апдейт 11 фев
Feb. 11th, 2022 02:34 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
aridmoorsОголенные нервы.
Я нашла книгу врача из Англии, This Is Going To Hurt, в которой он рассказывает о ежедневной практике. Это дневник. Он не менее крут, чем Вересаев.
Его работу надо перевести на другие языки.
Врач, который ТАМ, который присутствует, который чувствует всею что происходит.
This Is Going To Hurt.
Я приобрела его книгу в Амазоне, я почитала - я всем советую. Да, это классный доктор, да, это стоит читать. Надо перевести на другие языки.
Да.
https://www.amazon.com/This-Going-Hurt-Secret-Diaries/dp/1509858636
Вы можете приобрести и из вашего Амазона также.
Friday, 10 September 2004
I notice that every patient on the ward has a pulse of 60 recorded in their observation chart so I surreptitiously inspect the healthcare assistant's measurements technique. He feels the patient's pulse, looks at his watch and meticulously counts the number of seconds per minute. To give myself a bit of credit, I didn't panic when the patient I was reviewing on the ward unexpectedly started hosing enormous quantities of blood out of his mouth and onto my shirt.
Sunday, 17 October 2004
To give myself no credit whatsoever, I didn't know what else to do. I asked the nearest nurse to get Hugo, my registrar, who was on the next ward, and meantime I put in a Venflon and ran some fluids. Hugo arrived before I could do anything else, which was handy as I was completely out of ideas by that point. Start looking for the patient's stopcock? Shove loads of kitchen roll down his throat? Float some basil in it and declare it gazpacho?
Hugo diagnosed esophageal varices [a horrible complication of liver cirrhosis, where you essentially get huge varicose veins inside your oesophagus, which can rupture at any point], which made sense as the patient was the color of Homer Sympson - from the early series, when the contrast was much extreme and everyone looked like a cave painting - and tried to control the bleeding with a Sengstacken tube [a tube you can wedge down the throat that - when it's in position - can be inflated like a balloon, to put pressure on vessels and stop the bleeding].
As the patient flailed around, resisting this awful thing going down his throat, the blood jetted everywhere: on me, on Hugo, on the walls, curtains, ceiling. It was like a particularly avant-garde episode of Changing Rooms. The sound was the worst part. With every breath the poor man took you could hear the blood sucking down into his lungs, choking him.
By the time the tube was inserted, he'd stopped bleeding. Bleeding always stops eventually, and this was for the saddest reason. Hugo pronounced the patient's death, wrote up the notes and asked the nurse to inform the family. I peeled off my blood-soaked clothes and we silently changed into scrubs for the rest of the shift. So there we go, the first death I've ever witnessed, and every bit as horrific as it could possibly have been. Nothing romantic or beautiful about it. That sound. Hugo took me outside for a cigarette - we both desperately needed one after that.
And I'd never smoked before.
Tuesday, 9 November 2004
Bleeped awake at 3 a.m. from my first half-hour's shuteye in three shifts to prescribe a sleeping pill for a patient, whose sleep is evidently much more important than mine. My powers are greater than I realized - I arrive on the ward to find the patient is asleep.
Monday, 6 December 2004
All junior doctors at the hospital have been asked to sign a document opting out of the European Working Time Directive - because our contracts are non-compliant with it. This week I have seen Hugo for under two hours and worked for a grand total of ninety-seven. Non-compliant doesn't quite seem to cover it. My contract has taken the directive, dragged it screaming from its bed in the dead of night and waterboarded it.
Thursday, 20 January 2005
Dear drug-dealing scrote,
Over the last few nights, we've had to admit three young men and women - all dry as a husk, basically collapsed through hypotension, and with their electrolites up the fuck. The only connection between these individuals is their recent use of cocaine. For all its heart-attacking, septum-shrinking risks, cocaine does not cause this to happen to people. What I'm pretty confident is going on here - and I want a Nobel Prize or at the very least a Pride of Britain Award if I'm right - is that you've been bulking out your supply with your nan's Furosemide.
