Week 27: Trauma surgery-- broken bones, sewn up wounds and death.

I finally got my hands dirty this week! My first of six weeks of trauma surgery and I'm in the emergency room. I plan on staying there too seeing that I have already observed enough knee and hip replacements to last me a life time.

I'm working with a fairly new doctor. There is almost always something going on which is great. The four days flew by.

I loved going to work with my dad in the emergency room and I still enjoy it now. I like that you don't know what is coming and what needs to be done that day from the get go. You take care of the patients and then move on to the next. It's just not predictable and I like that.

Most of the time I would follow the doctor around and see patients with her. I sewed up three patients during the week. We had a lot of people come in that fell on their way to work or at school. There were only small broken bones: fingers and toes, nothing big.

We did have an interesting case. An older lady comes in because she supposedly fell and hurt her knee. She couldn't really tell us when we asked her but mentioned pain while we examined her joints. Her son had said that she seemed to become more confused over time. We did multiple x-Rays of the areas she had pain but found no fractures. Due to some really high lab values, we had a CT scan of her head done. It showed us a big structure in her brain that was thought to be either a meningoma or a calcified aneurysm. She was transferred to the Neurologie department so I'm not quite sure what it ended up being.

I spent most of my Friday with one of the first patients to come into the ER. Again, an older lady fell. She had a big open wound on the side of her head from the fall. By the time she made it to us, she could hear what we were saying but wasn't reacting appropriately, we immediately had a Ct scan of her head done and it sadly showed a huge bleed. Even sadder was that it was a kind of bleed that can't be operated on. She was basically going to bleed to death while slowly becoming more and more unconscious of the world around her while her body reacts to the rising pressure in her head. Her son told us that she had contemplated attending college seminars the day before. She was just a few years shy of 100. It really made me sad that a person who was more or less absolutely fine the day before could so easily be given the prognosis of dying in the next few hours just because of a fall. Her son left the ER to take a walk. The nurses and doctors all moved on to work. I was the last one left in the room and sure wasn't going to leave this lady to die alone. I cleaned her up a bit and helped when the rising pressure in her head made her vomit. Other than that, I just sat there and held her hand. When she was transferred to the ward, I went along. I asked a nurse to help me clean the patient up a bit, put a new night gown on and I cleaned the blood out of her hair from the wound we stapled. I sat there for another 2 hours holding her hand waiting for the son to come back. At this point, I was pretty sure she wasn't registering the outside world consciously anymore and I had to get back to the ER. I asked the nurses to keep a close eye on her because I didn't want the relative returning to find her covered in vomit. I was disappointed that the son was gone for so long. I understand it being hard for a child to be with their parent in that situation as well but I would want to be there as a child. I'm sure she didn't have many more hours to live.

This weekend I'm spending some time in Paris. Monday is a national holiday in Germany so I don't have to go to work and I'm taking Tuesday off as my study day. So it'll be a short 3 day week but I'm hoping to learn some cool things and help some more people. 

Stay healthy!