Neither of us had ever seen anything like it. The resident who was with me took a picture of the hallway with his smartphone. He was drooling all over his chest, he was barely breathing, and in his wake he left a long trail of blood and stool that smeared the entire hallway behind him. One of the nurses threw a bedsheet over his naked body, and we wheeled him up, his head slumped on his chest, to the ICU. I had the room emptied so that we could get the wheelchair out of the bathroom and roll the patient to the ICU. Given how sick he was, I knew I didn’t even have the time to fully examine him. He brought the wheelchair right up to the bathroom door, and I carried the patient with the nurses from the toilet seat to the wheelchair. I asked one of the nurse assistants to grab a wheelchair. I quickly realized two things: There was no way the bed was getting into the bathroom, and there was no way we could get the patient into the bed. The man was barely breathing, but he had a pulse. There was complete chaos, and no one had any idea what was going on. The nurses were trying in vain to lift him up, while a few others were attempting unsuccessfully to get his bed into the bathroom. The bathroom was very small, and the patient was at least six and a half feet tall and must have weighed at least three hundred pounds.
He was slouched over on the toilet seat, totally naked, and the entire bathroom floor was covered in black and bloody feces. I made my way through the throng and found that there were three nurses in the bathroom struggling with a patient who didn’t seem to be fully conscious. One of the nurses directed me toward a room outside which a large crowd had gathered. When I got there, the whole ward stank of human excrement. I picked up my stethoscope and shuffled toward where the emergency was. There was a medical emergency on one of the wards. It wasn’t long after I hung up that my pager buzzed. I called my wife, ecstatic that I would be done early, and asked her to call our friends so that we could actually have the Super Bowl party she had so wanted to host. When the clock struck three, the ED was not buzzing, all our patients were well behaved, and there was no one headed up from the wards, so after checking again with the team, I called the shuttle service to come pick me up at five. It was so relaxed that I did the unthinkable: I asked my team who was going to be there overnight, whether I could call the shuttle early if we continued to have a quiet day. My team was done with rounds by noon, and we got no new patients afterward. But this Sunday was an almost miraculously quiet day. I was scheduled to be there until seven in the evening and it would take me an hour to get back to Boston with the traffic, which would mean I would miss a large chunk of the game. The Patriots had lost the week before, so my interest was somewhat muted, but still, it was Super Bowl Sunday. It was a Sunday, Super Bowl Sunday no less, and it was my last day in Brockton. In the primary hospital where I was training, there was a surgical ICU, a neurological ICU, a cardiac ICU, a trauma surgical ICU, and a bevy of medical ICUs, but there was only one ICU at Brockton, leaving the care of patients with a host of acute conditions in the hands of the medical residents and the supervising physician. Unlike the large academic referral center we were used to, with an abundance of nurses and doctors, the Brockton ICU was run predominantly by the residents even though the patients there were sicker in many ways. Medicine residents from my program would go to the intensive-care unit (ICU) in that hospital for an away rotation, and it was an experience of legendary proportions. The town of Brockton is served by a community hospital that mirrors many of the characteristics of the town it is located in. The town is awash in violent crime and drugs. Crooked goalposts stand half erect in fields with tall grass that might not have seen a game of football in decades. Brockton, on the other hand, is a town falling apart. With Revival- and Georgian-style buildings intermixed, Boston is just rough enough to be photogenic. The red brick Federalist-style apartments of Back Bay, many built in the colonial period, have just the right amount of decay, which gives them a deep and rich texture. Boston carries a tasteful level of agedness, akin to a hint of silver hair. As you move away from Boston, you can actually see rust accumulate on bridges, signboards, and fire hydrants. Brockton is a small town about a half-hour drive south of Boston, but in many ways it seems a world apart. It had been the longest of months-in both the best and the worst possible ways.
0 kommentar(er)
