Thursday, March 09, 2006

Now ICU, Now I Don't

When you're an intern, everything that happens seems momentous. Every patient is unique, every experience is new, every sensation is intense. The learning curve is so steep it feels like it's carving a permanent groove in your brain. You're always in high gear, rarely sleeping, alternating between panic and exhilaration. You know you'll never forget a single moment of this.

Of course, you do forget. I've forgotten. I've forgotten a lot of it.

But there are those experiences, those patients, that are truly unforgettable. Impossible to erase from your memory, even if you wanted to. This was one of them.

The guy seemed a little wacky from the get go. We should have known better.

Oops. I mean, "47 year old married male presented to the emergency room, accompanied by his wife, who expressed concern that her husband might have consumed an excessive amount of aspirin in a state of despondency."

The guy is denying ingesting anything, although he admits that he's been depressed, and refuses to tell his wife or the ER staff where he went that afternoon when he was gone from home a few hours. (This is the time during which his wife suspects he overdosed.) His behavior is strange enough, however, to put up a red flag for the ER doc. They go round and round a while, and finally it's decided that he'll check in for the night for lab tests and observation.

They send him up to the ICU, since there's at least a possibility that he ate a bunch of aspirin, which could throw his body chemistry into deadly disarray. This is where I come in. Those of you in medicine know that the first doctor a patient sees in his hospital room is the intern. Wet behind the ears, eager and sleep-deprived, assigned to do the dreaded "H and P". History and physical. Getting the basic info about the patient. That was me, on my medicine rotation at --we'll call it General Hospital (names have been changed to protect the guilty).

So I trot into the room in my white coat, loaded with pocket-sized reference books and tools of the trade, clipboard and pen at the ready.

The guy is sitting on the bed, fully dressed in his street clothes. I think, "That's odd; usually they come up from the ER in a gown, with their stuff in a bag. Oh well, I heard this guy was a little wacky. Maybe they cut him some slack."

Out loud I say, "Hello, Mr. X, I'm Dr. Spencer. I'm here to do your history and physical."

"Well, I'm leaving." grunts Mr. X.

"Sir, I'm afraid I can't let you do that." The brave little intern, asserting her authority as The Doctor Who Knows Best.

"You gonna stop me?" He stands up, pulling his hand out of his coat pocket to reveal a very small, shiny, grey ---good Lord, it's a gun!

About face. Change in attitude. From brave little intern to backing-out-of-the-room-with-hands-surrendering-in-the-air intern. Hey, you wanna leave? Be my guest. Me, stand in your way? No sir! I'll just skedaddle on outta here. You do whatever you please. I'm no hero. Not stupid, either.

Once out of immediate danger, I hustle over to my chief. "He's got a gun!"

"What? No way! He couldn't get up here with a..." he bit it off and ducked behind the desk as Mr. X emerged from his room, gun in hand, and hit the nearest stair exit, banging through it before anyone could speak or move. "Shit!"

He grabbed up the phone and called security while the nurse called the ER and warned them Mr. X was on his way down and out with a gun. Then we all held our breaths. One word. Then the phone rang. It was the ER. "We haven't seen him. Are you sure he came down?"

Oh no. No. Shit, no!

Yes. He went up. Up, into the hospital. A crazy trapped animal with a gun, loose in the hospital. be continued.............

I'm just teasing you. That, believe it or not, was pretty much the end of the story. After an extremely nerve-wracking half hour, we got word that the police had picked him up across the street from the hospital at a fast food place. He didn't go on a shooting spree in the wards, in fact he never showed his face up there that anyone could recall. How he got out of the hospital, nobody ever saw. The police came back over to interview me and show me the gun for confirmation. Mr. X traded his comfy ICU bed for a jail cell. I never heard what happened to the ER staff that let him out of there without going through the usual routine. I never saw Mr. X again. And I never forgot him.


Heather said...

Wow. I'm sure you couldn't forget him if you wanted to.

And you were killing me with the "to be continued..." !!!

Dr. Al said...

It seems, Dr. Peg, that all interns run races with themselves that they can't win. I guess all we can do is settle for coming in a "close last." I enjoyed your story immensely, but I was hoping for a provocative, sensational, or moralizing ending to the story. NEVER tell the truth! When the ending seems a bit bland, make up a new one. While that makes for a decay in the author's integrity, it sure entertains the hell out of those of us who have nothing beter to do than read and write blogs. Dr. Al

Dr. Al said...

Please forgive my poor spelling of the word "better" in my last comment. You would think that by now I would have learned to proofread my comments. Oh, well. Dr. Al

peg said...

Dr. Al - "Never tell the truth"??!! Sheeshamola! Trade integrity for impact?

"Is this what you do in your exam room, doctor?" says the lawyer on the stand.

I'm kidding. You're right, if I were writing fiction. This one happens to be true, and I just wanted to tell it the way it was. Heck, I thought it was pretty exciting when it happened, and I was grateful for a "bland ending" at the time, believe me!

It was a first draft, spat out in one sitting the other day. Maybe one day I'll turn it into a fiction thriller - and put you in the credits!

Thanks for reading and posting.


PS You might like "Stillborn" better .

The Authors of "50 Ways" Interview on KCHF TV

50 Ways to Leave Your 40s TV interview with Phoenix' Pat McMahon