A Shift

In this edition of the Physician Grind Dr. Wiseman shares with us the type of shift that keeps her coming back to emergency medicine. This piece was a submission to the Physician Grind Narrative Medicine Contest.

Tonight on my 8 hour single physician shift in my small community suburban ER I saw:

Traumatic intracranial bleed with temporal bone fracture and blood pouring out of the ear (transferred that).  

Upper GI bleed with bright red blood in a cirrhotic alcoholic patient (stuck a large 16 gauge needle in his fluid filled abdomen to get a quick fluid sample, then intubated him for his own protection). 

Ruptured abdominal aortic aneurysm (radiologist said it was fine on CT but my rudimentary CT reading skills told me otherwise, so I nervously called vascular surgery who agreed the patient was about to die... transferred that).  

Benazepril overdose with blood pressure in the 60's (called poison control, gave fluids, admitted to ICU).

Spontaneous retroperitoneal bleed with potassium of 7 and peaked T-waves in a dialysis patient (medicated, called renal for dialysis, admitted).

Elderly DNR/DNI patient with pneumonia who had decent vital signs then suddenly died (charge nurse called over from his desk "Your patient in 4 expired". Whaaat!!!)

A gnarly hip fracture (yes ma'am your hip is completely broken and you are not walking out of here).

Apparently I missed the mass casualty excitement of a school bus accident that had come in a few hours before my shift, phew because that might have pushed me over the edge.

I ran out of the ER an hour after the end of my shift hoping to evade the irate and aggressive mom of a 17 year old marijuana user who insisted we put him on a psychiatric hold NOW without any indication because she had to go to work tomorrow and she didn't want to deal with him.  

Jumped in my car and locked the doors so the homeless guy sleeping on the extra hospital bed being stored in the physician's parking lot next to my car didn't ask me for money again.

But in the end, I realized as I was driving home, that tonight validated my choice of career as an ER physician. I had been grinning all the way to the car and was still smiling as I thought about the craziness of the evening.  

I'm looking forward to my next shift.  

Share your Career Defining Shift in the comment section below.

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Dr. Wiseman's Bio is below keep scrollin

Colette Wiseman MD

Dr Colette Wiseman is a full time ER doctor and mom to 2 school aged children, a 16 year old cat and an absent minded professor husband. She enjoys mountain climbing, and has a side business as a Lactation Consultant.  She currently lives in Hong Kong, where she is homeschooling her children, learning Chinese, doing telemedicine and traveling around Asia. She is considering taking up a hobby like painting to make life more exciting.  She also is a breastfeeding councelor. Her website is http://mamasmilkworks.com/

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