Ped vs Car

Anger is a good performance enhancer. Beat my previous best 4km run time by nearly 45 seconds. Maybe I should get angry more often haha.

So haven't blogged properly for a while, mainly because I've been lazy. Guess I mainly use it to vent, as a form of catharsis.

I'm currently halfway through an elective in the ED of Gosford Hospital, just hanging around seeing patients, learning from assessing patients the way a proper doctor would and tagging along with other doctors if they have intersting cases, practicing my IV cannula and venepuncture technique, etc. Saw this interesting trauma case yesterday, the first major trauma I've seen so far. The patient was an old guy who as a pedestrian apparently got sideswipped by a car which had just collided with another car. He was rushed in with a variety of injuries including minor head trauma (GCS 14), a 'degloved' right forearm (ie the skin had been ripped off), significant hypotension (60-70 systolic) among other things. But the gory bit was his legs. On his right leg, he had an open fracture dislocation, with his foot completely dislocated from his tibia, and the distal end of his tibia sticking out of the wound. His left leg had a fractured tibia and fibula, and nearly his entire calf was 'degloved'. It reminded me of doing dissection in my 1st and 2nd years of uni, the way the underlying muscle of his calf was clearly visible. Anyway, it was interesting seeing the ED doctors stablising him, doing the usual trauma stuff like primary survey with ABCDEs, chucking in IV lines, a urinary catheter, and a chest drain for a suspected haemothorax), intubating him, XR of chest/abdo/cervical spine, and basically trying to find any source of bleeding to explain his hypotension, which persisted despite 10 units of blood and 10 units of colloid being pumped into him. The way they reduced (ie popped back in) his dislocated foot was also cool...seeing 3 big boofy doctors straining like mad to get the thing back in. So yeah, it was exciting stuff...beats an office job any day. One of the nurses said it was like watching an episode of ER, but since I've never watched it, I couldn't agreed with him.

Well that trauma patient was yesterday, today I went up to ICU to follow up on him, and he's had his fractures fixated, on fluids and inotropes to maintain his blood pressure, but with his past history of stroke and ischaemic heart disease, and his generally poor condition, his prognosis is pretty grim. Even if he survives and manages to avoid the sequelae of long hospitalisation like infection, DVT/PE etc, it'll still be months before he can walk, if ever. Poor guy. Sometimes I think it would've been more humane if the car had killed him outright. After all, he's lived a long life (he's like 80-90 odd) and he'd definately had suffered less if he hadn't survived. But then, who lives or dies is up to a power greater than I.

Forgotten

Wow I can't believe it, but I am not looking forward to returning to Melbourne as much as I usually do. Of course it will still be nice...but less nice than usual.

It is terrible how easily I get pissed off, over something that in hindsight is probably not that big a deal. But hindsight is yet to come, as I'm not yet past what happened. But knowing me and my poor memory, I'll probably wake up tomorrow and have forgotten why I was so angry tonight. Hopefully.

But yeah, it was less about what happened, and more that I wasn't taken into consideration. Forgotten even. Grr...