I am currently having a Buffy break.
I seem to be having a lot of those lately 
Be it, break from reviewing some literature, break from revising for my second attempt at MRCP Part 1 or as right now, break from the Big Clean
Big Clean. Urgh. I haven’t lived in the same place for more than a year since 2003 and the yearly move and house clean is really starting to wear thin. Granted if we’d kept the apartment cleaner in the first place it wouldn’t be so time consuming, and if we didn’t have so much crap it wouldn’t have taken so long to move (but I love my Buffy comics, My Little Ponies and various hoodies from uni societies – why get rid of them?!)
I received my rota via email last week. I don’t quite understand it… it’s weekly and very confusin but we haven’t been assigned yet, that’s for Wednesday. It also looks like we have to cross cover Neurosurgery overnight… which creates a huge collective yargh from all my neurons. Granted it’ll be the Reg taking all the referrals and doing the complicated stuff (like angios and coiling) but I’ve only ever referred to Neurosurgery before (which, I might point out, takes FOREVER) I haven’t ever looked after the post op patients or anything like that.
Nimlodipine and dexamethasone… that’s about my knowledge of Neurosurg, still steep learning curves are the way ahead in medicine… aren’t they??? Please say they are…
When I worked in A&E I referred a patient to the local Neurosurgical centre and it was one of my favourite A&E experiences. When you see a patient in A&E, there’s a sheet of paper for you to clerk on that has all their details already and what the reception staff has ‘booked them in’ as – it could be chest pain, ankle injury, fit… etc. This patient’s was ‘head injury’ – the A&E staple. Though following a history and exam I thought otherwise… no signs of head injury and no memory of the events, coupled with focal neurological signs and a Glasgow Coma Scale of 14 – not good.
CT scan and primary intracerebral bleed later I was on the phone to the Neurosurgical SpR who seemed to like to discuss things with their Consultant quite a lot! They then phoned back again for more information at which point my response was ‘Well we’re just taking him into resus as his GCS is dropping… he’ll probably end up tubed’
(That was me trying to sound really cool and like I was on ER… hell, I was really cool and in Emergency… just with much fewer patients and gunshot wounds and interstaff relationships)
The patient made it to Neurosurgery and had the bleed evacuated and is having rehabilitation. It was a good story, sometimes you forget about all the things that happen in medicine that are amazing. Personally I can think of so many situations where “I should’ve done that” or “Maybe that wasn’t right” or “That definitely wasn’t right” or even crying for hours cause someone died (and I was too emotionally involved) and you forget when things go right.
That’s an important lesson. I think. Maybe I should learn it myself sometime…
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