It's been awhile since my last post. I have since been to NZ and back, spent a month on the stroke ward, 1 night and day in Melbourne (Slash Concert), 1 week on acute coronary care unit (ACCU), and 2 days on general medicine. my motivation to study has peaked and waned. The sun had dawned and set like a metronome keeping the tempo, while the gale wind blasted the forte and the rain whispered in sotto voce.
Hanging out in General medicine wards makes you feel very young and very sad. First epiphany is obvious enough, and sad because you see some young frail old people and in complete contrast to old young people who don't look their age. The young frail old people are ones who are young in age, but with a body of frail old person. This is probably in keeping to their lifestyle. Then you see the 90 somethings who looks younger than they are, generally more positive and recovers better. You can't help but wonder which you will end up being.
Stroke unit is a sad place to be. The patients generally become debilitated or impaired in some way. Apart from the body functions they were deprived of, most also lose their independence, sometimes dignity too. There was the former Who's Who, whom with one word, could change the lives of hundreds; but now he can barely utter a word through his dysphasic bulbar weakness. But the saddest of all was not the lost of half your body, but your other half. I saw a lady who woke up with a devastating stroke that morning, came in to ED and there was little we could do for her. Her husband sat next to the bed listening to the Reg explain about palliative care while holding back tears. It's one of the hardest thing you can tell another person. It was just so sudden. There were family meetings where we explained to families that the prospect of recovery is grim, and pretty much directed the treatment towards comfort care. There were a lot of medical ethics at play, what we despise as written assignment highlights itself as delicate situations where people's lives were at hand.
On the ACU, I met a 90 year old gentleman who was an opera singer. He looked more like an early 80 year old. He came in because his wife died last week, and it literally broke his heart. They had been married for 60 years and now all of a sudden, she's gone. He had no previous cardiac problem, but since last week, he'd developed arrhythmia and possible angina. I am not sure how much of his story the treating team actually bothered finding out, as he was referred to as the old guy by the window bed who was crying. JD and I were going around the ward practicing history/exam, when he told us about the wife, I pulled the chairs around and we sat down. He needed a medical doctor who is also a human who is willing to just sit with him for a little.
This morning, one of the SOB patient went into AF. As we hooked the usually quiet old man up to the ECG leads and oxygen, he became very excited. "I am the machine man!" His heart rate shot up to 120 while the atria fibrillates away. I don't think he understands that his excitement was causing those of us on the bedside deeply worried. Nevertheless, If he were to go "I AM IRON MANNN....." then I probably would not be able to refrain myself from joining him in the Black Sabbath chorus. In between his machine man chants, we manage to give him IV metoprolol and I was called away.
Ending on a good note. There was an old gentleman of 85 on the ward, his wife was by his side throughout. One day as she was leaving after a visit, she had a syncope episode and collapsed on the way out, she stayed. The ward arranged so their beds are next to each other, and their beds are closer to each other than the usual estranged distance between beds separated by curtains. They were both discharged today, together.
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