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Monday, August 31, 2009

Espen Lind Fuentes Holm Sing Halleluia...

One of my all time favorite songs...
I Came across this version a few weeks ago. I've been meaning to post this here but i never got around to it.
I think These guys sound amazing. They interpreted many other classics including David Gray's Sail Away, Seal's Kiss From a Rose and songs by U2. They also have a few songs of their own. Great music.

Saturday, August 29, 2009

Dear Sarah...

I came in and you were there. I sat at the table and you were around.
With your fresh looks, you stood out from the crowd. With your enticing smile, you caught my eye. There is something about you that played with my mind all night. Is it that smile? is it your hair? Or is it just as simple as your being at such odds with all of our dearly held ideals, self-ordained stereotypes and mundane ideas and clichés of the laws of attraction, that I just couldn't let it go?
So I told you. And from that moment, you knew my secret. You blushed and smiled. I did the same.
I was struck, and I knew so little. At an unfair disadvantage. But I will brave it.
I told you, and it wasn't that simple. He has your heart.
It's not to be. Not for now, maybe not ever. Or maybe...

Thank you for a pleasant night.

Saturday, August 15, 2009

Yesterday, the day it all went wrong...

Have you ever felt like a stone surrounded by glass? Like you couldn't make a move without something or everything shattering and crumbling down in a deafening rumble and screaming racket? Minutes or seconds later, you look back: nothing more than a hole in the ground, where once all the great plans you had just built up seconds -or years- ago stood tall. Nothing left... Be it an hour, a day, or an entire lifetime, actions and their consequences are the same. Well at least they act the same. With a little hindsight on things that have happened in my life as far back as 15 years ago, or as recently as yesterday, I realize how strong and steady of a truth it is that when you make decisions, life starts moving so fast that it's not like you're moving through it anymore. It just starts happening to you.
It's strange to realize that this holds true at all scales... Whether it's your career choice, or that crush you decide to finaly do something about after so much hesitation. You just make the slightest move and it puts in motion some restless unstoppable mechanism, like thousands of cogwheels all spinning, each at its own speed, but all equally inexorable in their relentless thundering stride toward that common end point, like an army marching to the Valkyrie.

Here we go. I didn't know I was on one of my late night ramblings again... I didn't get the memo! I'm rambling again. It must be the melancholy found in the resignation to a few concequences of a choice made in the past, no matter how distant, with a certain goal in the future, no matter how remote.

Sunday, August 9, 2009

The Emergency Room... Oh the Anarchy!

If I had one word to sum up the ER and what comes through there in a day, it would be Chaos. But it's amazing. Challenging in a way I could never have imagined. It took me 2 days to realize that what you can learn in one day of an ER clerkship really amounts to more than you will learn in 2 weeks of patient care and follow up on the ward floors. There is no comparison. You can see, examine, process, and discharge 10, 15 patients a day with ranges of problems so varied it'll make your head spin!
On any typical day you can see:

-The prissy church choir girl (girl being a serious misnomer here, seeing as how she was 74, but hey...) who "burnt" her hand trying to put out a blanket, placed a bit too close to a candle, caught on fire near the church store room. She had two of her fingers covered with melted nylon which stuck after cooling down. She came to the ER not because she had a burn, but because she had no idea how to remove this thing of DEATH that had entrapped her silly fingers!!!

And then minutes later...
-The poor 24 year-old construction worker (A.) who had a 6-kg rock fall over his head from the top of a 9-storey building while he was out for a walk on his break. He sustained multiple fractures of the skull, and was brought to the ER with his mashed brains pouring out the top of his head. Scientifically speaking, and to put things in perspective for my med readers, the brain CT report was significant for multiple skull fractures reaching the base of the skull, severe depression of a part of the calvarium deep into the brain causing midline shift, trans-tentorial herniation, and severely increased intracranial pressure with all of its sequelae.
We stabilized his vitals after 3h of fighting and 4 L of I.V. fluids.
The poor guy died in the ER exactly 48 hours later.

This is a small idea of the spectrum of sights and colors we see on a day at the ER. But what struck me the most is surprisingly not the patients. It was not the drama, the excitement, the rush of dealing with life and death. It was the patients' families. Why? It became apparent to me how everyone saw nothing but themselves, nothing but their own, and just dismissed everything and everyone else in complete and utter disregard.
As poor A. was expiring in Trauma 1., we were also handling a patient (in S2) with mild head trauma. He had been hit by a car at low speed and hit his head against the windshield. He was awake and oriented, and his studies all came back negative, so basically he was fine. All he had left was a small laceration on his forearm that we had to suture before we could send him home. Naturally when the alarms went off on A.'s monitor screaming that he was going into severe tachycardia and O2 desaturation, we all left S2 to go check on A. and see if there was anything that could be done. Obviously there wasn't.
Now imagine this. Coming out of Trauma 1, heavy with heartache and shaken to your core by your first ever encounter with death and a patient who slowly died in your hands, you and your resident take a tough walk out to the ER waiting room and make sure the parents know that their worst nightmares have come true; "we are truly sorry to have to tell you that your son passed away 2 minutes ago. There was nothing more we could have done."
Now imagine walking back into the ER, in that state of mind, to find an obnoxious old lady, S2's grandmother, in a panic, screaming at you and yelling all sorts of nonsense asking you how it was possible for "doctors" to leave his wound uncleaned, knowing that she was coming to see him. She hates the sight of blood apparently.
How could we? how could we have such disregard for her great presence and not have wrapped him up before we tried to help a truly dying person? I don't have an answer to that.
This was even more destabilizing to me when I thought back at A.'s parents' reaction when we told them what had happened. Actually it was not in any way worse than the old lady's panic. No. Even less dramatic in my opinion.

So is worrying about a loved one an all-or-none sentiment? Can anyone worry, but at the same time have as little as an ounce of consideration? Can anyone worry, but realize that there are priorities and that there are always people who are worse off??
The answer is, YES, worrying is an all-or-none sentiment. From the stupid prissy choir girl who came for a hand-cleaning session, to the exceedingly unfortunate A., rest his soul, brought in by the Red Cross with only a few breaths of life left in him, and to the mind-twistingly annoying and naggy fat boy who twisted his ankle and had no signs of injury remotely indicating even as much as an X-Ray, you will be surprised to see that the parents all act in the same craze, the same insanity, and the same "treat-my child-first" attitude. You will be surprised to know that sometimes it is even reversed, that families of patients in dire emergencies will seem more composed and cohesive than families of patients with petty scratches not even worthy of a band aid. And for now, this is what makes the ER stand out.