Is there such a thing as an "average" day for a doctor? So much can happen––and all at once––taking things from zero to sixty with barely a moment's notice.
After Redditor WafflesontheWeb asked the online community, "Doctors of Reddit, what was the thing that made you go "Oh god, oh ****"?" doctors shared their most striking experiences with the patients in their care.
Warning: Some graphic content ahead.
"Literally saw someone..."
Literally saw someone have progression of a stroke in front of my eyes. My intern tells me that she's concerned about a patient because since the previous night he's had some right arm weakness. We go see him together. When starting out he is talking perfectly normal, but then all of a sudden he starts slurring his speech and half his face droops.
(Immediately called a stroke code, but he was outside the window for emergency intervention since his symptoms started the night before.)
"Those kids are the ones..."
Every kid that comes into the ED needing resuscitated from abuse. Those kids are the ones that keep me up at night.
When performing an emergency Caesarian and the baby's head is lodged so hard in the pelvis that it just won't come out. It is really scary.
Those poop events happen almost on a daily to weekly basis, especially on a gastro ward. Worst was a old little lady on an ITU ward who hadn't passed any thing for a couple weeks. We sent a nurse in with a commode pan, a few minutes later the nurse emerged holding the pan with a thin paper towel draped over a clearly overflowing stack of human faeces that was the size of a newborn.
"Hitting a pocket of pus..."
Hitting a pocket of pus as I removed a chest tube and all of the juice spewing out onto me.
Disimpacting a WW2 veteran who hadn't pooped in 2 weeks. Same result but with poop.
"I mean, not much after awhile..."
I mean, not much after awhile, but I do remember this guy with his renal function in every way but the right one. He had collapsed in the out patients department while waiting for his heart clinic appointment. After he's resuscitated and everything, I'm asking him how much he drinks (He reeked of booze) and he says around 2-3 bottles of whiskey. Now that's a fair bit for a week, but people always underestimate so I go to clarify:
"So two or three bottles a week, any beer with that?"
"No, two or three a day. And sometimes some beer, yeah."
"How much beer would you say-"
He then starts seizing on me and his vitals drop through the floor. Yeah, he was drinking so much apparently the 2-3 hour wait for his appointment resulted in him going into withdrawal and seizing. You ever try to correct someone's electrolyte levels when their blood is mostly alcohol? It's a bad time. He arrested multiple times and it took us a solid three weeks to get his blood work anywhere near normal. This dude would be stable for a few seconds and then immediately swing into horribly unstable. Can't believe he was walking around like that for months beforehand. His blood had enough alcohol in it you could've run a car off it. If someone had lit a match around him I wouldn't have been surprised if he straight up exploded.
"During my time in the NICU..."
Pediatric Resident here.
During my time in the NICU I had several „Oh shit" moments, I think everyone of us does. In one of my first night shifts a 500g preterm newborn on non-invasive ventilation stopped breathing. I immediatelly started to bag her, which usually works nicely to stabilize the patient. Didn't work this time. I had the nurses call my attending to get here ASAP but he was about 20 minutes away, which was way too long for the patient. I had to intubate an extreme preterm baby on my own for the first time. The patient became bradycardic very quickly, the nurse started chest compressions, while another nurse handed me the laryngoscope. For some reason I stayed relatively calm and just thought „you better not f*** this up". I successfully intubated on my second try, heartrate shot back up, O2 saturation followed shortly after. We put her on a ventilator and when we were all done my legs just gave out. I had to go back to the doctors room, my whole body was shaking.
"I was saying that under my breath..."
I am a doctor. I was saying that under my breath as we were losing a 13 month old kid during a resuscitation.
"He used to tape a plastic shopping bag..."
There was a clinic patient with a colostomy who was not performing good maintenance. He used to tape a plastic shopping bag over his ostomy. You would smell him before you saw him. There was no amount of mint oil on the planet that took the smell away from the room and it hung there for days. It also didn't help that the guy was a raging putz who was non-compliant and likely on drugs.
"12 year old comes in..."
12 year old comes in with complaint of double vision. Came on suddenly a few nights ago and has slowly gotten worse. I perform cover test to assess eye alignment, but it doesn't make sense. She has severe divergence excess. Basically, the eyes are pointing outward more while focusing on something far away compared to close up. For eyes, this doesn't happen often because they have to converge (or point toward the nose) much more for an object up close. Then, it dawned on me. She had seen another eye doctor for an annual exam the month previous with absolutely no symtpoms; it had to be a tumor. We refer her out for surgery that day, but the hospital is hemming and hawwing. They put her off because "oh well she can just close an eye if she's seeing double."
When they finally X-Rayed her MORE THAN A MONTH LATER, the tumor had aldeady compressed her optic nerve and she lost all sight in one eye.
"Little old lady signs an RMA..."
