4 JAN 2008 No good deed goes unpunished.
I'm waiting for 1600. At 1600 it will be okay to start surgery on my patient. We would be done by now but he decided to have a nice big egg and fruit breakfast. "Oh yes", he said yesterday in the clinic, "I understand" as we instructed him that he couldn't eat or drink anything after midnight. No food, no drink, not anything, I explained. I had the translator repeat it several times.
Last night I was on call. We had a steady flow of blown up and shot up Iraqis and US troops. One came in with CPR in progress. He had been shot in the side and had lost his vital signs at the scene of injury. The crew worked tirelessly and hustled him in. But he started dead and he stayed dead. We worked on him to try and get back signs of life but to no avail. How many more?
One of our patients from yesterday is a man who lost his legs when he he opened his car door and the car blew up. It had been booby-trapped by Al Qaeda. An outlying hospital worked on his stumps and then sent us to him. Now he is in our ICU. He is a medical doctor.
Another patient is a boy who lost an arm to an electricl burn, and may lose more limbs. Each day he gets his wounds washed to see how much more muscle and skin has died. He would be a complicated case in any hospital.
We were so busy with emergency operations yesterday that I didn't finish the last scheduled case of the day until 0330 this morning. I couldn't tell which hurt more: my shoulders from helping Vascular Surgeon M. lift a hundred siding planks onto the roof or my feet from standing at the operating table for 20 hours. I struggled to keep awake as I completed my paperwork for the night. After preparing my morning report I eventually passed out in one of the chairs in the PLX for a couple hours.
In clinic yesterday I saw a patient with a minor condition. It required a simple day surgery, but it isn't something we usally treat here at our war hospital. However, I was asked to see this patient as a favor, and I said I would. We made an exception to schedule his elective surgery and gave him the very clear instructions that his belly needed to be empty for his own safety during surgery. This morning he claimed to have only had a sip of tea. The anesthesiologist went to pick him up for the operation and that is when he decides to spill the truth abut his grand slam breakfast. So now I am hanging around here until the he has had enough time to digest his little feast and it is safe to operate. This is one of the many reasons I prefer to take care of children. They won't lie when they have completely disregarded your directions. By rights we should just cancel the case. But that just throws away the preparations we have made and passes the problem on to someone else. And when I said that I would take care of his problem, I didn't qualify it by saying only if he behaved. As I sit here post call watching the clock, I find that I still haven't learned that no good deed goes unpunished.
Guess which dwarf I am today? It's not Doc.