Saturday, June 14, 2008

The Cross Is In The Ballpark

There are very few moments in my job when I feel real fear; I see a lot of unpleasant things. I see a lot of sick people, and many of them make me anxious, because I'm always thinking the worst. But that's what I'm there for. Get on and treat.

But sometimes, something will happen that makes me pause, that sucks the breath right out of me. A time when you begin to think you might not have whistled loud enough on your way past the graveyard.

Perhaps this will clarify:

Last night began humourously enough; I forgot my scrubs, so borrowed a set from Sister. Dressed as I was in blue, everyone took the opportunity to look askance at me and call me 'Sister Shroom'. And it was honestly as funny the 20th time as it was the first.

Then, in one of the surreal moments that EM throws up, our reverie was broken by the arrival of an Ambo, breathless, clutching a small child in her arms. But come from the wrong direction. From the main Hospital, not the Ambulance bay. Such a simple thing confused me; I must have looked like the Village Idiot - slightly slack-jawed, as her words washed over us, in short, staccato bursts. Something about purple hands and feet.

Thankfully, the real Sisters had more presence, and we deployed to Resus. A beautiful little boy, small for his age, even smaller when marooned in the middle of the gaping trolley. He was gazing about, fixing us all with his eyes; he had beautiful blue eyes.

We all noticed that.

Dad gave an history of non-specific illness for a few days, topped off with lethargy today, and then the episode with purple hands and feet.

(As an aside, I'll simply ask you to regard your own hands and feet, and their colour. Unless you have circulatory issues, or are a grape fetishist, see how far removed the colour is from purple? Got it? Good. So you can imagine where purple is on Shroom's list of Colours I Am Glad My Baby Is Not)

He was cold, for sure, but he hadn't been in the cold. Rubbing his hands, I press his fingernail gently between my finger and thumb. It blanches, corpse white, and stays that way for far too long. We strip him off, compounding his indignity, adding to his childish outrage at life. His chest and belly are mottled. Warm bu mottled, and I can leave a ghostly fingerprint on his sternum for several seconds.

He's sick.

So shut down that I'm struggling for access; I call Paeds early, stammering over my presentation - the Model Professional. It always stings my pride a little to have to call them for help early, but it's not about me, and the kid doesn't care who draws his blood. In fact, I get a line in while I'm waiting for Paeds. Third time lucky? His hands are freezing, and I can see his veins, but they lie guttered beneath his skin, and I'm really running on hope. It's rare that I feel I really need a drip in someone, now, but I felt that way about him.

Anyway, Paeds arrives and we give her the lowdown again. She runs the ruler over the kid, establishing that his skin is not normally mottled (which I didn't even think to ask...)

And then it happens.

'And what about these petechiae?', she asks. 'How long has he had these?'


The Little Medic said...

Argh I was terrified just reading it.

You'd think I'd be able to look forward to starting work but stories like this bring back the realisation that I'll soon be responsible for real live people!

scalpel said...

Powerful story, well-written as usual. Thanks for sharing it.

Pro et Contra Medic said...
This comment has been removed by the author.
Pro et Contra Medic said...

Sounds like an example of when medicine is a little bit to exiting. If it’s any help nobody is absolute perfect.

In paediatric placement, I saw a young school boy who had been admitted with some strange looking rashes at his right knee. He was running around the department with the other patients, and had falling infectious parameters. Sow there weren’t any concerns.

Four days lather, his mother called inn concerning his younger brother, who had got some rashes along his back and knee, and was a little bit off colour.
The reason she called was because some of the nurses talked about that they were a little bit anxious regarding any child with a rashe, because it could be meningococcal disease, witch his brother didn’t have.
When the youngest one came in, he had falling BP, ecchymosis and petechiae.

On speaking to the family later, they had all the previous days been throwing up and had headaches....

SeaSpray said...

Thank God there are people like you on the front lines to help all of us.

I agree with Scalpel...powerful story.

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