EMT here. 3am call for leg pain. Little old lady signs an RMA and refuses transport to the hospital. Her husband pulls me aside and asks me to try to convince her to go because he's afraid that if it worsens, he won't be able to get her there himself and doesn't want to call for an ambulance again. I talk her into going-she refuses a stretcher or stair chair and climbs in the ambulance herself. We're on our way and I notice one leg is significantly shorter than the other. Yup-femur fracture.
"Our suspicion index..."
We were a Navy ship in a support role with a full surgical suite but minimal facilities in total. We had 2 doctors and 20 corpsmen. We were in port, and got a call from a small ship one dock over: Their corpsman was out, could they send a 3rd Class with chest pains over?
Our suspicion index is low - it's pretty rare for active duty sailors to have heart attacks, and 3rd Class is a low rank so it's someone young. So sure, send him over. What are the symptoms?
Well, he's got chest pains, but he thinks it might just be the burritos he had for lunch.
Our suspicion index is very low.
SO, we wait for this guy to come over. We get a call from the quarterdeck - he's here, they just walked up the gangplank.
Ok, our suspicion index is very, very, low.
Patient arrives. He is a middle-aged black man, a reservist. Suspicion index raises. He's holding his chest, sweating, and panting. Suspicion index to high. He takes of his shirt, he's got a scar from previous open heart surgery!
Panic Stations! Immediate EKG, Nitro under tongue, etc.
Turns out it was just the burritos for lunch, but things got tense for a bit when he first presented.
"I spent at least 30 minutes..."
Had a delirious post-operative patient following resection of some part of the colon(i forget exact details but probably left hemi) who had yanked off his ostomy bag and surgical dressing over a midline abdominal incision. There was melenic stool(dark black stool because of metabolized blood which has a very special stink) all over the place including within the surgical wound. I spent at least 30 minutes irrigating the wound and cleaning the patient. It was a f****** nightmare.
"As a student..."
As a student I was doing research in cardiac surgery and watching an aortic valve replacement. They'd used a minithoracotomy approach (6cm cut on the right/front of the chest wall) instead of the big midline one you usually see in cardiac surgery. He'd just come off bypass (the machine that acts as heart and lungs for a patient) and the blood pressure plummeted. I saw a systolic of 12mmHg on the art line (normal is 120, the pressure of static blood in blood vessels is around 7). A surgeon jumps on the chest to start CPR and every pump results in a huge gush of blood from the incision. The new aortic valve had torn off, so he was losing blood into his chest (and onto the floor) at a rate of ~6L/min (1.5gallons/min - basically your entire blood volume in 60 seconds).
Surgeon is frantically working in this tiny incision with everyone staring at him and yells "We're going back on bypass". Keeps working for another 15 seconds, then "SAW. NOW." He pulled off a thoracotomy (cutting skin, splitting sternum) and bypass cannulation in about 2.5 minutes. I've seen this take 40 minutes. Valve fixed, patient taken to ICU under sedation. No idea what the neurological outcome was, but the collective sphincter tone in that room would would make diamonds from charcoal.
"Grab the chart..."
First year doc on a medical ward, no seniors around. Nurse flags me "Hey doc your patient in 2 has a pretty low BP." Poke my head in and see someone I've never met before, who has the look of a dying man, with a systolic of 62. Grab the chart to get some fluids into him while I figure out what the fuck is going on and see that he'd been given 4 litres (1 gallon) over the past 3 hours. Panic.
Turns out he'd been admitted from ED 6 hours prior with biliary sepsis (not usually my team's responsibility) and only just arrived on ward. Things that went wrong: Admitting Dr did not tell ward staff they'd admitted a sick++ patient, admitting Dr did not see the patient again after initial assessment, patient sat in ED for 6 hours awaiting a ward bed, patient transferred to ward in septic shock, ward Dr not told patient had arrived on ward. Poor guy ended up dying a few hours later, alongisde my faith in that hospital's systems. There are SO many steps where someone could have said "hey something is wrong" before we got to the subtext of "Can you make the call to press the buzzer so I don't get in trouble for doing it if I'm wrong?"
"I was on my first practical as a nursing student..."
I was on my first practical as a nursing student and at morning handover we had been told one of the patients during the night had been delirious and ripped out his catheter (tube placed up the shaft of the penis into the bladder). This issue with this was that you don't just slide a tube in, once it's in you inflate a small balloon to prevent it from slipping out and when you remove it you need to deflate it in order to get it out.
Obviously the patient had not known/been able to deflate the balloon so it tore up the inside of his penis on the way out. Initially, the nurses/doctor on the nightshift had been able to replace the catheter and there seemed to be no further issues.
Around midday the patient started to become delirious again and the on call doctor said we needed to remove the catheter. I will never be able to get the image of bright red blood literally pouring out of this man's limp penis any time it was held in a position other than vertical.
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