I am currently on my third shift of "trauma nights" as I sit typing this in the hospital library at 130am. Stuart is being a wonderfully helpful and patient husband during this experience! The next few days will be a bummer because as I leave the house at 6pm, Stuart will be arriving, and as I arrive home at 6am, Stuart will be leaving for work. But we will make it through and I'm sure appreciate each other a lot more because of it!
So what is trauma like (for a medical student at least)? Basically I sit around with my residents (or hide from them in the library) and wait for the calm-voiced lady on the overhead speaker to say "Trauma alert to the trauma room". Then I drop everything I'm doing and run downstairs to the trauma bay in the emergency department. What you might find is always a surprise. It could be something 'minor' like a goofy teenager who got shot in the head with a BB gun, or something disturbing like a man with a near amputation of his leg due to a car accident (if you want more yucky details than that, you can ask me! Of course the only details I provide are those that are HIPPA approved!) My job during these sessions is that of an 'information gatherer'. I take a trauma history and physical form ("the pink sheet") and write down all the patient's vitals and exam findings. Sounds easy enough, right? Well ... it would be, except for the fact that there are approximately 8 other people in the room all examining the patient at once. Each person is focused on a different part of the patient, and they all yell out their findings at the same time. Basically, I wind up running circles around the patient with my pink sheet in hand, and sticking my head into places I would rather it not be, saying "Wait, were those weak upper extremity pulses or normal? Did you say he had decreased breath sounds? Which bone is that sticking out of his leg?!?"
When it's not busy around here, I sometimes get to do really neat stuff that I otherwise would not get to do if it were day time and there were more qualified people around (associated pearl of knowledge for you: try not to get sick at night time). For instance, tonight I was able to help put in a subclavian
central line. The resident got it started for me and I did over half the procedure by myself! And of course, if someone needs stitches then I am the one to put them in.
As an aside, last night I got to suture 5 or 6 lacerations on a drunk man who wrecked his car. He was not a happy camper and kept trying to take a swing at me while I was stitching his arm. We tried to sedate him and he did not tolerate that well, so my resident just held his arm down while I sewed. I am usually a fairly patient person, especially with my patients. Nevertheless, I thought I was gonna have to smack that man in the face.
So, personal lessons learned thus far on the trauma service:
1a. I never knew what tired really was. I thought I had been tired before now. But yesterday around 330am I fell asleep sitting up at the nurses station while writing a patient progress note.
1b. Coffee is a good thing.
2. Always keep your toenails in check. 70% of the patients I have seen the past few weeks have outrageously disgusting toenails. Yellow, cracking, thick, peeling off toenails. Perhaps fungus is more prevalent than I thought, or maybe people just don't take the effort to bend down that far. Regardless, I think I'm going to paint mine when I go home today.
3. Nothing good happens at 2am.
4. Always wear clean/cute underwear. In the unfortunate event that you are in a traumatic situation and come to the ER, you will have all your clothes stripped/cut from you and everyone will see you in your skivvys. At least until those get cut off too.
5. If your patient has a gun shot wound, you ask why, and they say, "I don't know, I wasn't doing anything", they are lying to you. If a person gets shot "while reading their Bible downtown", they also are lying to you.
