She Likes Surprises

I’m frequently surprised in this line of work, usually in a good way; for example seeing a very unwell patient drag themselves back from the brink in resus, or seeing a young trauma victim recover from their horrific injuries and carry on with their life. One in particular was a teenage girl who had been knocked off her bike and had broken every limb as well as a severe head injury; I first saw her in the operating theatre where one of her femurs was fixed with metal rods, her ankle was manipulated back into place and casted, and the following day her wrists were fixed. Then, a couple of weeks ago I was covering the paeds room over lunch and she walked in for her 6 month checkup. I recognised the name instantly and was genuinely blown away when I saw her walking without even a limp after such a short time. She’s got a fair way to go until she’s fully recovered, but the fact that she’s outwardly fixed is incredible.

There are some unfortunately common nasty surprises too; abuse and violence is something that many health care workers have come to accept as a part of the job, regardless of the NHS’s policies on unacceptable behaviour. It just wouldn’t be practical to dismiss every patient who shouts at or hits you, so you judge each individual situation as it occurs and decide whether it’s worth continuing. In the case of dementia patients there’s usually a way of continuing with the examination without risk to the patient or the staff, and it would be idiotic to take these incidents personally as the patient is absolutely not to blame. Drunk patients can usually be reasoned with, or at least sent back to A&E to sober up for a bit, after which they tend to become slightly more amenable and occasionally even apologetic.

My scariest incident (so far at least) didn’t even involve a patient though; I had just been to NNU to do an abdomen x-ray on a very unwell preterm baby who had rapidly deteriorated despite the efforts of the intensive care team. As I walked out of the secure neonatal unit I could hear shouting from further up the corridor but couldn’t see anyone, so I continued walking. I got to the nearby stairwell and contemplated changing floors to avoid the commotion, but it was then that I noticed it wasn’t an actual fight, but a lone man getting angry with the world. I gave him a wide berth and continued on my way (it’s a fairly long walk from one end of the hospital to the other) keeping an eye out for the nearest phone so I could call security and report the issue. Normally it wouldn’t be necessary, but it was 8.30pm and he was directly outside the neonatal unit and the delivery suite so not only were staffing levels reduced, but also vulnerable people were in the vicinity. As I stopped to reach for the phone I heard running footsteps behind me and it was at this point I freely admit that I panicked; clutching the imaging cassette to my chest I ran as fast as my flat, tired feet would allow. He screamed some rather vulgar comments aimed at me (even more vulgar than my usual tone, which should give you an idea as to the nature) and then just started shouting swear words whilst occasionally kicking the wall or throwing the folder that he was carrying, all the while running (chasing?) behind me.

Did I mention it’s a long way back to x-ray?

I got to the stairwell outside theatres and ducked in to phone security. As I hung up a porter walked up the stairs, about to walk straight into scary-man’s path so I advised him against it, told him security was coming, and ran away like a scared girl.

I had never been so happy to get back through the secure doors and into x-ray. I told my colleagues what had just happened and waited for the NNU x-ray to process whilst my pulse rate settled. Barry pointed at the security monitor which shows us the corridor outside x-ray and said “is that him?” and I glanced up to see scary-man tussling with a security guard outside the lifts on his way out of the building. Phew!

And then there are the really unexpected surprises like today’s trauma patient who came in for a chest and T&L spines. I did the lateral T-spine and saw a metal artefact covering one of his vertebrae; it was a similar shape to an ECG clamp so I removed the one that I thought it was, checked for anything else in the way and took another image. The artefact was still there so I completely searched his chest looking for the culprit, at which point he casually mentioned that he had been shot some years ago, as if it were a normal predicament for someone to find themselves in. The bullet fragment was huge and had migrated over the years from his upper shoulder to below the scapula, not that it was relevant to this particular hospital visit. Other than that he had no injuries.

People eh? A rather surprising species.

One Comment on She Likes Surprises

  1. Captain Chaos
    July, 5th 2013 at 5:07 pm

    Continuing to enjoy the blog Trish. Oozes authenticity – I intend to give it a strong plug when the students return. M

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