I can't imagine doing a burn unit rotation that early in a program... I was nearly a year into my paramedic program (with a few years as an EMT before that), the burn unit still sticks out as one of the more 'memorable' rotations.
This was a great piece and I would encourage others to read it... but yeah, as another user said, brutally vivid. It's stories like these that really cemented my desire to pursue healthcare. I will never forget the first code I witnessed in the ED. Every single little detail of that moment is just etched into memory. After I clocked out I just drove for a solid 4 hours trying to process it.
I've been working in the software industry while going to school and at the time of the above, my bosses wife had just returned to nursing, opening an acute care facility. This is after spending nearly 20 years in the same exact ED that I was now at. I got some excellent advice from her, my favorite bit was about learning to love the "absolute shitshow" of healthcare and how to cope with loss. The shitshow aspect is spot on and what this piece really nails. The crazy stories are abundant and at times it feels like we are still very deep in the stone ages.
This was a great read, thanks. As was the OPs link.
> That world! These days it’s all been erased and they’ve rolled it up like a scroll and put it away somewhere. Yes, I can touch it with my fingers. But where is it?
This really resonates with me. What a powerful way to end that story.
> CCU, night shift: A house painter who cut himself now has full-blown tetanus and is on a ventilator. We have paralyzed his diaphragm with curare to override the muscle spasms, and so we must fog his mind with a cocktail of drugs. We take excellent care of his body and read to him when we can. If the unit gets busy we play audiotapes for him, mostly about American history. Weeks later when the tetanus has run its course and we wake him up, he is convinced that FDR is president. Otherwise, he is fine.
The progress in medical sciences can be surprisingly messy. Moral issues abound, and a lot of important work has been done against the scientific consensus.
Early operations on human heart were gonzo and against the prevailing wisdom[1]; discovery that stomach ulcers are caused by bacteria was the doctor purposefully drinking bacterial cocktail, falling ill, and curing himself with proper antibiotics [2]; the first cardiac catheterization with imaging was done on the doctor himself via subterfuge because otherwise he would've been stopped [3]. An Air Force doctor strapped himeslf to a rocked sled and rigorously subjected himself to up to 42Gs and near-Mach windblast, with the results greatly improving air safety [4].
And that's just off of the top of my head.
--
[1] early on it was considered impossible to perform successful heart surgery; among others because the tools would disrupt heart rhythms with electricity produced by galvanic reaction
Such stories in medicine always bring up two sets of memories. One is a nurse I dated years ago whom I met when we both worked graveyard shift and lived in the same apartment complex. She later died from epilepsy.
The other memory is of a poem written by a young cop in tribute to a nurse he was dating. He went to pick her up one night but found her asleep, stressed out by her shift during which two of her patients died (through no fault of hers). He covered her, careful to not disturb her rest, and was inspired to write a poem about it.
That poem became a song composed by a friend, and their band recorded it. That song was "Wildflower"[0]; the band was called "Skylark" and included a young David Foster.
To this day, it is one of my favorite songs. Donny Gerrard's vocal is indescribable, and composer Doug Edward's haunting guitar moves me beyond words [1].
"A few babies have medical problems which affect feeding. Babies with gastro-intestinal tract (GI tract) disorders who need an operation will not be allowed to feed at first and will get nutrients intravenously."
I am sorry to say that those babies were being passively euthanized. Starved to death, to put it more bluntly. It was a very different time; their lives were considered disposable. The fact that I now have a 27 year-old son with Down syndrome, who is the light of my life, makes those memories otherworldly and almost unbelievable. --The author
>those babies were being passively euthanized. Starved to death
This breaks my heart. Doubly so, given that I have similar cases[1] in recent memory[2] where the medical staff and even the even parents were forbade and forcibly prevented from feeding the kids.
Thank you for writing the article, Janet, however painful it must have been for you. It's better that we know, and can act upon the knowledge.
> Doubly so, given that I have similar cases[1] in recent memory[2] where the medical staff and even the even parents were forbade and forcibly prevented from feeding the kids.
This is untrue, and the cases are not even remotely comparable to OP's story. Alfie Evans and Charlie Gard had both suffered heavy brain damage and were incapable of feeding or even continuously breathing on their own, with no realistic perspective of improvement.
My mom is a nurse at a large research hospital, and the stories I hear give me extreme respect for nurses and doctors and the decisions/conversations they have to have. It's incredible what they have to deal with physically and emotionally on a day-to-day basis.
My first wife was an ER nurse then cardiac critical care. The doctors would look for her to talk to the families of patients who had died because they said she was good at it.
