Saturday, September 24, 2011

Internal Medicine

Dr Tabubil is doing internal medicine.

Her first patient of the day was an ancient, emaciated man - very ill.
            "How are you feeling today, sir?"
            Dr Tabubil, trying to hold back a laugh, ripped out a snort so loud that the drip line trembled.  She fled precipitously, while the consultant in charge sniggered.
            Her second patient was an equally ancient woman, suffering from advanced cancer.  The doctors would like to start chemo, but she weighs only 39 pounds, and they need to get her up to 42 before they start tearing her body apart again.  There is a miracle nutrient solution that "builds muscle on you, dear, won't you eat?"  But the bewildered old dear didn't understand, and Dr Tabubil was was treated to the sight of the consultant virtually sitting on the ancient woman's fragile ribs, shoving a bowl against her chest and a straw against her mouth and bellowing  "Eat! Open up!  Swallow!  Eat! Please!" while the bird-like old lady piped tremulously "but I'm not hungry, dear." and declined to open up.
            Dr Tabubil was asked to go back to the profane old man and perform an Arterial Blood Gas on him.  An ABG is like taking a blood sample, but it requires the needle to go into the radial artery in the wrist instead of the vein down in the forearm.
            "Does it fountain?"  I asked with interest.
            "Only if you do it wrong!"
            "Have you done it before?"
            "Once, and i got the sweetest Venous Blood Gas you ever saw.  Missed the artery completely.  But today I did it just GREAT."
            As she leaned forward to inject a local anesthetic before she took the ABG, the old man remarked conversationally to the consultant: "By God.  She's got nice breasts, hasn't she?"
            "Mr __________!"  The consultant cried, shocked.  "You're really not supposed to say that."
            "Yeah."  Dr Tabubil said, giving the old man an evil glare.  "I haven't given you the local yet, have I?"
            In a spirit of charity, she did give him the juice, and was then glad for it, because she spent 15 minutes poking into him and missing the vein every time.
            "I just hit the bone, over and over and over.  I kept imagining that I was going to chip the bone, and thinking that I was one poke away from breaking the needle and leaving it in there.  It was awful.  But eventually i got it, and it went sooo perfectly -  when I pulled out, I didn't even leave a blood blister, and even the consultant did that last time."
            She picked up her vials of blood, beat it out of the room, and the wall started swinging toward her and the next thing she knew, she was sitting in a chair in the nursing station, with the consultant leaning over her and looking concerned.
            "Are you okay, Dr Tabubil?"
            "Sure!"  She said brightly.  "Just fine!" 
            She jumped up and headed for the stairwell, and found herself hanging from the railing.  Instead of being sensible, she kept going, all the way down to the pathology lab, where she succumbed to a bad case of the shakes and fell over again.  And the consultant laughed and laughed and laughed.

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