Last week ended really well - I was seeing my own patients and writing notes on them, and most people were easy post-ops who ended up going home. On Friday, I even got out over an hour early because everything was done! I can see how the job would be rewarding (and even fun) on those lighter days.
Mondays are another story. Traumas from the weekend are in, and weekend traumas are usually the worst traumas. Car accidents involving young drivers, falls down stairs caused by alcohol intoxication, drunken assaults...you get the idea. And, today we had another consult from the ER for a man who had been drinking and had seriously uncontrolled high blood pressure - a terrible combination. He hit his head on a shelf while drunk, and because his blood vessels in his brain were already stretched to the max from his hypertension, they ruptured and he had a huge bleed in his brain. We actually went down to the ER right when he came in to evaluate him, and we saw him get intubated and whisked away to the OR for an emergency shunt placement to redirect the extra spinal fluid and blood caused by the trauma and bleeding. He had a GCS (coma score) of only 9, where 15 is perfect and anything below 10 is basically not good. The worst part was that he was only middle-aged, and that we had to tell his wife and daughter (who was around the same age as me) what had happened and what was likely going to happen next. I don't know what his status was when I left, since he was likely still in the OR. I really, really hope he does well, even though I know deep down that he probably won't.
Another patient who probably won't do well is a teenage boy who was in a car accident over the weekend. He has some serious bleeding on the brain, too, and even after bilateral craniotomies his brain is very swollen. So...I'm not optimistic. But, he's young, so you never know!
Hopefully the rest of the week calms down like last week did!
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