This one hit hard. It's less common now, but it still happens:
CCU: It is a Catholic hospital. “Amazing Grace” plays on the intercom every night at 10. Some nurses kneel when a priest enters the elevator. The head physician of the Respiratory Care Unit next to us refuses all thoughts of terminating care for a non-responsive intubated aged woman whose back ulcers now reveal spinal bone. Her family pleads with him.
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[ 1.4 ms ] story [ 58.6 ms ] threadI've been working in the software industry while going to school and at the time of the above, my bosses wife had just returned to nursing, opening an acute care facility. This is after spending nearly 20 years in the same exact ED that I was now at. I got some excellent advice from her, my favorite bit was about learning to love the "absolute shitshow" of healthcare and how to cope with loss. The shitshow aspect is spot on and what this piece really nails. The crazy stories are abundant and at times it feels like we are still very deep in the stone ages.
> visited upon the body of one
https://www.narrativemagazine.com/issues/stories-week-2014-2...
> That world! These days it’s all been erased and they’ve rolled it up like a scroll and put it away somewhere. Yes, I can touch it with my fingers. But where is it?
This really resonates with me. What a powerful way to end that story.
> CCU, night shift: A house painter who cut himself now has full-blown tetanus and is on a ventilator. We have paralyzed his diaphragm with curare to override the muscle spasms, and so we must fog his mind with a cocktail of drugs. We take excellent care of his body and read to him when we can. If the unit gets busy we play audiotapes for him, mostly about American history. Weeks later when the tetanus has run its course and we wake him up, he is convinced that FDR is president. Otherwise, he is fine.
”The cowboy cardiologists sneak in at night to try new meds or procedures on their patients."
wtf is that...
Early operations on human heart were gonzo and against the prevailing wisdom[1]; discovery that stomach ulcers are caused by bacteria was the doctor purposefully drinking bacterial cocktail, falling ill, and curing himself with proper antibiotics [2]; the first cardiac catheterization with imaging was done on the doctor himself via subterfuge because otherwise he would've been stopped [3]. An Air Force doctor strapped himeslf to a rocked sled and rigorously subjected himself to up to 42Gs and near-Mach windblast, with the results greatly improving air safety [4].
And that's just off of the top of my head.
--
[1] early on it was considered impossible to perform successful heart surgery; among others because the tools would disrupt heart rhythms with electricity produced by galvanic reaction
[2] http://discovermagazine.com/2010/mar/07-dr-drank-broth-gave-...
[3] https://en.wikipedia.org/wiki/Self-experimentation_in_medici...
[4] https://en.wikipedia.org/wiki/John_Stapp#Works_on_effects_of...
The other memory is of a poem written by a young cop in tribute to a nurse he was dating. He went to pick her up one night but found her asleep, stressed out by her shift during which two of her patients died (through no fault of hers). He covered her, careful to not disturb her rest, and was inspired to write a poem about it.
That poem became a song composed by a friend, and their band recorded it. That song was "Wildflower"[0]; the band was called "Skylark" and included a young David Foster.
To this day, it is one of my favorite songs. Donny Gerrard's vocal is indescribable, and composer Doug Edward's haunting guitar moves me beyond words [1].
[0] https://www.songfacts.com/facts/skylark/wildflower
[1] https://youtube.com/watch?v=YQ8n_Esop5I
I'm slightly scared to ask - but what would the explanation for that be?
"A few babies have medical problems which affect feeding. Babies with gastro-intestinal tract (GI tract) disorders who need an operation will not be allowed to feed at first and will get nutrients intravenously."
This breaks my heart. Doubly so, given that I have similar cases[1] in recent memory[2] where the medical staff and even the even parents were forbade and forcibly prevented from feeding the kids.
Thank you for writing the article, Janet, however painful it must have been for you. It's better that we know, and can act upon the knowledge.
--
[1] https://en.wikipedia.org/wiki/Alfie_Evans_case
[2] https://en.wikipedia.org/wiki/Charlie_Gard_case#Outcome
This is untrue, and the cases are not even remotely comparable to OP's story. Alfie Evans and Charlie Gard had both suffered heavy brain damage and were incapable of feeding or even continuously breathing on their own, with no realistic perspective of improvement.
https://annals.org/aim/fullarticle/2217632/annals-graphic-me...
Click on each panel to get a larger version.
My mom is a nurse at a large research hospital, and the stories I hear give me extreme respect for nurses and doctors and the decisions/conversations they have to have. It's incredible what they have to deal with physically and emotionally on a day-to-day basis.
CCU: It is a Catholic hospital. “Amazing Grace” plays on the intercom every night at 10. Some nurses kneel when a priest enters the elevator. The head physician of the Respiratory Care Unit next to us refuses all thoughts of terminating care for a non-responsive intubated aged woman whose back ulcers now reveal spinal bone. Her family pleads with him.