ER: Seventh Day (lots of suturing!)

Because I took so many days off (5 in the last two weeks), I'm working weekends until next Sunday. Today I worked with another Dr. T who was known to work at a "regular" pace. His scribe was relatively new to Harris b/c he'd previously been scribing at Southwest, and this was his first time working with a medical student. At first he thought I'd be taking work away from him, so I quickly said that since I can type my own notes, he won't be as overworked when we get swamped. Even still, I think it took a while for him to warm up to me, at least until 3:00 pm when we finally were able to get away for a lunch break. He didn't bring money so I paid for both of us, and now I really appreciate the physicians who pay for the scribes' meals (most docs have two scribes, and one or two have even paid for my dinner so the expense adds up)

There were a few routine cases like an "altercation" where a guy got beat up and robbed, chronic headache, and plantar fasciitis (aggravated by a bone spur), and then Dr. W (who works 4:00 a.m. shifts) saw me and asked how good I was at suturing. Apparently he got swamped this morning and kept Jeremy (who worked the 11 p.m. shift) around until 8:00 a.m. to help him suture lacerations. This was no different; there was a patient who had a huge cut in his ear that needed sewing. Fortunately Dr. W supervised me for the first few stitches before running off to discharge patients, and for the most part I think I did pretty well. Then Dr. T told me to sew up an elbow lac on an elderly patient. Stupid me, I only sewed up half the lac and thought I was done b/c the rest of the cut was occluded by blood, but when Dr. T came to check my work I realized what I'd missed and quickly finished the job. Toward the end of the shift I got to sew the finger of a guy who hurt it during a jackhammer job, and while some parts were easily approximated, other parts were not so much. I had to cut away some of the dead tissue, but through it all the man was a good sport and thanked me after we were done. We had to give him two digital blocks b/c too much time elapsed between the 1st and 2nd dose so that he c/o pain when I tried to sew the tip of his finger. Thank goodness he didn't feel the second block.

One of my more interesting patients was a young guy who was also deaf; he and his wife (also deaf) communicated through sign language with a sign language interpreter in the room with us. Despite that, he was still able to speak some words with good precision. He had an abscess on his knee, but fortunately it wasn't big enough to drain and antibiotics were all he needed. The scribe asked how people get abscesses, and I said it would be through sharing towels and bath sponges. I overheard Dr. Trot say once that he told all his abscess patients that abscesses were caused by having too much sex, and they believe him. Yikes.

I was scheduled to work with Dr. T again tomorrow afternoon but I decided to come at 4:00 a.m. instead to helpt Dr. W out since he needed a student today. Maybe there'll be a lot to do tomorrow.