Dead baby! Beautiful 9 month 1 day yr old baby, dead in the head holder of the scanner. Even for me that's uncommon. Followed by the 15 yo with the liver lesions who came in with mild belly pain now yellow and screaming ''KILL ME, I WANT YOU TO FUCKING KILL ME, TOO MUCH PAIN, CAN'T BREATHE FUCKING KILL ME''. I watched him come in a week or so ago chatting about the weekend, cute n cool to this, 3 drains, a lung as fucked as I've seen and pain no matter what they give him, 5 Dr's looking on, including the 2 Dr house infectious disease guys, fucked up. Mother is a theatre nurse with us, bawling her eyes out. Fucked up.
Next up guy in his 20's with adv aggressive bowl cancer to the point of obstruction. He doesn't know yet though. Came from day surgery. Such a strange dynamic as I smile, 'sorry for the delay, an emergency has to be put ahead of you'. Completely understanding 'he looks way sick man don't worry about it hey'. Tomorrow he may have had a slightly different perspective. On these days I have the stimulation I require, but horror and nowhere to put it. No way to use it. And then after all this, I have to deal with the beuarcrats; and that's what really hurts me.
Monday, March 28, 2011
Thursday, March 24, 2011
You meet these born again christians or ppl just back from india or just after reading their first philosophical or spiritual/pseudospiritual txt n they're so full of fervour n power n energy. See that same person 3yrs later with kids and a mortgage n they're all 'yer, I still believe in all that stuff its just meh'. Idk if the system just can not sustain habit without novelty to justify it, or if the exosystem only allows the spiritual to develop to the degree where you can finally shut up, keep a job and get married. But something happens. When you are hit with enough socially incongruous outcomes and an alternative appears ppl seem to take it. Or fake it. But you can tell when that lights gone and someone is fraudulently grasping for it back. But it doesn't come back that way. You have to keep walking, sometimes in the dark. Just for a while. None of us want to, but pretending its day light and walking into trees only makes it longer till dawn.
One of the things I'm doing is I'm trying to collect parapsychological data, and its out there, but sparing. A lot of stories. The master can slow his heart rate nearly to a stop... whenever he isn't wearing a holter moniter. He speaks in the woods and rattle snakes curl around his feet, he walks through lions dens and they don't attack him for he carry's no fear. Can he quickly carry his no fear through this pack of dogs in this lab? Nope. The master doesn't work like that. If he's in the lab he'll be there, if he's not he won't be. But what times the radio spot, 3pm? We'll be there. Book signing 9am? No trouble. The opening of the 7 grand a day day spa followed by another passing of the mercedes dealership? I think you may be in luck, the universe may just grace the master there. So few controlled studies. And why exactly would you find masters in places of great need; alongside a collection of followers? I understand how greater need would facilitate greater seeking, but Surely as with all great bursts in knowledge throughout history its in the rich there would be time for answers. There is an obvious connection between thought and world. It shouldn't be this difficult to research.
One of the things I'm doing is I'm trying to collect parapsychological data, and its out there, but sparing. A lot of stories. The master can slow his heart rate nearly to a stop... whenever he isn't wearing a holter moniter. He speaks in the woods and rattle snakes curl around his feet, he walks through lions dens and they don't attack him for he carry's no fear. Can he quickly carry his no fear through this pack of dogs in this lab? Nope. The master doesn't work like that. If he's in the lab he'll be there, if he's not he won't be. But what times the radio spot, 3pm? We'll be there. Book signing 9am? No trouble. The opening of the 7 grand a day day spa followed by another passing of the mercedes dealership? I think you may be in luck, the universe may just grace the master there. So few controlled studies. And why exactly would you find masters in places of great need; alongside a collection of followers? I understand how greater need would facilitate greater seeking, but Surely as with all great bursts in knowledge throughout history its in the rich there would be time for answers. There is an obvious connection between thought and world. It shouldn't be this difficult to research.
Drug Tolerance
A screaming young girl with multiple needles in her spine. She appears to be in so much pain that the dr walks out; refuses to give any more pain relief or complete the procedure. While getting her off the table I notice a fentanl patch like ali use to wear. It turns out this lass is on chronic high dose opiate medication like ali and as such the standard amount would not relieve her pain.
Crying, she tells me she tried to explain to the dr that her tolerance was high but he didn't listen. The dr said with what she was already on he was not prepared to give her anything else. Of course what she was on was just to manage her base level of pain. And we know for a fact drug tolerance exists, that's not in question, by anyone. But even given all that I guess the Dr doesn't want to be left explaining higher than usual dose medication for a certain procedure if something unlikely where to happen,when it is much easier and legally justifiable to just let the patient scream and suffer instead. A paperwork avoidance guarantee. That being said, its not uncommon to do similar procedures with just local. So Idk. The screams where certainly convincing.