Aside from the fact you're wasting my evenings and my unit's beds, it feels like fairly terrible business practice to be hospitalizing your customers. Kindly use chalk like everyone else.
Yours faithfully, Dr Adam Kay
Monday, 21 February 2005
Discharging a patient home after laparoscopy, I signed her off work for two weeks. She offers me a tenner to sign her off for a month. I laugh, but she's serious, and ups her offer to fifteen quid. I suggest she sees her GP if she's not feeling up to work after a fortnight.
I clearly need to dress smarter if that's the level of bribe I'm attracting. On the way home I wonder how much she'd have needed to offer before I said yes. Depressingly, I put it somewhere around 50.
Monday, 14 March 2005
Out for dinner with Hugo and some mates - a pizza restaurant with exposed brickwork, too much neon, menus on clipboards, an unnecessarily complicated ordering system and the almost total removal of waiting staff. You're given a device that beeps and vibrates when your order is ready, whereupon you schlep across the artfully mismatched tiles to collect your pizza.
The device goes off, I say "Oh my God" and reflexively jump to my feet. It's not that I'm particularly excited about my Florentina - it's just that the fucking thing has the exact same pitch and timbre as my hospital bleep. Hugo takes my pulse: it's 95. Work has pretty much given me PTSD.
Thursday, 16 June 2005
I told a patient that his MRI wouldn't be until next week and he threatened to break both my legs. My first thought was, "Well, it'll be a couple of weeks off work". I was this close to offering to find him a baseball bat.
***
Well, the whole book is like this, the author is... well, he certainly is a gifted writer, and a sensible person, a vulnerable human. It is shocking, it is honest, it is sad, it is dark-humorous. It does remind me of a Russian doctor (Veresaev), who worked in the early 20th century in Russia; he later became a writer, quite a renowned one, I think [renowned] for the reason that not many people are able to write THIS WAY about their experiences as a doctor. The tone is very similar, the circumstances and patients are similar... it's like nothing changed between the 20th and 21st century, human-wise.
If you can, purchase this book and read it. It is that good. I actually think it should be translated into other languages [and I rarely say this about any book].
Я нашла книгу врача из Англии, This Is Going To Hurt, в которой он рассказывает о ежедневной практике. Это дневник. Он не менее крут, чем Вересаев.
Его работу надо перевести на другие языки.
Врач, который ТАМ, который присутствует, который чувствует всею что происходит.
This Is Going To Hurt.
Я приобрела его книгу в Амазоне, я почитала - я всем советую. Да, это классный доктор, да, это стоит читать. Надо перевести на другие языки.
Да.
https://www.amazon.com/This-Going-Hurt-Secret-Diaries/dp/1509858636
Вы можете приобрести и из вашего Амазона также.
Friday, 10 September 2004
I notice that every patient on the ward has a pulse of 60 recorded in their observation chart so I surreptitiously inspect the healthcare assistant's measurements technique. He feels the patient's pulse, looks at his watch and meticulously counts the number of seconds per minute. To give myself a bit of credit, I didn't panic when the patient I was reviewing on the ward unexpectedly started hosing enormous quantities of blood out of his mouth and onto my shirt.
Sunday, 17 October 2004
To give myself no credit whatsoever, I didn't know what else to do. I asked the nearest nurse to get Hugo, my registrar, who was on the next ward, and meantime I put in a Venflon and ran some fluids. Hugo arrived before I could do anything else, which was handy as I was completely out of ideas by that point. Start looking for the patient's stopcock? Shove loads of kitchen roll down his throat? Float some basil in it and declare it gazpacho?
Hugo diagnosed esophageal varices [a horrible complication of liver cirrhosis, where you essentially get huge varicose veins inside your oesophagus, which can rupture at any point], which made sense as the patient was the color of Homer Sympson - from the early series, when the contrast was much extreme and everyone looked like a cave painting - and tried to control the bleeding with a Sengstacken tube [a tube you can wedge down the throat that - when it's in position - can be inflated like a balloon, to put pressure on vessels and stop the bleeding].
