Into the abyss

Back in bedlam, the chaos ensues. The ward I am currently working on has a number of different types of patient; some transient cases - fresh faces recently admitted and soon to bode farewell, whilst others have been lying in their beds for far longer than I have been in clinics. As I tag along on the morning rounds, I notice we become a point of interest. They lay there helplessly chained to their drips, watching silently as we continue the daily ritual. I carry on listening to the doctors, occasionally picking up an obs chart or scribbling an unnecessary sentence on my patient list in order to look preoccupied, all the time acutely aware of the row of screaming eyes only metres away.

Later on I am summoned to take blood from a patient down the corridor. Fearing failure I eagerly oblige with face full of false enthusiasm. Slowly, I gather the venepuncture equipment and make my way to the bedside. Rapport it seems, is unnecessary in certain situations. For this particular patient - dosed up on drugs could barely stay awake long enough to provide consent. As I tied the tourniquet around their arm, they broke back into a thunderous chorus of snoring. The concerto continued, as the first few attempts at striking oil proved futile and went seemingly unnoticed. A change of tactic and I tightened the tourniquet to a maximum possible tension. Their veins courteously came into play. As I took the needle and slowly forced it into the target I realised my mistake. A quick puncture of the surface and a jet of high pressured blood squirted out, leaving a large bloody mess on their white top. Panicked, I continued to force the needle through and took as much blood as possible, removed the tourniquet and applied a dressing. Sheepishly I scanned the opposite beds, and noticed a patient that I had nicknamed ‘The Walrus’ lying there watching as he gargled on his aspiration pneumonia. With the walrus being neither compos mentis, nor able to speak I breathed a sigh of relief. Another lesson learnt.

Days later, I am approached by a man who tugs on my arm with eyes shut and mumbles something inaudible whilst wildly gesticulating with a chocolate chip muffin. I ask if he would like it unwrapped, and proceed to do so, only seconds later to observe him waddle off in an ethanolic miasma dropping most of it in a trail behind him. I sigh deeply and set off to find a dustpan and brush before the nurses follow the trail of crumbs to the feet of the perpetrator to this mess – yours truly, the Hippocratic Oaf.

Once a week, we are asked to take a full history and examination from a patient to later present to the consultant in the scheduled teaching session. When a man as jaundiced as possible turned up on the ward one day, I almost jumped at the chance to clerk him. Profound obstructive jaundice - leaving the patient looking vaguely like Hans Mowlem of ‘The Simpsons’ infamy. I continued to take a thorough history and exam, and we talked for a while. I found out about his life, what he used to do, where he lives now, how he felt about being in hospital. Then came my first ever compliment – to be later told ‘he was ever so impressed by your professionalism, especially as you're only a medical student’. This good feeling was of course, fleeting, as only days later I was brashly informed of the awaiting death sentence of a diagnosis when presenting the case to the consultant.

Advised by my consultant to attend his endoscopy clinic, I made my way down one afternoon to observe what I believed would be a few hours of routine gastroscopies and colonoscopies. After about an hour of standing at the back of the room watching the video monitor the atmosphere abruptly changed. A peptic ulcer they had been treating, unexpectedly decided to bleed profusely. A flurry of action and the consultant summons me over to the table to hold down the victims helplessly flailing hands as they attempted to stem the torrential flow. Vomiting over a litre of blood and bringing new personal meaning to the term ‘haematemesis’, I watched with wide eyes as the patient turned from pale to white, all the while acting as a human straightjacket as I pulled down hard on their arms listening to a horrific melody of gag reflex and gastric reflux.

The Oaf has since started to develop a new found appreciation for life and love.