And New Workplace

The Friday just gone marked the last day at my previous GP practice. And I cannot believe it has been a year already. A year of seeing and managing patients on my own.

My last day was filled with sadness, as I was moving away from a place of comfort to a new unfamiliar place. I think I’ll miss my supervisor, and the friendly work environment.

I ended up getting a cheesecake for the practice, and a bottle of shiraz for my supervisor on the Thursday (2nd last day of work).

Tomorrow is the start at my new practice. It is a practice that has book in appointments.

“You’ll probably find at your new practice, it’s not going to be as organized as this current practice” said one of my work colleagues. I sort of believe him, because having met the new practice manager, she seemed extremely disorganized. Missed calls and texts and emails, which take 2-3 days for her to get back to me on. Not to mention that she advised me once to rock up at 7:30 am for some computer program training 4 weeks prior to when I was due to start, and forgot the date, only realizing when I rocked up to the practice. And had an entire hour wasted when I was told to “just muck around with the program”, when I had thought that my supervisor would sit down to teach me the basics of the computer program.

Oh, and not to mention that I didn’t find out that apparently I was scheduled to work the first Saturday until I emailed her first (I do alternate Saturdays with the other registrar).

Yeap, I’m already starting to stress over the current practice manager. I have a feeling that the first day, it’s going to be absolute chaos, such as not being able to login to the program (when I last visited the practice, my login still wasn’t working, and that was about 2 weeks ago).

Anyway, I shouldn’t grumble so much. I’m only going to be 2 minutes away from my work practice yay!

The Curse of the Chaperone

Medicine is an interesting field that is a mix of science, ethics and art in a way. There is an art in how you apply theoretical knowledge, and a science behind the art of practicing medicine.

For a field that is quite objective and founded on the scientific approach (ie hypothesis based testing and evidence based practice), it seems a bit odd that there are still some superstitions held by practitioners. In emergency departments for instance, one should never mention the “Q” word (which in this case refers to the word quiet), lest there be a sudden increase in patient numbers with complicated issues and emergencies.

Taking that outside of medicine, I tend to believe that there are people that seem to bring trouble all around them ie that they are a “shit” magnet. I’ve heard many colleagues say that about themselves – everything seems to be going well, until the said person starts their shift, and then all hell breaks loose. Or that other person that just seems to bring about rampant chaos around them. A colleague told me that when they started their first shift as a general physician registrar, there were 3 metcalls during her first shift.

Yesterday, I did a shift of house call doctoring. A 6 hour shift. There were quite a few unusual things that happened during this shift, and perhaps it was just coincidence, but to the superstitious, you could attribute it to something other than just pure coincidence.

Perhaps the first sign of something not right, was the fact that I was sent off to see patients in another city, rather than the city I was living in. Then there was the fact that there were bookings from patients who logged jobs over 5 hours ago. I later found out that apparently 2 doctors who were supposed to be seeing patients where I was working had called in sick.

The chaperone (my driver and colleague who helps sort out the medicare details, bookings and phone calls – non medically trained) was a female who looked in her late 30’s to early 40’s. Very talkative and friendly, but appeared to speed quite a lot in the car. A few minutes into the drive, and she informs me that “people seem to say I’m a shit magnet”. At that point, I think it’s probably just coincidental.

In total, there were 18 jobs booked in, although I managed to see 13 patients only, with a few cancellations, and 1 job taken off and assigned to another doctor. I saw my last patient at 11:28pm, and advise that we should get going home.

10 minutes down the freeway, it’s pitched dark, with barely any cars around. On the left shoulder is a truck parked with hazard lights on. Twenty metres on, and I see a man on the side of the road face down.

“Oh my goodness, there’s a guy on the road” I mention to the chaperone.

“Oh, do you want me to stop and go help?”

I hesitate for a moment. We had passed the man for a good 50 metres, and I was concerned about reversing backwards on a busy freeway. I thought to myself that it was probably a drunk person on the side of the road. The car slowed down from 100km/h to 50km/h.

“Yea ok. Let’s go check it out.”

I start to feel some panic as I step out the car. What if it’s not just a simple case of someone passed out drunk? I walk out calmly and approach the scene. Three bystanders are on scene, with one other crouched over the man. At this point, my worst fears are realized. On the road, was perhaps a litre of blood, some of it congealed and caked. Above the man, is a bridge overpass about 10 metres high.

“Hi there, I’m Dr X, a house call doctor. What’s happened?”

“I just got here a moment ago, and found him on the ground. I’ve checked all pulses including pedal pulses but can’t find anything.”

I later established that he was a medic previously. I attempt to check a radial pulse, but don’t feel any. Of note is the icy cold hands. I put my stethoscope on his heart, and hear no heart beat. I open his eyes and check for pupillary reaction, with dilated non responsive pupils greeting me back.

This patient has died already. CPR won’t do anything. Where is the ambulance? What am I doing here?

“He’s not responsive. Should we start CPR?”

I snap out of my daze. The medic was right. We needed to start CPR no matter how bleak it was. CPR on a probable corpse was better than no CPR, because there could still be a very slim chance the man was still alive. We roll him onto his back, and take turns doing CPR. The medic started first. With each chest compression, blood foamed out of his mouth, with the tongue rhythmically moving in and out of his mouth. I attempt to do a jaw thrust, which seems to help prevent the tongue coming out. I ask the chaperone to get the guedel’s airway out, which I use to some effect. Unfortunately, my car has no defibrillator, nor any bag valve mask, so we end up just doing CPR for about 8 minutes before the ambulance arrive on scene. The police arrive later as well.

When the ambulance arrive, I let them takeover. They continue for a further 15 minutes. The medic approaches me, advising that him and the paramedics have noticed clear fluid leaking out of his ears. An extremely bad sign of cerebrospinal fluid leaking out. An ECG tracing is taken. From the distance, I look at the printout and note a flat tracing. A white towel is draped over the man shortly. My chaperone and I leave the scene later on.

“This would be the 5th incident that I’ve witnessed or participated in CPR of someone,” says the chaperone in a matter of fact manner on the drive back home.

It gets worse.

“I’ve also been involved in 13 car accidents in which I was a passenger. 4 of them resulted in fatalities. I have witnessed 4 other accidents as well in which CPR had to be performed. And I was also a passenger in an aircraft accident on the runway”.

I can understand if someone is involved in a car accident with a fatality occurring once in their lifetime, but this chaperone has witnessed it 4 times! I am in shock of this chaperone, and I can understand now why she was a “shit” magnet. Maybe this person really was cursed in a way. I certainly thought nothing eventful would come from my shift, but even on the way home, something like this happens where I witnessed a horrific fatality.

The curse of the chaperone? Or merely a coincidence?