Lacerations, alcohol and Star Trek

Last night, around midnight, I was sewing up the head of a young man who had been in a fight.  He was a little 'intoxicalated,' and angry about the fight.  He had other injuries, less severe, but was frankly a bit of a mess. 

And he and I had a great time.

I have no idea how it happened, but we stumbled onto Star Trek.  With my instruments pulling his scalp and skin back together, and blood dripping down his forehead (which he accepted with casual grace), we bonded over Sci Fi.

We both agreed that Jean Luc Picard conducted himself more like a Captain should, but that you have to love Jim Kirk and his tendency to get green chicks. 

We both thought that the latest incarnation of the Star Trek franchise was truly awesome, and that we honest to goodness wanted to like Khan.  Until we remembered who he was, and what he was capable of doing.

With his head sewn up, and swollen from local anesthetic, he had an appearance that prompted me to say, 'dude, you look like a Klingon!'  We had a good laugh about that.

It would have been easy to dismiss him.  Just another drunk.  Just another crazy young man in another fight.  But I would have missed his charm, would have missed that essential connection.

Sometimes the ER and its denizens can make a sane person crazy.  But other times, all of the weirdness, all of the surreal stories, the drama and smell of blood and alcohol; all of the pain mixed with hope, it's simply...

Wonderful.

When we learn to love everyone (by which I mean the verb love...not always the emotion love), then our work becomes a daily delight, no matter how challenging.

Because we see the hurt and the broken. And we can reach them far better with love, gentility, laughter and heck, Star Trek, than we ever will with policies, procedures and sterile professionalism..

Edwin 'Bones' Leap
Chief Medical Officer, Starship Emergency

Residency flashbacks and a new experience

I recently did some locums work in a very small emergency department (four beds) in a very small hospital (26 beds).  It's so small, in fact, that I acted as hospitalist as well. While this is the stuff of a much longer post, I can say that I had flashbacks to residency.  I had to round.  I had to write orders and dictate discharge summaries.  While it has indeed been a while, I must say that it does come back...not exactly like riding a bike, but not terribly difficult on the surface.

Two things, however, were particularly odd.  The first, that I stayed in the hospital for 72 hours (except for quick drives to get carry-out).  I haven't been 'on call' for a very long time.  And the longest I was ever truly on call was about 24 hours (with 12 hours of subsequent rounding on the trauma service in residency).  It was surreal to stay in one place that long; to be 'on' that long. Fortunately, it was low volume and not stressful.  But when one is sleeping in the hospital, covering the emergency department, the threat of a phone-call always looms and seems to banish deep sleep.

The other, however, may be more bizarre.  In that 72 hour period, other than hand off from the previous physician, I did not see a single other doctor.  Nurse?  Sure.  Social worker?  Absolutely.  Case manager? All day long.  But no other physicians.  I can't recall a time in my medical life when I experienced that sensation.  And it wasn't all bad.  It was just different.  And oddly validating!

I hope that whatever and wherever you are practicing, you find new ways to stay fresh, sharp, engaged and interested.  To me, this work is what puzzles are to others. A way to challenge and stretch my mind. 

Because in medicine, ruts are easy to find.  But there are plenty of ways to climb out.  And one sure-fire path is to work off the beaten-path, and to do it all alone.

Edwin