Tuesday, December 22, 2009

Ode to a Torturer....

For six months I've been at the mercy of a relentless tyrannical torturer.

Yes, you Dr MB.

I arrived at this secondary hospital in July, expecting to belong to a team of caring superiors who would teach me medical secrets at every corner.

Instead you educated me in how to most annoy your colleagues, how to brew evil pranks involving patient's bodily fluids and gave me a daily lesson in torture.

And in the way a victim comes to expect and almost have an affinity for their abuse, and in the way that a cat tortures it's pray before it kills it, you killed me today when you left to go back to that cold country of yours.

I'm taking comfort in the fact that I at least managed some sort of revenge over the last few months, and for this I'm very grateful.

So here's my thanks:

•Thank you for helping me save lives...and thank you for reminding me, every day, all shift that you are a hero, have a superior intellect, are the best doctor in the universe and furthermore are generally the alpha male in all situations blah blah blah blah blah.

Thank you for not letting the psych patients injure me while trying to sedate when you unintentionally/intentionally eye-gouged a poor mentally ill music professor who wanted to make me his woman and tried to capture me.
FURTHERMORE - thank you for injuring me in resus and leaving massive bruises on both my person and my ego thus injuring me irreparably for which I will probably require a few years of therapy to recover from...and then...thank you again... for referring me to the psych department on my birthday for the aforementioned therapy.

Thank you for being a walking textbook of medical knowledge...thanks for adding extra chapters to my textbooks including such gems as “Dr S's Discharge Eponymous Syndrome: very smelly vagina, 99.9% fatality” Nice. Very nice.

Thank you for looking after me when I was going through my HIV needlestick issues, thanks for then stealing my patient stickers and placing one in the logbook next to a diagnosis of: retained foreign body, ?sex toy!
Thanks also for thus inspiring my revenge, with your very own diagnosis of: ?Haemaphrodite. Vaginal Bleeding, Grade IV prolapsed rectum and dysmorphic buried penis. ( Never mess with Dr S!)

Thank you for inspiring us to eat healthily and snack only on things like lettuce and nuts...thank you for being nuts and shoving a steel bucket on my head with plaster of paris leftovers after we had a lovely chat in the POP room and then claiming that it was a beautiful home-made hat and canning yourself stupid when the sister came in and found me lying on the stretcher with the damn thing covering not only my head but also my face and shoulders so that it looked like I was being RESTRAINED by the bucket NOT adorned by it .

Thanks for dribbling water on my head while I was resting my weary head on the desk...thank you for then standing still long enough for me to deposit an entire coke bottle full of God knows what on your person and smacking you on the head with the thing when it was empty. (HA HA! I win!)

Thank you for making me coffee at the end of a long shift...and thank you for suspending me upside down and threatening to drop me on my head after I stole your coffee jar which was totally justified because you made me a prank cup consisting only of hot water and milk purely to piss me off.

Thank you for letting me hide peanuts in your shoes...thanks for still eating them when you found them and thus not wasting food. (Weirdo!)
And on the subject of peanuts, thanks for throwing them at me across the doctor’s desk and making a massive mess on the floor. Thanks also, for NOT helping me clean it up when the head sister shoved the broom in my hand and forced me to start sweeping under threat of bodily harm.

Thanks so much for being thoroughly evil and waiting until I was in resus with a smelly patient who had made a moerse foul smelling kak, and then locking me in the bloody room with her so that I could die a death by noxious fume asphyxiation while you looked on smiling and waving through the glass doors!!!!!

You're going to be terribly bored in the UK. You'd only done one chest drain in three years before you got here, and in the 14 months that you've been here you've done over a hundred...When you arrive in England, with three feet of snow to welcome you...I'm going to lie on our beautiful world-class beaches in the hot Summer's sun and think about you and laugh because I finally got the upper hand over you...

Not really.

I'll be sad.

I'll be teribly sad that my adopted sibling is gone and that there's no-one left to play with at work...

