Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Sunday, January 12, 2003
    Day Seven

    Sunday morning in the ICU:

    Conversation between two residents about a patient, now off the ventilator.

    "So I see we've extubated him."
    "Actually, he extubated himself."
    "Excellent! When?"
    "At three o'clock this morning."
    "With his tongue."

    It's quiet in the unit early Sunday morning. Except for the one guy who's yelling like crazy. I look to one of the residents:
    "COPD [emphysema to you], schizophrenia and cardiomyopathy. Not a good combination."

    The fellow won't keep his oxygen on, except when one of the nurses (I'll call him Frank) goes in and talks to him sternly. I know Frank a bit, as we went through an ACLS (Advanced Cardiac Life Support) certification class together two years ago. Frank is an excellent unit nurse. He is also gay, and somewhat flamboyant. One of the residents tells me that not long ago, the unit team was trying to resuscitate a patient in cardiac arrest and something went wrong with the shock paddles: a spark appeared.

    "What's that flaming?" someone on the team asked.
    Like a shot, up went Frank's hand: "That would be me."
    It broke everybody up, in the middle of a code blue.

    I left the house at 7 am. It is now about 10:45 pm. I'm still not done, but the hell with it. I'm going home.



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