Chest Compressions and an Acute Subdural

Not every day in the ER is action-packed or exciting. Today, however, I got my money's worth.

This month I am in the ER. I love the fact that my shifts are only 8 hours and the time goes by quickly. Today started with a middle-aged man with a migraine headache that resolved quickly after we gave him our special "headache cocktail." His wife treated me like I had just cured cancer and kept thanking me and telling me what a wonderful job I did. I can't take the credit for what 3 simple drugs did: compazine, benadryl, and toradol.

Another lady came in looking really sick. Before long, she started turning blue and we had to put a breathing tube in her. The next thing I knew, her heart stopped beating and I was doing chest compressions on her. It was a wild ride, but the compressions kept her going until our drugs kicked her heart back into shape. I am not sure if she is going to make it, but we definately rescued her from the clutches of death.

My last patient of the day was a healthy looking guy who complained of a headache since coming here from NYC 4 days ago. When I examined him, everything appeared completely normal except for a slight clumsiness in his left hand. I couldn't shake the feeling that there was something wrong with him despite the fact that his physical exam was not impressive. I went ahead and ordered a CT scan of his head on a hunch, and lo and behold, he had an acute on chronic subdural hematoma. In general terms, he had old and new blood in his head from veins that had been traumatized in some way. I called the Neurosurgeons and he may need surgery to drain the clot from inside his head.

I finished my shift and walked out to my car, reflecting on the day's events. I am very thankful for the nagging feeling inside that motivated me to order a CT scan to look at the man's head. Although medicine is usually very logarithmic and unimaginative, there is still room for intuition. Looking back at the last 11 months, I feel that the experiences I have had in a diverse array of specialties are helping me to develop a medical common sense that will serve me well for the rest of my career.