Q2 - JOURNAL ENTRIES

Journal entries from the second quarter of my first year in basic specialist emergency training:

• I ask a patient of mine to get into the foetal position for a rectal exam and step out to give him some time and privacy. I go back in to find him on all fours.

• A guy in his forties is found passed out. By the time I see him, he’s fully alert but has an obvious left-sided facial droop and can’t move the left side of his body. A newly appointed nurse comes in to take his vitals and starts laughing when she hears his slurred speech, thinking he’s doing it on purpose.

• I order a tetanus vaccine for a patient of mine who sustained a laceration. I tell the nurse to just give it to him when it arrives from the pharmacy. When it arrives, she hands the patient the brown bag.

• I’m seeing this patient with transient global amnesia, which means his memory keeps resetting every few minutes. He’s also good friends with a cardiologist. The cardiologist knows the guy and assures me that he’s gonna be fine. In fact, he had him sign a discharge-against-medical-advice form. The patient had no idea what he was signing.

• I’m assigned to the minor care clinic, where I should be seeing ESI 4s and ESI 5s. My patient, whom I just transferred to ITU, doesn’t quite agree with his ESI staging.

• A patient tells me I should know what meds he’s on cause I’m a doctor. I stare into the distance and wonder how much of medical school was for nothing.

• The patient who came in with a two-day history of coughing and sore throat asks me if it’s always this busy at the ED.

• A young guy with a heart attack just signed out against medical advice to go our for a cigarette and then re-registered to undergo the life-saving procedure. 

• The carer that accompanied by patient from the long-term facility actually knew something about the patient. I thanked her profusely. 

• My first patient has a headache that radiates down to his toes. It’s gonna be a long, long day.