Sunday, November 12, 2006

The self doubt that keeps us all human

I've just walked in from another night in a hospital. This was my first night on in Moose Jaw. It was the kind of night we dream of, lots of quiet with only a few interruptions of paranoid mothers or drunken teenagers. And yet, even with a night like this I felt uneasy. As with most things in life the waiting is worse than any event that could actually happen, and when your on call - you are always waiting for something. Yes, you get used to it and most times now being in the hospital for days at a time doesn't bother me, but sometimes you just get a feeling.

So at 5:30am, the ambulance phoned - 2 minutes out with an old man having a massive heart attack. Now in Moose Jaw as with most rural communities- if you're on call you're it until you convince someone better to come in from home, and in Canada we try to save everyone. So in they come, fat 82 year old white guy, cold as ice sweating, drooling, out of it. He needs me. So as with every time this happens to me, I go really quiet, I want to wait to see what happens. In lots of places, I'd give them a few seconds to die. Anyway - not Canada. The nurses are running around me, each with their specific job, and my mind is just going through a sequence of random events. Many snapshots from long nights during internship, all the stupid medical decisions I have ever made, all those I have been reprimanded for that I did not make, and lots of pictures of pharmacology textbooks and scraping to remember the new protocols that came out last week.

So finally I get to the only thing that helps me - he's dying already, anything I can do will only help. No-one is expecting him to live. Even though I'm at least half the age of most of the nurses here, I'm the one with the authority even if they are more experienced.

So off we went. IV lines, ECGs, masks etc. I had to intubate and first time got the stomach, resulting in a flood of stomach contents and heaving and much more distress. Eventually airway in, me pumping madly to keep air going into his lungs and suctioning to stop his stomach acid from going into his lungs -the cardiologist arrives. It was probably only 5 minutes, but it felt like an hour. I stayed and helped in a nurses capacity, which sometimes I feel much happier in. As he confidently ordered different drugs I knew them all in sequence in my head. They are in my rote learning section, lists to know in your sleep - but yet I was so grateful that it was him and not me. Sometimes the know how is not enough. Again I felt like the quiet girl who no-one will take seriously, who doesn't know if she can be a doctor.

So now old man is in ICU, he will see at least one more day and I had something to do with that. I did my best even if my best wasn't as slick as it should have been, or as ER-y as you would like to imagine, for today it was my best, and next time I will do better.


At 9:07 AM, Blogger Geoff said...

This is just like that one episode of Scrubs where Elliot can't intubate. Or is it JD? Wait - maybe it was Grey's Anatomy. Awww, shucks I'll need to look it up now!

At 7:04 AM, Anonymous sally said...

ah sounds so exciting clara! makes me think how dry and selfish my career in numbers is gonna be...

At 6:43 PM, Anonymous juan vassil said...

hey...seems like that scenario keeps repeating...even in dreams and in I have had to realise from my loved one and her recollections of the same kind of thing...seems like hindsight is brilliant and that you always feel like an idiot in real time....
Goes with the territory


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