The Joys of ER

Now that the ER month is over life has gotten significantly busier. I have been trying to find time to blog, but between working, eating and sleeping (with a little bit of watching the Olympics) I haven't had room for much else. Last week was an 86 hour work week (I only know that because they force us to track all of our hours). I love what I am doing though, so I can't complain, other than the fact that I wish I could see Abbey and the boys a little more.

We had some crazy things come through before I left the ER. One of my favorites (sorry in advance to all of you squeamish people reading) was this guy with a tree branch though his forearm. He fell off a horse, slid down an embankment and only stopped after impaled his arm on a branch. His buddy chopped off the branch on each side and he was flown to the ER with this through and through injury. The branch was, no joke, 2 inches in diameter sticking out both sides of his arm. I tried to get a picture but when I went back in the guy was in so much pain and was so angry, that I didn't dare ask (this after 60 mg of morphine, which is a lot of morphine). Most of what you see in the ER is really routine, so for your sanity, it is really nice to have the day broken up by the atypical like people impaled by branches.

I don't think that I am ever going to be able to bike on the street again. I swear more than half of our traumas were for cyclists hit by cars. At least wear a helmet!!!

I had this patient a few weeks ago who was so obviously faking a heart attack. Due to our medical legal climate you have to work them up fully though. This is one of the most frustrating things in medicine. People get a $5,000+ work up you know they don't need but out of fear that you might get sued you do it anyway. It is a total joke, but it happens everyday in every hospital. If you are going to fake an MI (myocardial infarction - heart attack) at least get a few things straight:

1) Your left arm should be hurting, not your right.
2) MIs normally do not cause jump off the table chest wall tenderness. Meaning, when the doctor gently pushes down on your chest don't scream and push their hand away. In fact, nothing really causes that much tenderness in your chest.
3) If you are going to fake tenderness don't forget to be consistent. If I can't even touch your sternum with my hand how come I can push down pretty hard with my stethoscope when you think I am just listening.
4) Lastly, make sure no one is going to quietly walk back into the room while you are going through the drawers obviously looking for drugs. Oh, you were looking for a pen, right, right! No nurse is going to be stupid enough to leave narcotics in a patient's room.

Now at least you can convincingly fake something.

This stuff is interesting to see, but I would never swap the 30-40 hour ER work week for my busy schedule and delivering babies. I have only been on labor and delivery call two nights, but have had 8 deliveries. I know it is not for everyone, but being there for the birth of a new little baby and being the one to do the delivery is one of the coolest experiences there is. Well worth working 86 hours to have.