Crying, she tells me she tried to explain to the dr that her tolerance was high but he didn't listen. The dr said with what she was already on he was not prepared to give her anything else. Of course what she was on was just to manage her base level of pain. And we know for a fact drug tolerance exists, that's not in question, by anyone. But even given all that I guess the Dr doesn't want to be left explaining higher than usual dose medication for a certain procedure if something unlikely where to happen,when it is much easier and legally justifiable to just let the patient scream and suffer instead. A paperwork avoidance guarantee. That being said, its not uncommon to do similar procedures with just local. So Idk. The screams where certainly convincing.
Monday, March 14, 2011
Just had huge fight with the head of radiology that can't be undone about how insane it is that someone who can manage a central line, insert a picc or access a port can not put in a cannula. As we aren't part of the hospital but a conglomerate; all she has to do is approve the 1 DAY course and I get an extra $5 a day, that Noone even applies for, but would significantly impact my life to $80 a month.
That's my electricity, phone and internet bill, $5 matters to me. We run the courses every 6 months ourselves, I've been with the hospital for years without a complaint and with commendation and have a graduate education in science, unlike the hospital cannulation team. But No. No explanation, even with full support of the Dr's on my side, no. No discussion. 1hr of no discussion in her office. She's clinical manager, only her opinion matters, just No. I hate this whole world, these people. These fucking people. Everywhere.
That's my electricity, phone and internet bill, $5 matters to me. We run the courses every 6 months ourselves, I've been with the hospital for years without a complaint and with commendation and have a graduate education in science, unlike the hospital cannulation team. But No. No explanation, even with full support of the Dr's on my side, no. No discussion. 1hr of no discussion in her office. She's clinical manager, only her opinion matters, just No. I hate this whole world, these people. These fucking people. Everywhere.
Tuesday, February 15, 2011
Patient today, UQ professor of english and linguistics. Whole life organising and exploring in his mind, wakes up at the apex of his career with a headache and a massive lesion over his language centres. Alive, reasonably well, just difficulty speaking or organising thoughts. At best its start again and get roughly back too where you were up to just in time for the end. Your days of ground breaking contemplation in your lifes work, or even understanding your own work, over. Realistically, there will be more incidents from here and u'll be compelled to choose another perhaps more simple life. Yet, most all the rest of you, undamaged, will still be the same old you striving, against walls already past and worse. Its this scenario, when I find the one I'm in already similar in so many ways, that knocks me for 6 the most when I see it. My organising and personal 'progress' is what I have. And hope for the right cva that brings a kind of peace Idk what to think about that position.
Monday, February 14, 2011
So here is an ethical one.
I'm trying to buy jelly beans from the pharmacy in the few minutes between a nerve root injection and a biopsy when a patient, who has just had a scan of some variety but not with me (but wool on his arm so very possibly CAT scan as no other out patient scan uses IV), has a 'turn' where he suddenly can't talk, drops his films ect. Wife is going mental. But not my patient. I'm not a physician. And I'm due back with the other patients who I do actually get paid to take care of. And I don't need to be involved in things, its not exciting for me, I've been involved in enough things in my medium sized low trauma private hospital. If anything its a major hassle and I kinda want my jelly beans. And besides, theyre all sick! What is the difference?
But the pharmacists seem confused, and are asian cause its late, I am here and it is technically an xray patient. So I ask if there was an injection for the scan to kind of assess what's going on and that's it; I realise accidentally I'm involved. I can't just then say 'oh shit eh. Well good luck with all of that' and keep walking. I don't know what my legal obligations are, but after he coded in the hallway n came for an inpatient CAT scan in 20mins I would have been recognised for sure. I grab a dr, a new xray dr by chance, in the hall who's on his way home: not interested. Helps me lift him into a wheel chair n leaves. The wife keeps harping about them not missing their specialist appointment 'cause its about cancer', like that means anything, you do not get sudden cancer emergencies n I'm thinking 'its gonna be a short consult if the guy can't speak you dumb mole' but instead I say 'look I'm taking him to emergency, you can call the specialist from there if you like, but that's what we're doing here'. To which she replies 'well, you know what's best'! Total 180! Why do I suddenly know what's best?! Insanity. The whole place is so surreal, none of it flows.
The infection control officer leaves caps off syringes and doesn't swab high risk injection sites or wash his hands but lectures others. There are at least 3 more stories from everyday, but I guess the only point is, for next time in this type of case, surely the pharmacists could have handled it? Maybe not in a timely fashion, but his death\irreparable brain damage risk would have increased only, Idk, 1%? 20%? 50%?who knows. Not by too much. Unless she tried to keep her appointment and the pharmacists where asian. Idk. Idc. Isn't it all just about us wanting to be helped; which is unrelated to anything we do. If it wasn't for the 'he just had his scan and now he can't speak' comment I probably would have just got my jelly beans. Idk.
