Femme Suisse

Bring It On

femmesuisse — Sun, 22 Jan 2012 18:00:18 +0000

Two nights ago a man came in with a broadcomplex tachycardia very suspicious of VT. I called the cardiologist and ordered iv amiodarone. As the amiodarone ran in the man become more and more anxious with severe chest pain. Badly circulating I figured he needed electrical cardioversion. The cardologist wanted to give the medicine more time.

After two hours both the patient and I were done with it. I called the cardiologist back and told him I was going to cardiovert. The anesthesiologist came in and I set the defibrillator for 15 J. Never having done an actual cardioversion for VT I figured it could not be hard. He converted after the first shock.

Last night a bodybuilder came in with a dislocated shoulder. I gave him local anesthesia and a sedative and tried to reduce the shoulder. After ten minutes of traction-countertraction the shoulder still would not budge. Even with a different technique the shoulder would not give way.

The thought of having to call someone and explain how I, a board certified Emergency Physician, was unable to reduce a dislocated shoulder was not great. So I got out Tintinalli and looked for a third method. The external rotation in adduction with a successrate of 78% sounded great. It took two attempts and the shoulder popped back in.

I do not see myself as a great doctor but I am definitely trying to become a better one every day. It is not about the things that you know how to do, it is about not knowing and coming up with a solution. Lazy cardiologists and muscled guys with shoulder dislocations, bring them on any time.

iCare

femmesuisse — Fri, 11 Nov 2011 03:02:39 +0000

Yesterday my family buried my aunt. She died from a massive braintumor by essentially not waking up from the biopsy that confirmed her sentence. She was a wife, and a mother to my two cousins who are my age. I had not seen the entire family for years yet seeing those tear-stained faces I could do nothing but hug them tight.

And now I am on a quiet night shift and found the time to lie down on the couch. I cannot catch my sleep. Thoughts keep drifting back towards that funeral. What was it that hit home? The resemblance to two years ago?

Actually, no. What happened two years ago sent me to the Himalayas. I walked and I cried, I yelled, I stamped. I hurt. I hurt so badly that I thought it would never stop. But it did. By the time I got to Australia I was looking forward more than I was looking back. My journey has long since ended.

My cousins, my uncle, theirs has barely begun. And I want to be there for them. Not because I know, but because after so many years in medical practice, seeing so many unknown people die and cry, when it matters, I still care. Thank God for that.

God Is Great, Beer Is Good, People Are Crazy

femmesuisse — Wed, 26 Oct 2011 05:11:42 +0000

I have been in the United States of America for nearly two weeks. It all started with a conference in San Francisco. A couple of thousand Emergency Physicians from all over the world thrown together in Sunflower City. ‘Zoo’ really was the appropriate term.

Anyway, when in the States you might as well enjoy yourself. Hiking in Yosemite National Park, that sixty-something woman who tripped and broke her wrist could not believe her luck when I happened to walk by. So much for being a doctor on holiday.

A week later I met up with some really nice retired people I had met while hiking in the Himalayas the year before. I guess the state of Utah should have rung a bell, but no. Interesting thing to spend a night in a house at Sun River Retirement Homes with Mormon people.

Apparently Americans have a fascination with the Wild West. The number of ranches I have encountered I cannot recall and they include shootings and hangings. Oh and no, none of that required my doctor skills. Going with the flow, the beer was good.

While cruising the canyon lands I am slowly making my way towards civilisation again – Sin City, here I come. Maybe time to win back the hefty cost of the plane ticket to see the White House. Or just to see how crazy people really are.

Weren’t You Dead?

femmesuisse — Wed, 12 Oct 2011 11:09:17 +0000

A doctor has certain status. Sometimes I wake up in the morning and still cannot believe I actually am one. Mostly because I am quite down to earth, and because a lot of the time I feel like I am actually in a comedy show.

A man came in with shortness of breath and a whole trail of family members. One of his sons looked at me and exclaimed, ‘ah! It’s that same doctor again, wonderful!’. One look at the patient and all I could think was, weren’t you dead?

Just yesterday I started my shift taking care of a 98-year-old with heartfailure. As her pH was approaching 6.90 I thought this was no longer compatible with life. As we put her in a room to die peacefully, she started to recover on her own. Why can’t old people just die like they’re supposed to?

I cheat a lot too. When an ENT specialist wanted to know the bloodpressure on my epistaxis patient, I told him it was fine, hung up the phone and ordered the nurse to take one.

The woman with a piece of glass in her hand brought her niece to the ER because she was studying to become a nurse. As the niece told me she found it all extremely interesting because she had never seen this before, I told her I hadn’t either. Will never forget the horrified look on their faces…

I am not mean. I am just trying to make my days as interesting as possible. Because Emergency Medicine is frantic, it is chaotic, it is very serious business. You might as well get a laugh out of it, or you would quit tomorrow.

History Repeats

femmesuisse — Fri, 30 Sep 2011 14:30:58 +0000

When my mom met my dad, she also met his gigantic family. The family contained at least one sister who had children before they ever thought about having one. The sister never left an opportunity unseized to tell my mom what a great gift children were. My mom, not sure whether she wanted to have children, hated it and it drove her crazy.

When I met my boyfriend, I also met his family. In the midst of the impending loss of his mother coming at us like a freight train I did not take too much notice of the extended family. Now, years later, the dust has settled and his nieces and nephews are in my face every time I visit. I am not even sure I want to have children, and it drives me crazy.

