Sunday, February 05, 2006

The Witching Hour

Ah, nights - ya gotta love 'em!

Well, actually you don't. They're shit. I am but half way through my punishment and I've already had enough. Here in the rarified surroundings of my hallowed institution, we get to cover both neurosciences and neurosurgery at night. One can only imagine how thrilled the patients, their famillies and attendant lawyers would be to learn that the doctor looking after them doesn't know a monkey's fuck about what has or is about to happen to them. By now I've given up trying to delicately bat away questions about what exactly various surgeries entail and have instead decided that it's far more fun to just make up what I think my happen. Spinal decompression, I explain, is much like loosening your tie and undoing that top button on ya shirt when you've got a headache - it gives the cord a bit more room to breathe, see? Nobody seems to care anyhow.

Most of the work is mundane. Like a machine I process the new admissions, producing beautiful crafted clerkings for elective surgical patients that I know nobody will ever read. What do the surgeons care if vibration sense is decreased in the left leg or there's a hiss of mitral regurg? All they do is drool and dribble over the prospect of fresh flesh to cut. A starved patient with a beating heart and normal bloods will do them just nicely thank you.

Still, there is the odd bit of fun to keep you ticking over. Last night one of the epileptics went crazy. I heard the nurse screaming as I was cannulated some old dear down the corridor. I popped my head round the door just in time to see Cathy being chased into the female bay by a man wearing only white briefs, screaming in Italian and waving his clenched fists around in a murderous rage. In the carnage that ensued we managed to wrestle him to the ground but only after he'd knocked one old dear flying off her commode, sending a river of rancid piss dangerously close to my knees. Somehow he'd managed to bite his tongue and, as he arched his back and writhed under the weight of four burly security guards, blood pouring from the sides of his mouth, alternating between blasphemous Italian and maniacal laughter, I did have the distinct in impression that I might be in a remake of the Exorcist or the like. In the end it took one and a half hours and 50mg of diazepam i.v. to fully exercise his demons, after which he was carried like a limp rag doll and dumped back on his bed to 'sleep it off'. Cathy complained loudly that she needed danger money to do this job and I nodded soothingly and reassured her that diazepam is long-acting. All the same, it beats clerking.

4 Comments:

Blogger Dr John Crippen said...

To be absolutely serious for once, don't knock the immaculate clerkings you do of surgical admissions. First (OK, OK pompous old fart....) I know I acquired a huge amount of medical skills by having to do routing clerking of surgical admissions. I remember getting a much sought after house job on the Professorial Surgical Team and finding to my horror that as NOT mentioned in the job description was the Sunday afternoon clerking in of the check cystocopy list for Monday. Always between 20 and 30 patients.

And you are right. The urologists did not give a monkey's toss about the odd bit of irrelvant patholgy I picked up...but I did pick it up.

Nowadays, where I work, there is no routine clerking by the housemen. The patients are called in a week in advance to see my friend the nurse "specialiast" for a pre-op "assessment" and the GP is sent a circular asking him to fill in details on the patient, allergies, medication etc etc.

So the punter is not properly clerked, and the houseman does not get the experience.

I think it is great that someone like you is clerking in the surgical patients. You will pick up any serious pathology that would mostly be missed by the nurses and certainly be missed by our dear friends the neuro-surgeons


And I love the neck tie analagy for cord decompression. I shall send you 10p every time I use it!

John

12:48 pm  
Blogger The Venial Sinner said...

Don't worry - I'll keep on clerking. Indeed, so beautiful and artfully conceived are my clerkings that, in my more haedy moments of megalomania, I sometimes come to believe that they would not be out of place hanging in the National Gallery, next to a Van Gogh or a Velazquez.

1:34 am  
Blogger Simon said...

Dunno about van Gough - this stuff is more like Kafka.

9:27 am  
Blogger The Venial Sinner said...

Kafka - I wish!

6:05 am  

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