Saturday, July 17, 2010

Humour



Once again, a spontaneous bout of gastroenteritis for your reading pleasure.

Isn't it amazing how humour varies from culture to culture whilst retaining its common denominators. I think, one of the real perks of growing up and functioning in a multi cultural environment is that you learn to appreciate the various senses of humour that are exhibited by different cultures.

Even on an individual level. Whenever you get to know some one, make a new friend, whatever.... notice their unique sense of humour. Laugh with them. It is an instant people bonder.

Especially when you are a doctor perhaps, I think a sense of humour really helps in gaining some personal perspective. Yesterday, I walked into the hospital at 8.45 am. 15 minutes late. This being a rehabilitation ward, I wasn't too worried about that. I put my stethoscope around my neck and got out my pen from my bag, when a lady's voice blared quite calmly over the loudspeaker.

"ATTENTION PLEASE, ATTENTION PLEASE. CODE BLUE. SOUTH WARD."

I froze for 2 seconds. Then turned around and ran to the south ward. See, code blue means a medical emergency. As I passed by another ward, I could see there were other doctors rushing towards me with a view to going to the south ward.

I got there to see an old man sprawled onto the ground. He was struggling to breathe. Eyes rolled up. There were already a lot of people there. One of the doctors was holding him in the "recovery" position. This means the patient is lying on his side so that in case he was choking or vomiting, the contents come out of his mouth more easily than when he is lying on his back. (gravity will otherwise push the vomitus back into the throat and obstruct his airway).


I wasn't too sure what the circumstances of the collapse was. But I could clearly see that there was respiratory effort. I saw that one of the doctors confirmed that he had a pulse. So immediately, I realised that this was NOT a cardiac arrest. This was probably some one who has choked on his morning breakfast and needs securing of his airway.

Confused as to why this wasn't already done, I rushed in, held his head, put my index finger into his mouth and did a sweeping motion until a big chunk of masticated food came out. Then I yelled, "SUCTION please". A nurse stumbled about and got me a suction tube. This is basically a plastic tube with a vacuum at its end that helps suck out anything that is down the throat or larynx. I sucked out some more gunk. He was still unconscious.

Some one put in a gaddell's airway and put a bag mask over his nose and mouth. I whipped out my stethoscope and listened over his anterior chest wall. I could hear that there was air entry bilaterally -  oxygen was getting into both his lungs. Oxygen saturation came up to a 100%. His BP returned as 152/74.  I quickly gained IV access, took some blood off for analysis and handed this over to another doctor. Meanwhile the ambulance had arrived to take the patient to the acute hospital.

2 minutes later, I exhaled slowly as I washed the blood off my hands. As i dried my hands with a paper towel, I glanced across the room to see a little old lady in the corner staring with a blank look. Nobody was near her. I somehow got the feeling that she was his wife. I walked towards her and stopped.

"Mrs Johnson?"
"y.. yes.." she stammered.
"Mrs Johnson, my name is Dr. Kumanan. Your husband seems to have choked on his food. It's all okay now, he just needs to go the main hospital, and be observed for sometime. Alright?" I said, with as much understatement as I could possibly muster. (This man probably started walking towards the white light a good 2 minutes before I even got to the scene.)

She swallowed and composed herself.
"Thank You doctor for talking to me. Choked on his food did he? Choked on his food. Right. Well thats clever isn't it. What an OUTRAGEOUS way to meet your end, god forbid. Oh that STUPID STUPID man...", she said fighting back tears, as the paramedics took him past us in a stetcher.

I stared at her with absolute disbelief for 1 second, hardly able to contain my laughter. Then I put my hands in my pockets, and walked away towards my ward, smiling and shaking my head.

The time was 9.10 AM.

3 comments:

  1. I love your expression: "walking towards the white light." I hope that this man, when he got to the main hospital, was queried as to how food got into his airway. Often bad habits such as chewing food insufficiently set up a near-death experience. Sometimes it's a matter of loose dentures that make chewing nearly impossible. A reader-friendly source for choking and other swallowing problems is the recently-published book "SWALLOW SAFELY: How Swallowing Problems Threaten the Elderly and Others. A Caregiver's Guide to Recognition, Treatment, and Prevention" available through www.SwallowSafely.com. Joel Herskowitz, MD, Boston, Mass., USA.

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  2. Hello, thanks for your input doctor. That book sounds interesting. I will take note of your website address.

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  3. I re-read the post after speaking to you. I smiled.

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