Friday, 10 August 2007

Ups and downs - Me and Them

My mood is veering wildly between momentary highs and swooping lows. The brief pleasure I take in having explained something to a patient's satisfaction, so that they finally understand what their doctors are doing to them, is rapidly overtaken by my despair that I STILL CAN'T GET A CANNULA IN THEIR SMALL WRIGGLING ELDERLY VEINS. It sends me home literally hanging my head in shame. And because I'm working nights, it's the last thing I think about before I slump into bed.

I am the ultimate hands-off healer, a soother of furrowed brows, a talker. Woe betide anyone who needs an intravenous medication. I am not your man.

Mr Clark was a lovely old gentleman. With a soft Scottish accent, he was the politest, most grateful patient I've seen on the wards. His medical problem - inflammation of the gallbladder, very common and easily treated - was quickly brought under control, and he was sent home with instructions to recuperate for a few weeks. He would then come back to hospital for a routine operation to remove his gallbladder by keyhole surgery. Lovely stuff.

Things didn't work out quite like that.

When he was discharged, he went straight to the pub. Presumably to feed his raging alcohol addiction, which he hadn't mentioned - and noone had asked about. Nice polite old guys, who don't smell and have good personal hygiene, aren't alcoholics. Everyone knows that. Don't they? He didn't.

He was brought back into hospital the next day, having been arrested for shouting abuse at his neighbours and waving a knife in their direction. Despite his best efforts after discharge, 4 days of enforced abstinence in hospital had sent him into acute alcohol withdrawal.

We managed to calm him down by treating the alcohol withdrawal, but his gallbladder problem has flared up again. Back to square one.

So I'm not the only one going through hell over the last few days. And from now on, every patient I meet is presumed alcohol- and drug-dependent until proven otherwise.

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