ER: Eighth Day

As planned, I was back at Harris at 4:00 a.m. (must be out of my mind) and welcomed by Dr. W, who immediately sent me to talk to a patient who'd been thrown off a motorcycle after her husband swerved to avoid hitting a dog. "Should have just run the damn dog over," he muttered when I asked him for a history. Another patient was soon brought in with burns on his hands and head; apparently he'd been squirting kerosene on a fire during a campfire and received a flash burn for his efforts. Aside from a few patches of missing skin on his forehead, he looked as though he got a huge sunburn above his neck, mostly 1st degree burns. That alone wasn't serious enough to admit him, but when he began coughing and wheezing (and developing a "frog" voice), we worried that he had an inhalation injury as well. Normally all burn patients go to Parkland, but the transfer would require him to be intubated and he was not that sick for sure. Dr. W made several phone calls and it was agreed that he would spend the night in ICU under observation. He was a real nice guy, with a wife in nursing school at his side. She was of Korean descent adopted by a white family as an infant, and at first he asked if I was the same or if I was born in the US (neither). Still, it made for some good conversation to keep his spirits up. At one point Dr. W joked that our guy got a "cheap face peel," which I didn't think was terribly funny since his face was peeling, but everyone else found humor in it. (Dr. W is renowned for saying the most off-the-wall things and getting away with it)

We took a brief break around 7 a.m. and I got an earful of Dr. W and another doctor (Kate's preceptor of the day) talking about how a trauma surgeon got on their backs for not reading all their CTs (which only 1-2 ER attendings do). "If I had to read all those CTs, I'd never get any work done," said the other doctor. "Trot never reads CTs." Dr. W then said I could expect to hear a lot of similar griping at the division meeting this Tuesday, but also said that it was entirely possible that med students could get thrown out b/c there's usually a lot of head-butting at these meetings. Hehe, looking forward to it.

I saw several cases of patients in chronic pain who just needed medicine refills, and two patients who came were pretty drunk. Dr. W asked one guy if he had 1 or 2 beers, and he said, "Oh, I had way more than that!" and laughed. LOL. "We got an honest one here!" Dr. W joked. Later on we had a middle-aged man come in with an awful cellulitis of the hand b/c he "shot up meth" in his vein and missed. His hand looked extremely swollen, reminding me of the questionable snake bite I saw in Austin, but he was sure that it was the meth needle that caused the infection. "At least he's honest about it," I said, and Dr. W agreed, saying that it was a stupid thing to do but that many drug addicts are unrepentant or else lie about their activities. Fortunately we didn't need to drain the guy's hand; we did put him on two antibiotics though. Maybe that'll teach him not to shoot meth again.