PIGS AND PATIENTS

We arrived on shift at 4pm last night with twenty patients already waiting to be seen, and a constant stream of ambulances pulling up outside the trauma unit.

Yay!


Dr MB and I had still not recovered from this recent weekend of nights:
Friday, Saturday, and, Oh-my-God-shoot-me-in-the-head Sunday.

The reason Sunday night deserves adjectives is because our new Registrar, Dr KL, ALSO had a needlestick injury and unlike me was developing nasty side-effects to the ARV's. Knowing what it's like to be sick and at work, we sent the poor man home for some TLC from his wife.

HOwever, this meant that just MB and I were left to man the unit on a Sunday night, on Halloween weekend, on the end-of-the-month-I've-just-got-paid-and-will-thus-get-smashed-and-stab/shoot/beat-someone-close-to-me weekend.

40 severely injured patients later,and by the time the Monday morning ward round rolled around, we had both, understandibly lost our minds.

MB attempted to stay awake during the round by performing strange, sporadic,forward leg lunges .(Don't ask). I was so tired I did not know whether to cry or vomit, and so to prevent both, I focused on ridiculing MB enough to spur him into some sort of retaliation. This usually involves hair tugging, pinching or "reminders" about his superiority and general world dominance. Sometimes I respond with a witty comment. Sometimes my response is to stab his testicle with my pen. This is how we help each other stay awake. We literally fight to survive the long shifts.

Anyhow. That recent weekend of horror was the reason we were still exhausted when we returned to work for the Tuesday 4-midnight shift. As expected, it was insanely busy. Why wouldn't it be? And in the middle of the shift three policeman walked into the unit and informed me that they had brought a very violent and aggressive psych patient for admission. When I asked them where he was they said that they had left him in the van outside and that I should see him in the back of the van.

This already pissed me off. I weigh 52kg. I am not particularly strong or tall. These three policemen had biceps bigger than my waist. What in God's name did they expect ME to do with a very violent psych patient in the back of a police van? I demanded that they bring the patient into the unit where we could, with their help, immobilise him on a bed and thus facilitate proper sedation. They strode off sulkily, obviously not happy with being told what to do by a little lady doctor.

They returned with the violent young man in handcuffs who was complaining bitterly about being manhandled by the police, and shouting obscenities at everyone.

I took a deep breath and approached the patient. I noticed that he was bleeding from his leg.

"Oh you poor man!" I began in my sweet, soothing, comforting voice,while stroking his hand," You have been so badly hurt, how terrible. I'm sure you must be in a lot of pain, will you let me take a look at that and give you a nice injection to make it better?".

This is my sneak attack tactic when it comes to psych patients. They do not expect someone to be nice to them and are then usually caught completely off guard, and thus more amenable to cooperation. Destroy them with kindness. Being severely lacking in the brawn department, the only weapons I have at my disposal are my smooth tongue and powers of persuasion.

"Let's ask these nice policeman to uncuff you so you can lie on the stretcher comfortably, hey? What do you say?" He nodded his head obediantly. But the policeman refused.IDIOTS!!! Could they not see that I was busy working my magic here? Play the game with me you brain donors! I eventually managed to communicate non-verbally to the policemen that the cuffs need to come off so I could sedate him. Which I eventually did, with 20mg Valium and 10mg Haloperidol. The poor patient started swaying after 30 seconds at which time I informed the policemen that they needed to help me get him onto the bed properly in the next minute before he collapsed on the floor.

They jumped into action immediately by... staring at me with blank expressions. I caught the damn patient myself when he fell, and was assisted by the elderly aunty of a radiographer who happened to be walking by at that moment. The two of us struggled to pick the patient up off the floor and put him on the bed while the policemen played with each other's assholes.

Yes, I'm all for the empowerement of women, but why should that empowerment and chivalry be in competition?
Sometimes a girl just needs men to act like men.
Then again,how silly am I expecting those pigs to behave like men?

Like Bonnie Tyler said, in one of my favourite epic 80's rock songs:

"Where have all the good men gone
And where are all the gods?
Where’s the street-wise Hercules
To fight the rising odds?

Isn’t there a white knight upon a fiery steed?
Late at night I toss and I turn and I dream of what I need

I need a hero
I'm holding out for a hero 'till the end of the night
He's gotta be strong
And he's gotta be fast
And he's gotta be fresh from the fight

I need a hero
I’m holding out for a hero 'till the morning light
He’s gotta be sure
And it’s gotta be soon
And he’s gotta be larger than life
Larger than life!

Sloth and Competence and knowing when to use them.

It's half past two in the afternoon.

