Wednesday, March 11, 2009


I am beset by flail; more will follow. Feel I owe it to my newly swelled battalion of followers

Wednesday, March 04, 2009

New York Mining Disaster

Navel gazing. Contemplation of self.

I now have 2 new followers. Welcome to the fold. Props also to madsagirl who has read through all my back issues. I call that dedication; even I haven't read 'em all through.

Anyway... my last wasn't a cry for followers; it's good for the ego, sure, but I'm just as happy if you wanna be an occasional reader. I know fr a fact several of my more citrically inclined readers do so at a distance. So; however is fine with me.

I might even try to post more frequently. All I have to do now is do some interesting stuff.

Currently, in case you were wondering, I'm watching ER Season 13.

Rock, and indeed, roll.

Tuesday, March 03, 2009

Slip-Slidin' Away

I feel crap today; this is karma for bemoaning people's inability to cope with pain. For what it's worth, I'm keeping my intestinal colic to myself; except for you lot.

And... I'm haemorrhaging followers. From a peak (!) of 17, down to 13... something I said?

Monday, March 02, 2009

Through The Viaducts Of My Dreams

Years ago, when I was first on the House, we worked on call shifts; long, long hours, but with the option of going to sleep when nothing was happening. After a while I took to sleeping in scrubs, so I could hit the ground running.

One might argue that you save only a few minutes, although in those days I still wore a shirt and tie to work, so it took a little longer to get dressed when a call came; however, one particular call convinced me of the need to roll out of bed and be on my way.

The cardiac arrest bleep woke me, shrill and insistent next to my ear. I jumped, literally out of bed, and was dismayed to discover I'd been asleep with both my arms behind my head, lying in such a way as to put them both to sleep. They hung uselessly by my side...

If there's a way to pull trousers on with neuropraxic arms, I've yet to learn it, and no-one believes that's why you're late to the arrest

If I Ventured Into The Slipstream

Managed to survive nights; again.

Something of a week for stabbings. I've seen six since I've been at South Coast Hospital. I suspect my North American readership will sneer at this, since, if t.v. is to be believed, every shift in US EDs is a stabfest. Anyway, it's a big deal for me. Five of the six have been in the last week.

Number three was perhaps the most eventful. Young fella, stab to the epigastrium. Over the phone, his obs didn't sound too bad - lowish BP, normal pulse. 'Course, its all relative, but I worry about the young ones that are tachy more...

These calls are always a bit like Schrodinger's Cat. Until they arrive, they might be really sick, or not too bad; so they exist in a kind of quantum state in between. Then they arrive...

It didn't take a modern day Astley Cooper to figure out which end of the spectrum this guy lay. Agitated, pale, clammy. His hands and feet, ice cold, were mottled. They looked like the skin of someone having a Bier's Block, if that helps. It's not a good colour.

On our monitor, his obs weren't quite so encouraging - pulse of 160, BP hovering around 100 systolic. His wound, square in the epigastrium, was small, maybe half an inch across. This measurement is worth knowing if you know how wide the knife is. No-one was quite sure, but we thought it was narrow.

Anyway - epigastric stab, shock... good air entry bilaterally, benign looking belly... I peeked at his neck. His veins stood out like cords.

Our survey said... tamponade.

Cardiology did the decent thing and confirmed on echo what Sonosite had hinted at, and the call went out to CardioThoracic. For a moment, when resus filled with the Surgeon, the Anaesthetist, the CT Intensivist, the General Intensivist... we were in danger of forming a sort of 'brains trust'. Lots of clever docs, all offering opinions about what needs doing, no-one actually doing much...

Fortunately, the Surgeon wasn't shy, and made his intentions clear. Five minutes later Stab three was in theatre, and I'm told, came out the other side.

It's nice when stuff works.