ER

Well finally I have come to the final term of my internship. And what a fitting end to an interesting year.

After honing my meal breaks to an art and de-skilling from medical school, I've been sent downstairs to the land know as the Emergency Department.

Now for those of you who don't know, there is an upcoming State election due next year which can mean only one thing. Time to crunch some numbers and show the public how wonderful and 'happy' the public hospital system is. And the best way to do that is to make the flagship of public health (the ED) reduce its waiting times. And so we are left with a bunch of junior doctors being told that their job is not to provide medical care (unless they're dying and even then that is debatable*) but to triage people and refer them to ANY admitting team. In fact it doesn't matter if you don't know the test results, if you know they need admission just admit them (much to the dislike of medical registrars).

And so we 'click-off' our patients and take thorough histories on people who are so vague/unable-to-speak-English/deaf/mentally-deficient and then procede to "buff and turf"** to the wards.

I must say at first I was a bit shell shocked cos I had no idea how the system worked but now I've grown to get used to the pace and it's actually a lot quieter in Emergency than on the gastro wards.

I was a bit scared the other day when I had to revise some obstetrics and thankfully avoided having to do a vaginal examination on the poor lady. I managed to diagnose a lung abscess on chest Xray and then got a pat on the back from the consultant.

But then today I found my new favourite activity...

Suturing!

That's right. I stand here today testifying to the fact hat one year ago I hated surgery. In fact I despised all surgical procedures and couldn't stand them. But I am now a changed man. I have learnt to appreciate the joy that can be derived from stick needles and sharp objects into people and fixing things with your hands and not with your head. You can just zone out and relax while you infiltrate with some local anaesthetic and then make nice wound closures and sew nice pretty surgical knots.

This evening I patched up a surfer who got on the wrong end of his surfboard fin and made a nice 10cm gash on his head. 20 minutes later he had a nice set of needlework on his scalp. Then a bit later I had another patient come in with a laceration to his eyebrow/eyelid. As I took his history he began to use medical phrases like "Um yeah, I saw the wound edges were nicely apposed" and asked if he was medically trained... turns out I was stitching up a psychiatrist! (no pressure there now!) But by the end I had a nice set of stitches that in 7 days time will come out and leave a very nice cosmetically-pleasing scar along his natural skin lines. Ahhh... I should have gone into plastics!

I have discovered that ED has it's own advantages too. Like being on shift work. I have realised that I am NOT a morning person and do not 'function' until after midday. And so wokring from 2pm till midnight all week is fantastic for me. It means I can sleep in, go for a swim and still have time for lunch with my 2 pharm girls*** before going to work being fully awake and ready. Add to that the fact you work 8 day fortnights and ED is not that bad after all. And so this week I've been getting outside and enjoying the beautiful sunshine on my shiny bald head.

Ahh... summer is almost here!


* Last week of my Gastro term, we had a patient almost exsanguinate in ED becasue they had been 'admitted' under us and as we weren't able to come and see him (due to our other 30 sick patients). ED just said "It's on your own head now, he's admitted under you" and so my Prof came down and cannulated and did bloods on this guy who was dying on BiPAP and gave him some much needed frusemide.

** See the book "House of God" by Samuel Shem. It refers to the process of making a patient look good and turfing them to someone else to sort out. It's soooo true!

*** Yes, my old pharm girls from the wards have been keeping in touch and we catch up for lunch. Gotta say, those chicken burgers are to DIE for.