I've just managed to teach my brain to communicate with my body again.

My brain was awake for an hour trying to convince my skeletal muscles that listening to what it has to say is a good idea.

Brain was saying that Skeletal Muscle should help Body get out of bed, hunt for food and evacuate the bladder.

Skeletal muscle was telling Brain to go fuck itself.

Brain won in the end, after a lengthy hour long debate.

Skeletal Muscle got it's own revenge though, and operated like a sulky teenager after being told to clean up it's room...apathetically, slowly, and with no respect.

Which is why I looked something like the illegitimate retarded offspring of Shrek and a three-toed sloth...slouching round the house half-blind, in last night's scrubs top, underwear and socks...mumbling incoherently while in search for the kitchen.


My keen sense of smell led me to the fridge - On which I pinned all my hopes and dreams for a nutritious lunch.

I opened the silver doors and the holy light from within flooded my sleep encrusted face ...

Aahhh *insert choir of angels here*

# Leftover pizza that someone ordered last night ( Score! It's mine now!)
# Crackers with gourmet prawn dip with real prawns from Woolworths.
# Zoo biscuits.
# And a jar of Nutella's spreadable chocolate.

This surely is heaven, and just reward for the shitstorm of last night. Thank you, Fridge Gods!


My call was insane. Which is why I was so tired that when I got home, I couldn't even perform my usual post call ritual of jumping in the shower and scrubbing off the evening's filth, until the top layer of my skin has washed down the drain.
I just shoved an energy bar down my gullet - took off my pants and collapsed on the bed.

The bullshit started out when the locum doctor, who was supposed to be on call with me, arrived two hours late.

While awaiting his arrival, I called the emergency contact number for the locum agency he was from to find out:

Exactly.
Where.
The fuck.
He was.

The middle-aged lady that picked up on the other end could possibly have been a product of incest.

Product of incest:"Oh, um, ja, who are you?"

Me: "It's Dr S from ________trauma unit. Where is the locum you are getting paid to send us tonight?"

Product of incest: "Oh yes, he called three hours ago to say he would be late. But, where is the other doctor for tonight?"

Me: "I AM THE OTHER DOCTOR. If you knew that he was going to be late - WHY HAVE YOU NOT INFORMED US of this fact timeously."

To which the product of incest replied...and wait for it...this really was her excuse..." I was in church!"

Me: "Being in church is no excuse for incompetence. You should stop using your religion to justify not doing your job properly. We'd all LOVE to be in church, or in mosque, or at home on the couch watching the Sunday night movie. But we aren't. We are here doing our jobs. "

I was too pissed off to listen to her ranting and raving that "being in church " was a valid excuse for letting us flounder in primary health care hell on a Sunday night without assistance. So I very politely put down the phone. That woman should take a good look at herself and pictures of her uncle/mothers cousin. There will possibly be very striking similarities.

When the guy eventually arrived - the tragic thing was, I realised that I was probably better off working alone as he was NO HELP whatsoever.

In total, we saw 100 patients from 17h00 to 07h00.
I saw 70. He saw 30.
He would do things like, send a patient off for a urine sample and then WAIT until the patient came back. One can see up to four patients by the time it takes a paralysed stroke victim to go to the bathroom and pee.

When a man walked into the unit and immediately collapsed while having a generalised tonic-clonic seizure, he just stood there and watched me ( 5o kg, petite female me) try to move the man onto a bed to begin treatment.
What a dick. I ended up asking the porters and security guards for help.
They were brilliant and knew exactly what to do - handing me the correct fluids and instruments for IV access.
Fuckwit doctor strode around the bed with hands in his pockets issuing instructions which I, of course, ignored. I don't take advice from brain-donor men who believe that they are automatically in charge - just because they own a penis.

The sisters and I spent the rest of the night ignoring him and swearing at him in Afrikaans. The guy was from Durban so had no idea what we were saying. They don't speak Afrikaans in Durban. Mean - but necessary.

The cherry on the top was when at o3h30 he announced that he had a plane to catch and would be leaving to get his things in order. He then asked the sister in charge to sign his on call sheet from 17h00 to 07h00 so he could get a full night's pay.

He clearly did not know about Sister CrL. She didn't sign his sheet at all. Good girl!

Can I just say - that as I am a community service officer - my rates are standard, very low and fixed regardless of how hard I work. These locums get paid more than double what I make as they are from the private agencies -so in effect I got paid half the amount and was working more than twice as hard.

Did I mention that it's five weeks and counting?


Jeez - just got a whif of myself while reaching over the table. I smell like the hospital!!! AAAAAAAAAAHHH!

I thinks it's time for that shower now...