The point is xray is my department, they did need help, I was there. But was I the only one who could give any kind of hand over? Isn't that what the hysterical wife (but who can't miss her appointment) is for? I'm sure her screeching would have done just fine. I had access to wheelchairs and dr's most quickly n emergency was pretty much on the way back anyway, that is all true. I mean I think we all agree I shouldnt really be working there at the end of the day anyway. But where else. And I know its a hospital but I just want that stuff kept out of my jelly bean runs at the very least, I think that's the crux. Really ali's grandmother had just written to me and I was miles away in thought so being brought back to work jarred me.
Actually, believe it or not, I was thinking of the thousands of dollars bill wise I commit this family to the minute I wheel this fellow thru the staff emergency entrance if I was wrong. The wifes weird reaction was throwing me. But the dr agreed (on the way to his car), I mean the guy lost the power of speech n his movement was going too. Just like that ER dr, george cloony, telling me to start compressions cause a patients not breathing after he's been called because I think the patients not breathing. And then the bill, no longer on ABC. Its all so criminal. Oh I just remembered I forgot to check if a mother can breast feed post injection. I did promise I wouldn't forget, but as with all medicine it changes by what dr is asked anyway.
And no, I never got the jelly beans.
I'm trying to buy jelly beans from the pharmacy in the few minutes between a nerve root injection and a biopsy when a patient, who has just had a scan of some variety but not with me (but wool on his arm so very possibly CAT scan as no other out patient scan uses IV), has a 'turn' where he suddenly can't talk, drops his films ect. Wife is going mental. But not my patient. I'm not a physician. And I'm due back with the other patients who I do actually get paid to take care of. And I don't need to be involved in things, its not exciting for me, I've been involved in enough things in my medium sized low trauma private hospital. If anything its a major hassle and I kinda want my jelly beans. And besides, theyre all sick! What is the difference?
But the pharmacists seem confused, and are asian cause its late, I am here and it is technically an xray patient. So I ask if there was an injection for the scan to kind of assess what's going on and that's it; I realise accidentally I'm involved. I can't just then say 'oh shit eh. Well good luck with all of that' and keep walking. I don't know what my legal obligations are, but after he coded in the hallway n came for an inpatient CAT scan in 20mins I would have been recognised for sure. I grab a dr, a new xray dr by chance, in the hall who's on his way home: not interested. Helps me lift him into a wheel chair n leaves. The wife keeps harping about them not missing their specialist appointment 'cause its about cancer', like that means anything, you do not get sudden cancer emergencies n I'm thinking 'its gonna be a short consult if the guy can't speak you dumb mole' but instead I say 'look I'm taking him to emergency, you can call the specialist from there if you like, but that's what we're doing here'. To which she replies 'well, you know what's best'! Total 180! Why do I suddenly know what's best?! Insanity. The whole place is so surreal, none of it flows.
The infection control officer leaves caps off syringes and doesn't swab high risk injection sites or wash his hands but lectures others. There are at least 3 more stories from everyday, but I guess the only point is, for next time in this type of case, surely the pharmacists could have handled it? Maybe not in a timely fashion, but his death\irreparable brain damage risk would have increased only, Idk, 1%? 20%? 50%?who knows. Not by too much. Unless she tried to keep her appointment and the pharmacists where asian. Idk. Idc. Isn't it all just about us wanting to be helped; which is unrelated to anything we do. If it wasn't for the 'he just had his scan and now he can't speak' comment I probably would have just got my jelly beans. Idk.
The point is xray is my department, they did need help, I was there. But was I the only one who could give any kind of hand over? Isn't that what the hysterical wife (but who can't miss her appointment) is for? I'm sure her screeching would have done just fine. I had access to wheelchairs and dr's most quickly n emergency was pretty much on the way back anyway, that is all true. I mean I think we all agree I shouldnt really be working there at the end of the day anyway. But where else. And I know its a hospital but I just want that stuff kept out of my jelly bean runs at the very least, I think that's the crux. Really ali's grandmother had just written to me and I was miles away in thought so being brought back to work jarred me.
Actually, believe it or not, I was thinking of the thousands of dollars bill wise I commit this family to the minute I wheel this fellow thru the staff emergency entrance if I was wrong. The wifes weird reaction was throwing me. But the dr agreed (on the way to his car), I mean the guy lost the power of speech n his movement was going too. Just like that ER dr, george cloony, telling me to start compressions cause a patients not breathing after he's been called because I think the patients not breathing. And then the bill, no longer on ABC. Its all so criminal. Oh I just remembered I forgot to check if a mother can breast feed post injection. I did promise I wouldn't forget, but as with all medicine it changes by what dr is asked anyway.
And no, I never got the jelly beans.
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