Friday, December 12, 2008

FUN STORIES IN THE ER, MY REAL LIFE JOB


Today started like a regular day for me. Woke up 10 minutes late (ignored the alarm) - hopped in the shower and threw on my scrubs. Read a few pages of the last Twilight series book while blowdrying my hair (what will happen to Bella and Edward?) and then kissed hubby goodbye and hopped in the car.

Traffic was super light today so even had time to stop at Starbucks - venti, sugar-free vanilla Brevee latte (my current fave) and got to work actually on time.

Here is the kicker - arrived to the ER at 0830 and not a soul waiting to be seen and only 2 people currently in the ER! This is insane.

So - thought I would spare everyone more details about our awesome kids' line (http://www.oohlalamama.com/) and hop on and share some of my favorite ER stories today.

These are some of my best stories of personal patients from over the past 10 years in no particular order. (please don't figure out how old that makes me - let's just say I was a child prodigy and went to med school at age 10).

*If you are squeamish - maybe don't read on. If this is you - if you were my patient - then sorry if you feel violated - no names or hospitals will be mentioned...

1) 38 year old male who was upset with his insurance company. They would not pay for a circumcision - they said it was cosmetic (that's what the patient said anyway) - so he decided to do it himself. Note - if you are trying to perform your own surgery, at least google how it is actually done first. No details here, but I will share that a circumcision does not involve removing all of the skin... This was a very interesting patient and multiple specialties were involved in helping this man (plastics, general surgery and urology). DO NOT TRY THIS AT HOME, Kids.

2) 23 year old male - who said that he did "too much cocaine" and got a glass shot glass stuck somewhere quite unpleasant. This - by itself - is not too big of a problem - however, friend of this patient decided to try to help him out. Pliers were used, glass broke and patient bought himself a ticket to the OR where I happened to be on duty for my geneal surgey rotation. What did we find? A broken shot glass, an orange, a small shampoo bottle and yes, an olive (maybe it was in the shot glass?) So - purchased a colostomy bag as well. Happy trip to the hospital. Hope the cocaine was worth it.

3) Baby 7 months old - brought in by mom with complaint of "multiple seizures." Baby was not breathing and lost his heart beat upon arrival to the ER. This was during my moonlighting in the middle of nowhere. Very, very small ER and I am the only doctor in the whole hospital. We put the baby on a ventilator, start an IV - doing CPR, giving meds and we get a heartbeat back.

OK - baby on ventilator, pseudo-stable, and doing better and I am calling on portable phone to the closest pediatric ER/ICU. Obviously this baby needs to get to a center - FAST. Helicopter cannot fly, weather too bad. We call 911 and I hop in the ambulance with the baby (don't worry, we called in a backup physician to take over the ER). Lights and sirens - scariest 20 minutes of my medical life - this little person depending on me to keep him alive. Upon arrival to other ER baby has a lethal arrhythmia, so now we are shocking baby and this is like the real thing - just like you see on ER (the TV show - I mean).

Baby is having seizures and we don't know why. Mom told me that all of her kids "have epilepsy" but still - something is not right. Baby has no fever so not meningitis and tox screen is pending... Could it be shaken baby? No other signs of trauma and too unstable to go to CT scanner. We keep guessing and trying to figure out what is wrong.

Turns out - baby has been given a tricyclic medication - overdosed by MOM! These drugs are often prescribed as sleep aids- in overdose they cause seizures. Official diagnosis: Tricyclic overdose, seizures and Mom gets a diagnosis of Munchausen by Proxy.
Definition by wikipedia: Munchausen syndrome by proxy (MSbP), are insidious disorders in which injury is deliberately and gradually inflicted upon a person usually for gaining attention[1] or some other benefit.

This baby and all of the mom's other kids are taken away through the court system. This baby did fine (from a medical standpoint) - recovered completely with no brain injury or obvious problems so far. As far as how this baby, and the rest of the children from this family fared - well I just hope that they were placed with a loving family and that they will all be kept together. I cannot help every problem. But on this day - I do feel like I maybe made a difference, that I kind of saved a life - just basic training that every ER doctor has but I will never forget this little one or the crazy fear I felt trying to save this little one...

So - that's it for this morning. Hoping the rest of my day in the ER continues to be calm - I am truly loving it. It is so rare to have a day where I can answer emails and maybe even write a bit.
Someone recently asked me how my job in the ER relates to my job as owner of Ooh La La Mama - kids' apparel line http://www.oohlalamama.com/. Well - it really doesn't. Most days my ER job has nothing to do with making onesies. But - I must say that it helps keep things in perspective. When an order is late or a customer gets upset with us for something that maybe did not go just perfectly - I still get stressed but I can sit back and take a deep breath and say to myself: Well at least no one died today...

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