Tuesday, October 04, 2005

Wheelchair Surfing

Day started out with a hip injury. An old guy in a wheelchair in a nursing home was doing wheel chair surfing. In wheel chair surfing, a person in a manual wheelchair grabs a hold of a person in a motorized wheelchair, who pegs the control hard forward and they go whipping down the halls. Well, they took the corner a little fast and the guy in the mechanical wheelchair went flying, and either broke or dislocated his hip. “What have I told you about going too fast?” the nurse scolded him. His legs looked a lot worse than they really were -- his left leg was splayed out an impossible angle. Turns out his left leg is a prosthetic. I gave him 9 of morphine in doses of 3 mgs, and his pain went down to nothing. He told me he lost his leg after he broke it playing football as a young man. It kept him out of World War II.

***

We went to a nursing home for difficulty breathing. When we got to the nursing station, the nurse looked at us and said, “Did you bring oxygen?”

I look at her cockeyed, and then say, “Oxygen? Oxygen? Oh, yeah, yeah, we’ve got oxygen, and we brought our stretcher too. And outside we have an ambulance with lights and sirens. We got in trouble once when we came in a Volkswagen bug. And look, we brought our bag. I don’t know what’s in it. Snacks, I’m hoping. And we brought our TV set, except the reception isn’t very good. We just get squiggly lines, and damn you get powerful shock when you try to fiddle with the stations. The Young and the Restless just won’t come in.”

“Okay, okay,” she says, “I get your point. The patient’s this way.”

***

We get called for a man who slashed his wrists. He has cut himself maybe eight times horizontally, which is not the right way to do it. He has hardly lost any blood. “Someone needs to call my brother,” he says. “He didn’t believe me, he didn’t believe my life was spinning out of control. This will send him a message. Let him know things are bad with me. Real bad.”

When I first started as a medic my preceptor, who was on the verge of burning out, scolded a patient once, telling him if he wanted to off himself, he needed to quit wasting everyone’s time and slash vertically, that way you ripped the veins opens so they wouldn’t clot. That was the way to really do it. I was, needless to say, appalled. While I don’t feel I am burning out, I was tempted to tell the man, “Look, here’s how to do it. You aren’t fooling anybody with your little cuts.”

But I don’t. I just say, “Yup, they’ll call your brother from the hospital. You got his attention this time.”

He says, “I love my brother, hate to bother him, but he should know, he should know what’s happening with me.”

At the hospital, the nurse listens to my partner’s report, then confronts the man, “Where you trying to kill yourself?”

What kind of question is that? Does she really expect the man to say: “No, no I wasn’t. This is just a desperate plea for help – a ploy actually – my plan was not to harm myself, merely to try to gain my brother’s attention so he will show me that he really loves me and that I am not alone in the world. If I wanted to off myself, I would have stuck a gun in my mouth and pulled the trigger.”

***

Last call was for an unresponsive. Instead of an unresponsive, we find a drunk holding himself up by hanging onto a fence. He is just two blocks from the hospital, one block from the liquor store. He has a hospital bracelet on. We take him back to the hospital. “How’d he get on your stretcher,” the nurse says, “He’s supposed to be in the unit.” It seems he had been there all day sobering up, and then somehow snuck out. Hit the liquor store on the way home, but didn’t make it down the street.