy is getting uncomfortable and that I wished people would let the respiratory doctor work. She said, "You're going home today. This is a good day." Then she left. I grabbed my prescription for pain medicine from the cheerful doctor who had worked on me seemingly obliviously to the pain of the man next to me (She wasn't on his team, at all. No one who worked with me was.)
And I went home.
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