Day 8
1. One of the cases that early morning for the registrars to operate on: Husband abuses wife. Wife smacks husband in the skull with a baseball bat. Horrible fracture on the left with brain herniating out being pushed by (surprisingly) a massive extradural bleeding from the right side.
2. Registrar gets a call of fractured spinous process admitted to neurosurgery due to fall of a bike (should be trauma). Bad mistake of unncessarily increasing the workload of the department, with 4-letter F* words flying out as she stormed out to the emergency department.
3. Consultant supervisor asked the residents how is the medical student doing, whether they teach me stuff..
Resident: Yeah, good good!! he did a lot of stuff - writing discharge summaries, chasing test results etc.
Consultant: Sure? Should I pass him?
Resident: Yeah yeah you should!
Consultant: You don't have to be too nice to him, you know? Otherwise later you get interns and residents that give you a headache in the future. I train good doctors, not mediocre ones, so my job is to exterminate them in the bud.
*swt*
Anyway, remember that temporal lobe tumour guy who wanted a video of his operation? Got discharged, and nothing a good buddy-like handshake couldn't fix.
4. At 4.00pm, I followed my prospective long case patient into the operating theatre, to undergo a stereotactic brain biopsy +/- EVD and CSF collection (whatever lar, can't remember the full name of the procedure).. Suppose to be a straight forward 30-minute procedure through a mini burr hole, but the operating registrar unluckily cut a passing vein (initially thought he miscalculated and hit the sinus).. My consultant had to come in (despite being in crutches.. boy did he reminded me of Dr House) to drill out a piece of bone and burn off the bleeding.. Then, something wrong with the machine which is suppose to map out areas of the brain. Consultant considered doing the tumour biopsy free-hand (which was common 20 years ago, can you imagine in the 21st century?)..
After finally obtaining a specimen, he requested for a chair to sit as his legs are getting tired. I pushed the chair with small wheels for him, but forgot to lock it down for grip. What happened? Upon leaning back, the chair became unstable, and he came crashing down on his back in the OT. *swt* He was on crutches and apparently re-injured one of his legs which was immobilised due to an accident. (I hope that is not the end of my rotation and assessment)
I helped arrange for histopathology to do a frozen section so that can decide further course of management in theatre itself, and I told the histopathologist that we will come over in 30 minutes (registrar's instruction). By the time we were done, it was 6.15pm. Lab already closed, and most staff had gone home. Lesson learnt: take note of the person-in-charge's name at the other end of the phone. Can't possibly leave the patient like that for an hour, so the unfortunate decision was made to close up. Couldn't even collect CSF for tests coz to everybody's horror from the CT scan, if the brain lesion is not cancer, but an abscess, then patient will die from infection once exposed to CSF.
Cut the long story short, left the hospital at 7.45pm, walked to the bus stop and train station in the rain (I don't have an umbrella), had dinner at McD, and arrive home 9.30pm. This is madness.
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