Monday, March 29, 2010

55 Word Short Stories



55 Word Trios

These 55 word short stories were written after a month long rotation in an emergency department in Manila, Philippines.  This developing nation was beautiful in many ways, but the things I saw in the ED gave me a lot to think about.  Some of these experiences make me ashamed to relate – ashamed of how I acted and what I thought.  Ashamed of how little I could do.  Each story is just a blurb in the whole experience, and there is much more behind each one.

 Blood, Sweat and Tears

Blood

Shannon poked him three times. We just don’t perform phlebotomy back home, we’re unpracticed.  Finally the syringe filled with dark maroon blood. No time for gloves.  As I held the vials for her all I could think about was the HIV and Hep B that is rampant here.
“You’d better not stick me.”
“I know.”


 

Sweat

She had no pulse.  Code.
Hands locked together, pushing down 2 inches required. 
My sweat was dripping on her, I was embarrassed. 
I felt her breast through her thin shirt and knew it was in the right spot, over the heart. She shouldn’t have to die like this. 
It’s hot. 
More sweat dripping.  Still embarrassed.

Tears
“They just don’t show any emotion.” 
Most of us observed this.  We’re used to patients who yell, scream, complain.  Families who cry, beg, annoy.  These patients were different – accepting, grateful, stoic.

But, when the CPR was over, I realized her daughter was crying.  The family had lost a matriarch.  They felt loss. They had tears.


 The Hospital

The Hospital

Open air wards.  Cats slinking in the alleys, in the halls.  Peeling paint, hand-painted signs, broken chairs. Hard steel cots, unpadded wheelchairs.  Family members crowded around in hallways, on cardboard mats – not visiting but vigilant.  Responsible for labs, transportation, ventilation, feeding, laundry.  5 nurses for 60 patients. 
“What’s your hospital like?”

“It’s not like this.”

 

Oxygen

The old man needed oxygen. Septic. There was no tank nearby. The tubing didn’t reach, he leaned back.  No IV pole so he shared, arms outstretched.  Uncomfortable. 
The woman behind him became pulseless.  CPR for 20 minutes, to no avail.
For the first time I thought it: “She’s dead.  Now he will be more comfortable.”

Breast Cancer

“Have you ever seen a breast cancer?”
“No”
“She stopped chemo in April.  Hasn’t walked since December.”
“It’s February.”
Angry, red volcano on her chest, putrid liquid pooling.
I wore my mask to avoid the smell.
Her husband leaned down to carefully wrap it back up.  Hide it.  Lovingly.  He didn’t even wear a mask.

 

Breath

Goiter

I’d never seen anything like it before.  No one in the US would let it get this bad.  The goiter on her neck was completely overshadowed by the large, red, tense, tender parotid cyst.  Disfiguring.
“Masakit?” – Tagalog for pain.
A mild head nod.
“Six days” she said.  “I can’t eat.”

Later, she couldn’t breathe either.


CPR

1 and 2 and 3 and 4 and…..
“Staying Alive” running through my head.
Hands locked, I kept my eyes and ears on the monitor, seeing how effective the compressions were.

When 20 minutes were up, and she was dead, I thought “ Oh good, I wanted my first time with someone who would die.”

 

Intubation

“Are you ready to intubate?”
“Yes, I’m ready.  When will they start coming in?”
“Oh, they’ll be in alright. “
The first was dead when I intubated her.  We worked for a while, then quit. Her husband leaned down to cry, say goodbye.
“Excuse me, sir.  You need to sign this form.”
I walked away.

Manila

Manila

A taxi winds through the narrow, curving, crowded streets  Various transportation modalities crushed together.  Roosters crow.  Houses made of tin, scraps of wood, cardboard.  River beds dry, filled with trash.  Smell of urine, feces, sweat, sun-rotting garbage.  High end shops next to dingy produce stands.
Children dart between traffic.

“They’re renewable resources” the residents said.


Beggars

Walking down the street we passed the children every day.  The girl about 12, the boy a toddler.  Siblings?  Mother and son?  God, I hope not.  The same cardboard mat every day.  The same dirty grins.  Reaching hands.  Begging.  Playing games on the sidewalk.  A smile, a coin, a cupcake.  Accepted, but still not enough.

Pharmacia

I felt guilty using their supplies.  Stopping at the pharmacy on the way to work seemed strange.  Vials cost mere pennies, IV catheters even less.  I bought $30 of supplies – two large shopping bags full.  It would keep the ED going for a day, maybe two. 
“Did you get any Foleys?”

“No.”  I had forgot.

Staying in Milwaukee

For those of you who don't know yet, we're staying in Milwaukee.

I matched into Emergency Medicine at Froedtert/MCW - my alma mater.  It will be nice to know a little bit before I start residency.

Now for moving.  We're moving to a new (bigger) apartment on Memorial Day weekend.  Crappy, yes.  But many hands make light work so if you want to help you are welcome.

Bry's finally about to start back in Watertown - he's pretty excited.  Abi is on vacation basically until July 1 and has been knitting up a storm.

Tuesday, March 16, 2010

MATCHED

Well we found out today that I officially matched.  We will find out on Thursday WHERE we will be living and WHAT specialty I'll be in.  We're getting pretty excited.  Will update on Friday.

Thursday, March 4, 2010

Back in the USA

Well we're back in town.  Not going to lie, it's been a rough couple of weeks.  We finally uploaded photos to Bry's computer so there will be some additional Palawan photos coming up.

I started my new class: Art of Medicine through the Humanities.  I'm loving it!  We're discussing poetry, books, plays and all kinds of non-medical things.  Last night we went to the Milwaukee Repertory Theater and saw a play (free!) that was interesting.  Bry got to come along too.  We also met with Edo de Waart, the newest conductor of the Milwaukee Symphony Orchestra who is world renowned, as well as with a wonderful basoonist from the Symphony.  It was an awesome day, and I can't wait to go to the Symphony on Friday (also free!).

In other news, Bry's mom broke her right arm (radius and ulna) on Monday.  She's going in for reduction today and isn't sure if they'll have to put metal in to hold it or not.  Bummer - she'll be out of commission for about 6 weeks.

I'm supposed to be keeping a journal for this class, so I might just give my teacher this blog link so she can follow along and I don't have to type things up twice.