If my life were a cartoon, the thought bubble above my head as I plummeted earthward would have contained nothing more than a giant exclamation mark. My first coherent memory after my frantic leap was the loud snap of the chute opening. After that, the only sounds were the muted drone of the Cessna in the distance and the occasional rustle of the canopy above me. It was strangely peaceful, drifting lazily a quarter of a mile above the prairie. It was also electrifying. I had my next jump date planned long before my feet touched the ground.
Elementary Questions
The summer I completed my medical training I landed a job as an emergency room physician at the Misericordia General Hospital in Winnipeg. One day my mother asked if I’d be willing to come to her elementary school during Career Week to speak about health care. I told her I’d be delighted.
I assumed I’d only be talking to one or two classes, but when I got there the principal apprised me I’d be addressing the entire school and escorted me to the gymnasium. It was packed with kids, all of whom were sitting on blue gym mats and chatting noisily. The principal stepped up to the podium, motioned for the students to be quiet and introduced me. I then launched into a kid-friendly description of my life as an ER doc. When I was finished, I asked if there were any questions. Two dozen hands shot up. I pointed to a boy in the centre of the crowd. He leaped to his feet.
“How old are you?” he queried.
“I’m 29.”
“What kind of car do you drive?” he continued.
“Um, a Toyota MR2.”
“Is that a sports car?”
“Yes.”
“What colour is it?”
“Dark blue.”
He grinned and sat down, apparently satisfied with my answers.
I nodded at a tiny girl in the front row who was desperately waving her hands in the air.
“Is Mrs. Gray really your mommy?” she asked.
“Yes, she is.”
“Is she nice at home?”
“Yes, she’s very nice.”
She smiled and sat down.
I pointed to a boy who was wriggling around on his mat like a worm.
“What would you like to know?” I inquired.
“Can I go to the bathroom?”
“Okay.”
He sprinted out of the gym.
I made eye contact with a girl near the back of the room. She squealed with delight and jumped up.
“I have a cat named Trixie!” she proclaimed triumphantly.
The audience went berserk.
“I have a dog named Rover!”
“I have a goldfish named Gipper!”
“We had a bird, but it died!”
“We’re getting a salamander next week!”
“My dog just had puppies!”
“QUIET PLEASE!” yelled the principal. “No more talk about pets! Does anyone have any questions about hospitals or medicine for Dr. Gray?”
Silence.
Approximately 15 seconds later a solitary hand went up.
“Yes?” I asked cautiously.
“My grandfather lives in Nova Scotia!”
Uh-oh… .
“We went to Disney World last summer!”
“I like Donald Duck!”
“My mommy just had a baby!”
“My dad thinks our cat might be pregnant!”
“Trixie has orange fur!”
“CHILDREN, PLEASE!” screeched the principal.
It was the longest 20 minutes of my life!
Life During Wartime
What can I say about ER work? It’s exhilarating, terrifying and hilarious, all at the same time. Like a handful of other strange professions (for some reason law enforcement and stunt acting come to mind) it’s impossible to predict what you’ll end up seeing over the course of your day. The only thing you can be reasonably sure of is that at some point during each shift you’ll run into something you’ve never laid eyes on before. Sure, there are a number of common ailments that trundle through those annoying sliding doors on a regular basis, but the red neon Emergency sign out front also seems to be a magnet for the bizarre. For example, yesterday I treated a woman who had been bitten on the cheek by a horse. Hmm, a horse bite in the middle of the city. Now there’s something you don’t see every day!
The typical shift in your average urban ER is fairly busy. For starters, you generally have anywhere from 15 to 30 patients tucked under your wing at any given time. It’s a heterogeneous group populated by the “worried well” at one end of the spectrum and the seriously ill at the other. Your job as an ER doc is to figure out what’s wrong with each patient as quickly as possible and then either fix them or relay them on to someone who can. As you work through each individual’s problems you also need to keep updating your mental tally of where all your other patients are in their respective diagnostic workups. Depending on each person’s description of their symptoms, their physical findings, the results of any tests ordered, and your instinctive gut feeling, certain illnesses move up or down their list of conceivable diagnoses. Once you’ve decided on the most likely culprit you can commence treatment and begin working on disposition. Walk-ins, crawl-ins and ambulance drop-offs add new patients to the already volatile mix every few minutes. If anyone in your flock takes a sudden nosedive you need to immediately drop everything and divert your full attention to the new priority. It’s not that uncommon to be hastily summoned to the stretcher or bedside of an unfamiliar patient who is only a few heartbeats away from death. In those cases you don’t have the luxury of being able to obtain a detailed history and perform a thorough examination to help shape a logical working diagnosis. Instead you have to immediately shift into augenblick mode and initiate potentially life-altering treatments based solely on a brief gestalt impression. It's like going from zero to warp speed without even having time to buckle in.
Imagine doing all of this in a cacophonic environment full of telephones ringing, faxes printing, monitors alarming and dozens of people laughing, crying, yelling, cursing, complaining, wheezing, coughing, bleeding and vomiting. I keep picturing some poor slob in a white lab coat juggling 20 buzzing chainsaws while balancing on a tightrope suspended above a shark-infested pool. Who could resist a job like that?
The Cleanest Boy Ever
Last Wednesday the ER was a non-stop frenetic cabaret of diseases of every genre. Around 2:00 in the afternoon one of the nurses handed me a chart and said: “I think you should see this one next.” A cursory review of the triage note revealed my next patient to be a four-year-old boy named Simon who was presenting with a rash. Meh. What’s so exciting about that?
I walked into the cubicle and came face to face with Lobster Boy. This poor little tyke was P.T. Barnum sideshow material. His entire body was covered in a brilliant red, swollen rash, and he was scratching like there was no tomorrow. Each time his nails scraped across his skin, huge welts bubbled up almost immediately. I had to force myself not to gawp.
“How long has he been like this?” I asked his mother.
“It started this morning, doctor.”
“This looks like an allergic rash. Does he have any allergies that you’re aware of?”