As the patient flailed around, resisting this awful thing going down his throat, the blood jetted everywhere: on me, on Hugo, on the walls, curtains, ceiling. It was like a particularly avant-garde episode of Changing Rooms. The sound was the worst part. With every breath the poor man took you could hear the blood sucking down into his lungs, choking him.
By the time the tube was inserted, he'd stopped bleeding. Bleeding always stops eventually, and this was for the saddest reason. Hugo pronounced the patient's death, wrote up the notes and asked the nurse to inform the family. I peeled off my blood-soaked clothes and we silently changed into scrubs for the rest of the shift. So there we go, the first death I've ever witnessed, and every bit as horrific as it could possibly have been. Nothing romantic or beautiful about it. That sound. Hugo took me outside for a cigarette - we both desperately needed one after that.
And I'd never smoked before.
Tuesday, 9 November 2004
Bleeped awake at 3 a.m. from my first half-hour's shuteye in three shifts to prescribe a sleeping pill for a patient, whose sleep is evidently much more important than mine. My powers are greater than I realized - I arrive on the ward to find the patient is asleep.
Monday, 6 December 2004
All junior doctors at the hospital have been asked to sign a document opting out of the European Working Time Directive - because our contracts are non-compliant with it. This week I have seen Hugo for under two hours and worked for a grand total of ninety-seven. Non-compliant doesn't quite seem to cover it. My contract has taken the directive, dragged it screaming from its bed in the dead of night and waterboarded it.
Thursday, 20 January 2005
Dear drug-dealing scrote,
Over the last few nights, we've had to admit three young men and women - all dry as a husk, basically collapsed through hypotension, and with their electrolites up the fuck. The only connection between these individuals is their recent use of cocaine. For all its heart-attacking, septum-shrinking risks, cocaine does not cause this to happen to people. What I'm pretty confident is going on here - and I want a Nobel Prize or at the very least a Pride of Britain Award if I'm right - is that you've been bulking out your supply with your nan's Furosemide.
Aside from the fact you're wasting my evenings and my unit's beds, it feels like fairly terrible business practice to be hospitalizing your customers. Kindly use chalk like everyone else.
Yours faithfully, Dr Adam Kay
Monday, 21 February 2005
Discharging a patient home after laparoscopy, I signed her off work for two weeks. She offers me a tenner to sign her off for a month. I laugh, but she's serious, and ups her offer to fifteen quid. I suggest she sees her GP if she's not feeling up to work after a fortnight.
I clearly need to dress smarter if that's the level of bribe I'm attracting. On the way home I wonder how much she'd have needed to offer before I said yes. Depressingly, I put it somewhere around 50.
Monday, 14 March 2005
Out for dinner with Hugo and some mates - a pizza restaurant with exposed brickwork, too much neon, menus on clipboards, an unnecessarily complicated ordering system and the almost total removal of waiting staff. You're given a device that beeps and vibrates when your order is ready, whereupon you schlep across the artfully mismatched tiles to collect your pizza.
The device goes off, I say "Oh my God" and reflexively jump to my feet. It's not that I'm particularly excited about my Florentina - it's just that the fucking thing has the exact same pitch and timbre as my hospital bleep. Hugo takes my pulse: it's 95. Work has pretty much given me PTSD.
Thursday, 16 June 2005
I told a patient that his MRI wouldn't be until next week and he threatened to break both my legs. My first thought was, "Well, it'll be a couple of weeks off work". I was this close to offering to find him a baseball bat.
***
Well, the whole book is like this, the author is... well, he certainly is a gifted writer, and a sensible person, a vulnerable human. It is shocking, it is honest, it is sad, it is dark-humorous. It does remind me of a Russian doctor (Veresaev), who worked in the early 20th century in Russia; he later became a writer, quite a renowned one, I think [renowned] for the reason that not many people are able to write THIS WAY about their experiences as a doctor. The tone is very similar, the circumstances and patients are similar... it's like nothing changed between the 20th and 21st century, human-wise.
If you can, purchase this book and read it. It is that good. I actually think it should be translated into other languages [and I rarely say this about any book].
