Friday, January 10

medicine: wk1, day5

today, i saw a cardiac catheterization + stent put into my patient's heart.

on the angiogram, the tortuous course of the coronary arteries demonstrated how advanced the coronary artery disease was. the surgeons were able to feed a catheter up the femoral artery (near groin area) all the back to the heart, and into the left anterior descending (a major artery of the heart).

so, on the monitor, i was able to see the wire go into a terribly narrowed and twisted artery. then, a small cylindrical balloon that was along the wire, was inflated, opening up the artery. after several balloon inflations, and a stent (a metal shealth that keeps the artery open), i was able to see the blood flow (perfusion) to the heart re-established, which would help save the pt's heart tissue greatly.

it was amazing.

afterwards, i went to visit him several times, though he was theoretically out of our service. on my visits, i noticed that he appeared drowsy, definitely a change from his baseline state. i looked to see if he had received sedation during the procedure. he had not.

i reported this to my superiors. they went to take a look at him too, and became alarmed. everyone was worried that the procedure might have caused an embolus to go to his head, causing a stroke (which might explain his drowsy, altered state, though he had received no sedating medication). thus, we ordered a CT scan of the head for him.

afterwards, i was commended for my concern for my pt, the follow visits, and observations. (no one else had noticed his somnolence, or that it was a big change from his usual state)

"you might just have saved his life," my intern told me.

wow.

i finally felt like i was really really helping someone. i also felt terrible about this morning...

****
this morning, when my team was in a tight room, discussing the care of patients, i had a sudden irrational urge to fart.

i had some gas, and i could have held it until the mtg finished. but, i was feeling a little crazy. i wanted to squeeze this out. i contemplated bearing down hard, and startling them all, or releasing a silent-but-deadly. can you imagine their faces, should i suddnely let a loud one rip? i wonder, would they be embarassed for me, and ignore it, or would they point it out and laugh?

or even better, imagine the chaos from a SBD. i have no problems admitting that i had farted. but i think if i denied it, like everyone else surely would, then it would be much more fun. in such close quarters, it would be impossible to tell who REALLY farted. everyone would start accusing the others.

i think i was getting too involved in my insane world, because the others started to stare at me. i guess i had been smiling inappropriately by myself, imagining me farting, while the others were discussing patient care.


yakob at 10:01 PM

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