Blood

The movies are right . The books are right . If you are a doctor sooner or later you will see blood and sometimes a lot of it.

From small injuries  to epistaxis to motor vehicle accidents and surgeries . Blood is everywhere . Ubiquitous is the word I think.

Believe  me I am as scared of blood as my five year old daughter ,maybe more. Still I do biopsies , lines , intubations if needed and all the usual stuff.  I pray I never have to see car wrecks or gunshots again and in my field I probably won’t but in my training I did, as all of us do.

So what to to if you are scared of blood but want to become a doctor . Well! fake it till you make it . (Courtesy Steven Tyler)

A jock friend of mine fainted the first time he saw a drop of blood . In our physiology lab we had to one out and each other’s finger for some lab work. Don’t remember what was the actual assignment . He literally fainted . Dropped flat on the floor with a bang. Now he is an anesthesiologist working in OR everyday.

Ii know girls who ran out of dissection hall and quit medical school  and I know the ones who ran out but did not quit medical school. Guess what ! The ones who did not quit did alright and the one who did quit did alright too.  But the one who did not quit got to be doctors , something they all wanted to do in the first place.

one word of advice for new residents and medical students . The blood you see is less then you think it is . A 100 ml bleed can look like a an entire pint of blood when it is spread flat on a surface . I m not telling you to be ruthless and careless. However if you placing a line or doing a biopsy don’t let a little bit of blood scare you into not doing it.  I would worry more about pain. Your procedures should be as painless as possible . Use that lidocaine.

One the other extreme is the daily labs . Almost no patient need daily labs but almost every one admitted in the hospital gets them.  If you have to get daily labs use pediatric tubes. Most of the blood that is collected is discarded. I know it’s only 5 ml in one tube but 5 of those tubes everyday for a week in an elderly severely ill person can take its toll. Because we as a doctor don’t actually see those tubes we don’t think about them. So next time you order daily labs if you absolutely have to , please order them to be collected in pediatric tubes.

I can go on and on on blood and may be I should. Some other day.

 

 

 

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Oxycontin

So I got a call from a pharmacy.

The pharmacist asked me “have you prescribed OxyContin to mr xyz”

I remembered xyz being not a very bright man , but did not remember any reason for OxyContin.

I replied “No ,I don’t recall”

” well he came in with a script for OxyContin. I thought it looked funny . Didn’t look like your writing . The signature was weird too ”

” let me go to my office and check quickly though”

I thanked God for the advantages of being in a small town . The pharmacist know my handwriting and the office is close enough that I can just go check. Sure enough that prescription was not by me. The pharmacist called the police and that man was taken To jail  . He was released on bail to show for hearing etc.

That’s when I remember the guy once told me how good a hunter he is . I remembered he told me he owned more then two dozen guns.

Did I just sign my death sentence. Maybe I should have given him  the OxyContin. So what if he made a few bucks selling OxyContin . May be he was doing a service. A public service . Perhaps I should call him and apologize . Give him a new prescription.

The next few weeks were terrible. There was a patch of trees behind my office . I usually parked right by it. Now I started to park way from it and walked across the parking lot. Did get some exercise though. Sometimes however since people never saw me walk before and didn’t believe I could they sometimes stopped their cars by me to ask me if I was doing ok and if I needed a lift.  Naturally I would get so startled by their stopping  that I earned  the nickname of Doctor startle .

My personal office window also opened to those trees. My chair which used to be right In front of that window now sat away from it. I had to lean on my right and squint to look at my computer screen. Lot of spellning mistakes in my notes from those days .

Every time I heard a loud sound . I thought it was the   end .  Scenes of Heaven and hell started coming  in my dreams. I became the most virtuous man alive . Giving to charity . Being sweet to my wife and children and every human in general.

If somebody cut me off in traffic I would be like ‘ thanks brother I did nt need to go that fast anyways,’

If a telemarketer called just as I was about to have dinner’yes of course I would listen to you my good man. Do you have a new phone service or are you sending me on vacation for free’ I freaked them out so much that the telemarketer started to hang up on me . I think they put my number on a do not call list , without me ever asking .

Scary few weeks.

It really was all in my head though. That man never came back to me . Eventually he did go to prison for a short sentence.