Friday, December 14, 2007

The weather has been rather cold in the Midlands over the last few days, and the roads have been icy. The British don’t know how to drive on ice or in snow, born out by no less than 8 RTAs coming through the doors of A&E last night.

Traumas in A&E are weirdly calm. Everyone knows what they should be doing, and gets on with it. Apart from us medical students, who mostly stand around and look worried. Although the other student and I did get plum jobs last night – she was the runner, and I was chief gelofusine bag squeezer, a job I performed with remarkable aplomb. Until the radiographer arrived to do the trauma panel… All the nurses and doctors scarpered to hide behind the lead screen, which left the chief consultant, the anaethetist and me to fight out 2 lead aprons. I clearly lost and had to stand behind the radiographer, still squeezing my bag of fluid and worrying about my ovaries.

This particular patient was a pedestrian hit by a vehicle, and when he arrived that was all we knew about him. His patient labels were ‘Unknown Male’ with a DoB 1/1/1900. The management was complex and fast paced, with many possible problems discussed and/or treated, but he was stabilized after about an hour in resus. He then went to the CT scanner, where it turned out his brain was full of blood.

Unfortunately I never found out how he was doing today. I can’t imagine it was good…

That’s one of the sad things about being a medical student – you dip in and out of patient stories without being able to follow the whole. At most you are lucky enough to witness a single complete episode of a person’s life, but you will never understand the narrative running behind that episode.

I received an email today from one of my GP tutors, from the practice I was attached to last year. On the 6th December last year, I met a lovely lady, with some odd symptoms and an epigastric mass. She had a battery of tests and was diagnosed with myeloma and amyloidosis. My GP tutor kept me updated with her progress throughout the placement, but I left the practice in March this year. He emailed today to tell me she had passed away. She had lasted only a year after I met her, generally well with hypotensive episodes and an epigastric mass. I know the end of her story, but happened in between? Who loved her, who cared for her? Who cries for her now she is gone? What is left of her life still, here in this world?

if I believe in God, I am known… God will know me, even as I cannot know myself. If he has created me, then he has lived with me. He knows the nature of my temptations and the manner of my failing. So I am not alone. I have for my companion the creator of the world.

At the hour of my death I would wish to be 'Known unto God'.

~ Sebastian Faulks


the little medic said...

A+E sounds exciting at this time of year. Not for the patients though I suppose.

Very much agree about not really getting the chance to follow patients up. I often wonder how some of the people I see are doing days/weeks/months after I last saw them. Maybe I should be a GP :o

Marysienka said...

Ah! the job of a medstudent!

There's this little girl I saw 2 summers ago, we suspected she had JRA, but I never knew the end of her story... I still think about her often. There are many times I think about the people I've seen, and I so wonder what happened/is happening to them.

And I know about the fight for lead aprons! In ortho surgery, Anes#1, short Nurse, and I were always fighting for the long (no "skirt"!), green, small size one. Of course, I was always losing...

Poor us! ;o)

Anna said...

Little Medic, perhaps general practice is calling to you...

I wanted to do GP when I started medschool, mainly because I liked the idea of following a patient's story all the way through, getting to know tham and their families. But now there are so many things that put me off being a GP. Knowing your patients too well is definitely one of them!