Saturday, December 12, 2009

Back pain and Triple A

At the entrance to the front room there is an old steel trolley that rules my life. On it lies the patient log book: The book of life and death. Every patient that requires our team's attention is recorded in this cruel master of the shift...

She is a terrible slave-driver, relentless in her ass-whipping...doling out her punishments with cruelty and wicked irony - throwing out the sucker punches of end-stage cancer/HIV/TB at one moment, and then blasting you with the shotgun shells of stabbed hearts, cracked skulls and eviscerated bowel post knifing. And then, right at the end of your twelve hours overnight, she cackles, and slaps you in the face with a flat, blue, not breathing baby that has just been delivered at home on the floor of the mother's kitchen.

Sometimes her torture is just slow and when she sends you the patient logged as "back pain".

Argh - the worst, the worst of the worst. What a vague awful random non-emergency type of complaint. Yes, there are life-threatening conditions that can present with back pain:ruptured abdominal aortic aneurysm, peptic ulcer disease, pancreas issues.

But mostly, it's the complaint of the the overweight or old and arthritic - and not exactly something I'm ever in the mood to deal with at three in the morning inbetween the heart attacks and incomplete abortions.

So what happens is that the back pain patient gets skipped over...and after sorting out one patient and approaching the book of life and death for my next beating, I purposefuly bypass the back pain for something I think is more worthy of my early morning attention. I know my colleagues are doing the same, and we are each secretly hoping that someone else will be the better doctor and go and sort that patient out, but are not willing to take the plunge ourselves.

We had exactly such a patient one day - and because she presented near the end of the shift she unfortunately was not seen by the time the handover round started. That morning, the consultant in charge of the handover was none other than the Godfather of medicine in the Western Cape, a legendary figure whose initials, Triple A,are both his nickname and the medical abbreviation for Abdominal Aortic Aneurysm...and he is just as deadly.

Triple A is renowned for his spot diagnosis and unparalleled clinical skill - having the uncanny and inspiring ability to diagnose a patient's condition from the end of the bed - sometimes by just looking at them, not even one question asked.

Not only is he an astute medical genius, but he is also a staunch atheist, a lover of incrediby rude jokes and also wholeheartedly committed to the poor patients accessing state health care.

The stories that circulate about him are the stuff of legend. One of them being that one morning on the hand-over ward round he developed chest pain, and went to lie down on the floor next to a plug on the wall.
When people asked him what was happening he replied that he was probably having a heart attack, and since the ECG machine was situated on the other side of the front room and that he knew there were no extension cords, he decided to lie next to a plug, thus could someone please go and fetch the damn thing and check him out. The poor intern did the honours, trembling all the while, not believing that he was bent over his grand master, and then exclaimed while reading the ECG that there were no classical ST elevatory changes to indicate a myocardial infarction.

Triple A, lying on the floor had a slug's-eye upside down view of the ECG and promptly exclaimed, "Fuck you, man, there's an R-wave in lead V1, I'm having an inferior infarction, get the streptokinase!". He then refused to be moved to another hospital, exclaiming that if he didn't have faith in his own place of work, then how could he expect his patients to do the same.

When we arrived at the bedside of the old, overweight lady with back pain, we presented her as an arthritis. But we might have been talking to the walls - Triple A wasn't listening. Ignoring us, he asked her to describe her pain, where it radiated to and what time she felt it during the day. That was all. And then he looked at us and proclaimed: "This woman has cancer of her pancreas". He hadn't laid a finger on her. We all balked. And there were mutterings that perhaps the senile dementia had finally got to him...But he insisted, she was sent for an ultrasound, and the report came back that there was a mass in her pancreas, most likely a malignancy.

We all felt like fools. Like shits. Like we knew nothing about anything worthwhile. Like we were mere amoebae in the presence of this medical guru.

Needless to say, I've changed my behaviour towards the back pain patient...and when the book of life and death throws that one at me, I'll accept the punishment gladly to try and atone for my previously wicked behaviour!


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