Easily satisfied

Couple of days ago a patient on the ward had a tumble, came away with a laceration on his forehead.

He was a charming old chap, led an extraordinary life. He was a sergeant in the British SAS commandos, been to a couple of tours around the world. He even did the sniper duty for the Queen's Coronation back in the days.

I volunteered to stitch him back up. To my surprise, my reg agreed; and even more surprisingly he agreed too, having only tuned down a surgical intern the previous night. Anyway, I gave a pretty good performance with a big audience of a reg, a RMO, a nurse and the patient's wife.

On the consultant ward round the next morning, he greeted each of us as we come in. When he saw me, he welcomed me warmly, "ahh! my plastic surgeon!"

Hehe...he made my day. I'm easily satisfied.

2 minute silence

Two patients passed away on the ward today, the sight of two families grieving made the atmosphere very very heavy.

My reg took me to do a physical exam on the deceased so that we can officially declare death. This is more or less a formality as 'an experienced nurse can tell you that with a glance.' But only

doctors can declare death, and this is one diagnosis you don't want to mistake.

On approaching the patient, they may appear to be sleeping peacefully. But when you look into their eyes, you realise that there is no life there anymore. It's quite distinct, something I've never seen up close before.

To look for signs of life, firstly you try and get a response from the patient with voice, then pain, check that the pupil is dilated and does not react to light. Then you put your stethoscope on the patient's chest and listen for heart and breath sounds, or the lack of any sound really. You listen for 2 full minutes.

This reminds me of the 2 minutes of silence when we pay tribute to those who passed away. Officially, as doctors, we are the first ones to pay the 2 minute tribute.