DOC Tales.. woohoo!!! [ season 1]

 

EPISODE 1- The blue baby

I was in my 2^nd year of Cardiac surgery residency when I was summoned to the PICU. A 5yr old child was brought to the emergency in a bad state. He was blue and was finding it difficult to breathe, and was snorting and was in severe distress.

The 1^st differential was a TET spell which is seen in babies with cyanotic congenital heart disease [ cyanosis= blue ] .

The 2^nd one was if something was stuck in his throat and so he was choking, a foreign body or something!

 He was quickly stabilised, given 100 percent oxygen and a  portable Chest X ray done . This showed a huge mediastinal mass, ruling out either of the above. He was promptly intubated as the mass was compressing his windpipe and so he was all blue! Later a CT scan was done which showed that the mass was compressing on the airway as well as the veins draining into the heart. A surgery was out of question as this was a lymphoma , and lymphomas respond well to chemotherapy! [ Thank God for that!] . Later on, I came to know that he had responded well to treatment! God is great! Hallelujah!

EPISODE 2- The ICD

It was 2am and I was fast asleep. It was at this moment that the phone rang loudly, waking up everyone in the room! My phone is never on silent or switched off, lest I miss a call from my hospital. [ and my wife still complains that I miss her calls and don’t call back, but hospital calls are never missed… tell me why?]

The call came from the ICU. Dr Prey called up to say that there is this 14 yr old girl, just admitted with low saturations. Her Hemoglobin is 2g/dl [ way too low, normal would be 12 to 14] and she has a massive fluid accumulation in her left chest cavity [ also known as a pleural effusion]. She feared a leaking aortic dissection [ which is unlikely, but a rare possibility] and wanted me to put the chest tube, the ICD. So I started my ride on my bike and reached at 2.45am. After the tube insertion she drained almost 2.5 litres and her lung collapse still persisted. But the good thing was that her saturations were up and she was breathing in a more comfortable manner! The aorta was not ruptured, as she thought [ Aorta=the large blood vessel arising from the heart and supplying blood all over the body] She did need a decortication for the lung to expand it completely!

EPISODE 3- The Bullet!

I had a reference from the ICU when I was practicing up North! A 37 year old had a bad lung infection and needed a surgery. How did the infection get there, in the first place.

The source was a bullet , which had narrowly missed the heart by 0.5 cm , passed through  the lung lacerating it and causing a hemothorax and then getting lodged in the back. After antibiotics and stabilisation , he was moved in for a surgery [ a thoracotomy] and his chest was toileted thoroughly. He eventually responded well and recovered well.

During the follow up in the ward, he said that we were a good team of doctors. And that the day he gets discharged he would send his friend to us! We said that there was no need for any formalities as a happy and healthy patient is what we seek, just that and no more accolades.

He said you are mistaken. Me and my friend had a brawl while drinking and then he shot me after I challenged him. Now, I will do the same and then send him to you for proper surgery! Lol!

EPISODE 4- The bulls horn, not the ‘eye’!

We were 1^st year residents in General Surgery and we came across an emergency situation. A 23 yr old villager, after a few glasses of toddy , was irritating his bullock. The animal grunted, took a few steps back and head butted him.

The result was a horn entering the chest. The guy immediately collapsed and was shifted to a primary health centre, which referred him to us. He had lost a lot of blood, in transit and collapsed in the emergency ward. Since the entry point was close to the heart’s apex the CVTS guys were called for and he was shifted to the CTOT. The horn had ruptured his RV [ right ventricle= the anteriorly placed chamber of the heart and thus prone to stab and penetrating injuries]. He was quickly transfused blood and the tear sutured with pledgeted sutures and reinforced with a glue-patch! He was in the ICU for a week and went home in a fortnight! The bulls horn had hit a bullseye, indeed!

EPISODE 5-The horses stable!

What do you get when you cross a young race horse with an inebriated jockey? The horse gets irritated and lands a tight kick on him. He is knocked out. He has a hoof as a memento on his left upper quadrant of the abdomen. And on CT he has a hemoperitoneum, a lacerated spleen, a transected colon and a ruptured diaphragm! Hell , that’s a lot!

So again quickly in.. open up the abdomen, drain the blood and take out the spleen , then tackle the colonic inury and repair the transected diaphragm! God, that s a lot to do too! He is lucky, as he landed in time [ a stitch in time , saves nine] and he walks home in 7 days, never ever to crack a joke, at the horses stable!

EPISODE 6- Stuck in my head!

I used to like F1 racing, and the racing bikes..till I saw what the bikes can do! We received a couple .. the guy was driving a pulsar with his gal as the pillion. Now the Pulsar had the rear seat higher than the front seat.. that’s a distinctive design, made the bike look attractive and give the pillion an unobstructed view of the road ahead! So when this guy was trailing behind a truck with rods jutting out [ with a red flag attached, so that people would stay away] and he suddenly screeched due to the brakes being applied at a high speed, the rear end of the bike rose up and the pillion was flung in the air, right in the front .

Unfortunately she flew into the truck and the rod penetrated her forehead! Game over! She was lifeless as she was brought in, her BF sobbing all the way. But unfortunately style over safety, never has a good ending!

EPISODE 7- The Drug overdose

I was preparing to go to sleep. Suddenly someone rang the doorbell. I opened the door to find a harrowed guy who lives on the 1^st floor. He said that I should accompany him. The tenant of the flat opposite him was in a grave problem.

As we entered the flat we saw the lifeless body of a 25 yr old guy. He was quickly given CPR and legs lifted up to increase the blood draining to the heart. Finally a faint pulse was felt after 2 mins. After continuing for another 5 mins, he regained consciousness [ though he was still delirious and disoriented] . He was moved to the ICU of the hospital near home, and received a good gastric lavage. Later on his story revealed that he was not able to complete the targets at office and was depressed. He had gone to the bathroom and consumed something that could end his life! And thus the ordeal started! I don’t think that he has realised that he was brought back from the upside down by Dr EL , thus warding off Vecna’s curse.

EPISODE 8-The stuck Baby , Baby s day OUT!

She had 3 kids and this was here fourth. The first 3 were gals, and this was planned thereafter. As she progressed through her normal labour, the pains brought her to the hospital , in her 36^th week. The baby s head had descended and was stuck! It wouldn’t come down, nor could it be pushed up! A catch 22 situation, and a phenotype for an urgent C section. Getting in wasn’t easy, as her previous section scars were adherent to the tissues , bladder and the bowels underneath. Dr Sha2 quickly dissected it layer by layer and reached the uterus. A transverse incision and she was in. But the baby s head just wouldn’t dislodge. Using all her skill and manoeuvres that could be used in this precarious situation, the baby was delivered . This situation put both the lives of the mother and the baby at risk. The mom was fine post delivery thanks to a good surgical closure. The baby spent a week in the NICU but went home fit and fine. And yes, it was a boy this time.