Wednesday, November 10, 2010

The Medical Emergency

I headed to the Medical Emergency ward on the fourth floor. The signs on the fourth floor were non-existent. So I wandered into a patient care area. The stench was piercing. This was different then the usual stench of human excreta in the streets. I knew the smell but could not identify it at first. I sniffed and sniffed. Yes the old memory cells woke up. It was smell when there is copious flow of pus. I had entered the surgical floor.

The medical floor was flooded with human beings. I could see some harried resident doctors working. The residents had worked all the previous day and the previous night too. Their tired faces had total resignation written all over them. I asked them to ignore me and carry on with their work.
They were eager to do that. I just stood there near the nurse’s station and watched. Patients were wheeled in by relatives on stretchers. The stretchers were the same I had used here in this hospital about forty years ago. The paint was chipped. The wheels never went where you wanted them to go. The steel bed was as uncomfortable as it could be. Most patients had I/V bags attached. The relatives were holding the I/V bags by hand. Their hands were tired at times. The I/V bag would go down and blood would flow from the patient to the I/V tubing.

The I/V stands were also the same I had used forty years ago. The stands were on wheels. The base was very heavy to prevent tipping. The wheels were crooked, small and had lost lubrication. Some stands had six I/V bags hanging on one stand. The bags were going to two or three patients. One patient fell out of bed and tipped a stand over. There were six bags on the floor. Some I/V lines came out of patients’ arms. There was I/V fluid all over the floor. I can just visualize the poor intern starting the I/Vs again. That part of internship is still fresh in my memory. Starting I/V in an emaciated and dehydrated patient is no piece of cake. You stick the needle again and again. The patient is cringing in pain and you have gone thru and thru again.

A middle-aged man came in clinging to his chest. I was told he had acute chest pain starting about two hours back. The EKG showed acute myocardial infarction. The resident doctor hurried to give him everything this place had. Oxygen was ordered but the orderly could not start it. Morphine was given promptly. He was to be started on streptokinase. After fifteen minutes the patient was still in severe pain. If the patient was rich he would have been in cardiac cath lab. But if he was rich he would not have come to this hospital. Even if he wandered in here by mistake, he would have been transferred to an intensive cardiac care unit.

There was a shouting match going on between a doctor and an orderly. The doctor had asked that oxygen be started and the orderly had ignored the request. There was not much the doctor could do but to scream. The orderly shouted back.

The evening rounds by the attending physician started. The attending went over each patient quickly. The attending told me he felt he was keeping the residents from taking care of the patients, so he wanted to spend the least amount of time on rounds. I left the floor with the attending. We headed to a roadside shack for a cup of tea. I was exhausted. I had spent only two hours in the medical emergency and had done nothing.

No comments:

Post a Comment