Gill slits

Last week I was taking care of this guy who had lung cancer. There were lots of things going on with the poor guy, and I don't think he slept for more than maybe 30 minutes over the two nights that I had him. But he had family there around the clock, and while he was obviously pretty sick, I was very unprepared to come back to work this week and find out that a few hours after I left he died.

Then Monday night I was given what everyone told me was a "difficult" patient. He had a GI bleed, so had blood coming out at both ends and kept me busy all night cleaning things up. But other than his overall discomfort, he was pretty calm and stable all night long. At change of shift I went in to say goodbye, and he was breathing a bit fast, which he did often when he would try and get up and move around. The tech was there to get his vitals, so I told him to take some deep breaths and try and relax, and to have a good day. He thanked me for a good night and I left. Five minutes later as I'm giving report to the day nurse, the tech calls from the room and even before I can get across the floor they've called a code. Doctors and pharmacists and whomever they all are pour into the unit, get him stabilized and whisk him off (freshly intubated) over to the ICU. I haven't heard a full report of how he'd doing (his heart never stopped but he just wasn't breathing), but as far as I know he hasn't died.

Codes on our floor are relatively rare, but this is the fourth we've had in a month, and I have to say I'm not a fan. I've spent so much time going over everything I did for both of these guys, trying to figure out if I missed anything, or if there was anything I could have done better, or seen earlier, or done differently. Fortunately for my sanity I can't think of anything, and both of these events surprised the doctors as much as they did me. But still it wears on you. If there was a way to call in sick from work that didn't mean leaving the shift understaffed, I totally would have called in the next day, I was just mentally exhausted. Catherine, I just don't know how you survive in the ER. All that adrenaline would be fun for a while, but I would just be dead afterwards.

Last night, despite my weariness, was a pretty good shift. I took care of this guy who has a leak somewhere in his lung, and his upper body is filling with air. Yes, you heard me right, he is a human balloon! Across his chest, down both of his arms, and up into his face, his skin feels like rice crispies breaking when you push on it as the air bubbles move around. Totally weird! His voice sounds thin and nasally, both because his throat is constricted a bit from the air in his skin, but also because the whole resonance of his head is off. They even made these cuts in his chest which we can kind of massage around them to squeeze some of the air out. They called them "gill slits". It was very weird. But weird in a kind of awesome way, I bet it is a very long time before I see anything like that again.

On a sadder note, one of my favorite people at work confided to me that she interviewed for another job. Selfishly I'm devastated, because I love working with her. But on the other hand I want her to do what makes her happiest. She hasn't been offered anything yet, and she is totally underplaying it, but I can't imagine she won't get the offer, so I'm counting down my few last shifts with her. ::sad face::

Oh, and now for something TOTALLY WEIRD AND UNEXPECTED. Even weirder than a man balloon. One of the other nurses brought in chicken curry last night. I was all, "I don't like curry", because, I don't. But unless it is made of spiders, I will try almost anything, so I took a bite. And it was the most delicious thing ever! It was totally mild, not spicy at all, and it didn't have that curry smell that I often find overpowering. It was just delicious. It was like the day I took a bite of a tomato and my whole life changed because it wasn't gross like my dad told me it would be. What is funny is I've actually had good curry before, I love chicken korma, which I assume is some kind of curry, but I never really thought about it before. Anyways, I came home and raved to David, who also hates curry, and he seemed open to the idea of trying it. So now I have to figure out how to make something with the good curry. I love expanding my palate!