Workings of the Mind

As I wrote before, for the last 3 weeks I have been on an elective in Neurosurgery.  It's been a heady (hee hee) experience being back in the OR.  Learning SO much about neuroanatomy.  Since the beginning of the month, we have been on-call for spine, so I've also been getting quite the education about spinal lesions and learning how to read MRI's.

We've been rather busy due to "trauma season," and at times have affectionately nicknamed the Trauma ICU as "Turban City" since 90% of the patients are ours and have their heads wrapped following surgery or ventriculostomies.

During the last several weeks I've come to realize a few things:

 - drunk anything is bad.  It makes you drive carelessly and hit 70 year old grandmas who then bleed into their brains.  It makes you jump on the hood of a car that then drives away, and you fall and fracture your skull and then bleed into your brain.  It makes you jump off a porch causing you to break several bones in your spine which leave you with weakened legs and needing a urine bag because your bladder no longer works properly.

 - you can be hurt by the ones you love.  The guy whose name you tattooed on your shoulder can shoot you in the head and dump you by the side of the road.  The family of your boyfriend can object to your relationship and cause broken bones in your face and head.  Your drunk husband can roll over the car causing you to have massive brain injury and leaving you as helpless as your two young toddlers.

 - walking down the street is dangerous.  You can get shot at, run over, mugged, or just trip and fall.  All of which can land you on our service.  So is riding your bicycle, driving in a car, or flying in a plane.

 - I like opening and closing surgical cases more than the actual procedure.  I know, weird.  But there's something very satisfying about gaining the exposure, identifying the lesion, then trying to cosmetically close the wound.  While drilling and plating is interesting, once I've seen the anatomy I'm satisfied.  I know, weird.

 One more week then it's back to the E.D. for my final 11 shifts.  We're on a countdown of 30 more days until I move from coast to coast... I've got to start thinking of new names for my blog...

Bang Your Head

Ok, so it's been a while.... Funny how some shifts just seem to have a theme.  Last night I found out all the different ways that someone could suffer a head injury.  It made for an eventful but tedious shift, and also kept the CT scanner burning away.  I think we all had radiation exposure since 80 percent of the patients that came in from 11 p.m. onward needed a head and face CT.

There was:

 - drunk, fell down and smashed head on concrete 

 - drunk, tripped and fell down hitting face forward on concrete

 - drunk, minding own business, and got whacked on head with metal pipe

 - drunk, minding own business, and got slammed on head with baseball bat

 - drunk, jumped into middle of fight and got hit on head and face with beer bottles

 - doing cocaine and got hit by several people's fists across the face

 - got drunk, drove without a seatbelt, crashed into several cars, jumped out and ran for about a mile from police that were chasing them, then needed an ambulance for a minor injury and ended up unresponsive with a breathing tube in the E.D.

and then there was the:

 - out with family and suddenly collapsed.  This patient had a massive brain bleed and ended up dying in the emergency room before the end of my shift.  They most likely had a brain aneurysm that ruptured and that was it.

The rest of the patients I had ended up being everything from a cracked skull to facial bruising, and I put the medical student to good use stapling and suturing all the various lacerations.  This, of course, kept me free to move onto ordering the next CT.