Don't drink and drive...

One patient learned a good lesson the (very) hard way today. She's in her early twenties, and was driving home from a night on the town with a BAC of around 0.24. She ended up going the wrong way on the highway and hit four cars. She broke her odontoid process (part of the second vertebra in the neck), her collarbone, her wrist, and her leg. She woke up (still intoxicated) in the ICU this morning in what I can only assume to be crazy amounts of pain, and she was put in a halo this afternoon. Halos are these huge contraptions that literally screw into the skull and attach to a vest to keep the neck extra stabilized while the fracture heals. In her case, the bone fragment was too displaced for surgery to fixate it, so the halo was the only/best option. You have to wear the halo for 8-12 weeks, and as you can imagine, showering, getting dressed, and going out in public are pretty difficult with one of these things on. Not to mention the permanent scars in your forehead! She's lucky to be alive, and I obviously don't condone her actions at all, but I still feel bad for her. Hopefully she learned her lesson.

Another interesting/horrifying patient today was one who was trapped in a burning building last night and had to jump out from the third floor to survive. He ended up with a completely shattered pelvis, an L5 compression fracture, and a ruptured bladder. I'm not even sure how they fix the bladder...or his pelvis, really, since from what I saw on the images, it was completely destroyed. But hopefully they can! We are only involved for his L5 compression fracture, which is definitely the least of his worries right now. They won't even surgically repair it until his pelvis is taken care of, because without an intact pelvis there's nothing to fuse the lower spine to.

So! That was my Monday. I also saw a bunch of other (less awful) inpatients and took out some drains. I've started seeing people on my own and writing their notes, which is nice because I feel like I'm helping the PAs a little bit. Overall, I think I don't love this rotation, even though I'm learning a lot from it and I think brains are cool. The cases are interesting, but also sad. We spend way more time in the ICU than I would have thought, and the ICU is probably the saddest place on Earth. It's full of people who, for the most part, were doing just fine, and then something happened to land them in the ICU. For older people, it's usually a fall. For younger people, it's a car accident or some other sort of trauma. Either way, the patients (in most cases) were doing totally fine before the accident, and then, due almost completely to chance, they end up in the ICU and their lives are changed forever.