History repeats itself, only this time there are mobile phones and chat programs available to ask for help. Thank you mom, for supporting me, and maybe one day those children-promoting people will realise that the world does not revolve around their children.

The Hamster

femmesuisse — Wed, 07 Sep 2011 14:16:41 +0000

You have a day off from your hard working doctoring life, it is raining outside, the hamster is asleep and will not play with you, so what do you do? You join Linked In. Or more specifically, you refresh the profile that has been there for years and you start looking around.

At whom exactly? Because the people you used to know, have changed. From fun loving characters to serious looking grown-ups. With different last names. Looking them up on Facebook will only reveal more shock and horror. Little people.

So you look around your house. Dishes everywhere, bits of chocolate melted to the couch in the spot where you usually hang out with your laptop. Oh yes, hamster in the corner. And why did you get the hamster in the first place? Because you could?

So they are married with children, have a good job and a nice house. You are living together with someone, most of the time pretending to be grown-up too. You have a good job you like most of the time. The rest is spent daydreaming.

About what exactly? Marriage? Children? Try Patagonia. Africa. Anywhere you can be young a little while longer before you become like them. Grown-up. Responsible. Because let’s face it: the hamster is already stretching it.

Crazy Little Me

femmesuisse — Sat, 20 Aug 2011 19:43:55 +0000

I thought that once we would be together again, everything would be allright. I thought that waking up together, living in the same house, was all it would take. I thought that after running around the world for eight months I would finally be ready to settle down. I was wrong.

Being together and waking up together is not all it takes. The hours I make do not help. The weekends, the evenings, the nights, they all do not help. And the fact that a befriended couple is tying the knot does not help at all. The one thing I loathe in the world, I am going to have to attend in two weeks: a wedding.

Do I not want a wedding? Do I no not want a baby? Do I not want to be normal, settle down, buy a new house and do all the things all other people seem to want to do when they are 31 years old? No wait, let me rephrase that: all the things I wanted so badly when I was out in my campervan in freezing cold Kiwi land?

I guess not. All I want is for us to spend time together. All I want to do is the crazy things that are always on my to do list that I never do. Like getting a hamster. Like disappearing off the map. Like skipping a wedding. I guess all I want is to be myself, the crazy little me.

Helplessly Devoted

femmesuisse — Sat, 20 Aug 2011 00:02:43 +0000

She was 23 years old, 6 years after the terrible motor-vehicle-collision that got her paralysed from a C1-fracture. She was in a vegetative state for weeks, woke up with a locked-in syndrome, but therapy got her into a wheelchair now. Her parents escorted her to my ER after a fall onto the shoulder.

The clavicle was broken and a nasty fracture it was. After much explaining to both her and her parents, she got a sling and we all gathered around the monitor to look at the X-ray. Her vision was bad so she could not see. At home there was a magnifying device so dad wanted to take a photo with his camera.

The flash ruined the picture and dad did not know how to turn it off. The once so happy family, scarred after what fate had handed to them, looked at me helplessly. I wrote down their emailaddress, broke hospital policy, and sent them the jpeg file. And look who is feeling helpless now.

Dying Heart Muscle Makes Me Feel Alive

femmesuisse — Wed, 03 Aug 2011 12:36:27 +0000

Most of the days I spend in the Emergency Room are busy days where you will find me running around juggling patients who do not have that much wrong with them in the first place. Those are the days when I wonder what I am doing this for. Luckily every once in a while you meet a patient reminding you why.

He was young and healthy and walked into the hospital with an ongoing anterior wall myocardial infarction. After seeing dozens after dozens of patients with non-specific chest pain who you admit for serial troponin levels and excercise testing who never seem to have anything wrong with them besides acid reflux, this was refreshing.

Pale, diaphoretic, suffering from chestpain you could almost feel yourself, ST-elevations and reciprocal depression on the ECG, this patients heart muscle cells were dying by millions. I loaded him up with blood thinning medication, booked him a one way ticket to a center for reperfusion therapy and waved him goodbye.

Last night I could not stop thinking about him and suddenly I knew why. Dying heart muscle makes me feel alive.

ER Junkie

femmesuisse — Fri, 08 Jul 2011 11:30:07 +0000

I have an addiction. Actually, I have quite a few, but this one I am not too embarrassed to talk about. I am addicted to ER. The TV series. I am aware that the show stopped running years ago but there is such a thing as a dvd. Or more like fifteen of them. I started watching the show when I was 17, still in highschool and barely aware that I wanted to become a doctor. I am beginning to suspect ER might have had something to do with that. Or maybe it was just John Carter.

So here I am, the Emergency Physician, working in my own ER. The thing about watching the show on a daily basis is that you get quite depressed. Yesterday I walked into my ER and saw none of my imaginary colleagues. No doctor Greene (and yes, I know he died, but not yet in season 6), no Weaver, no Carter. Furthermore, two hours into my evening shift I noticed that I had not yet performed a single thoracotomy. Or put in a chest tube. Or ‘tubed’ anyone. Boring!

Not really though. I admitted a guy after his so manieth epileptic seizure. Quite funny to see how his coordination was so screwed up he could not tell his nose from his index finger. I admitted a grieving widower with non-specific chest pain and brought a hypotensive lower gastrointestinal bleed to the ICU. I’ll just leave the blood to the television screen and tell my imaginary colleagues to up the voltage on the defibrillator or to suspect a ruptured aneurysm.

And maybe some day I will save the day by coming up with Radovici’s sign on a patient with elevated intracranial pressure. Everyone will stare at me and wonder how I knew. I will casually sigh and say I saw it on ER…