Last Friday the afternoon lecture took so long. It was a Clinical Chemistry class so you can imagine being bombarded with graphs and ranges of various compounds in the body on a Friday afternoon under the sedation of cheap ugali from the Students’ mess. The sedation would sometimes be very profound especially when you get a boring lecturer. My classmates usually come to my rescue during such gruelling moments and I love them for this one favour they do me, they send the lecturer away. Yes! they literally send the lecturer away, either by murmuring and making ugly and irritating noises or unanimously saying they are tired. They did it again. The lecturer had no choice but to give in.
We rushed out of class heaving with a sigh of relief. Finally Friday is here with us.The mighty Friday. Long awaited with zeal and anxiety.Lovers can be seen hurdled together, some are yelling like high school girls and boys on heat. Some two lovers remained in class giggling emphatically reminding me of the high school heat. It had a characteristic slow onset, increased gradually and nothing done to relieve it. I did not have a mate here so all roads were leading to the Casualty.
I love the casualty. It is a great place of learning medicine and a great place to have your log book signed if you fall a victim of the last minute rush.For my non medical readers, log books are books where we have our supervisors sign after we have observed or done a procedure. For the next couple of weeks that I will be in internal medicine rotation, the casualty would be my home every Friday.
The wailing siren of an ambulance, the howl of patients in pain, the motley of humanity and the raw, acrid, heavy and festering scent of blood welcomes me to this place. A lot of activities are taking place simultaneously. A first aid is going on besides the ambulance that got in few minutes earlier, a nurse is fixing Intravenous lines on the observation room right next to the entrance, a medical student is drawing blood at the far corner on an already stabilised injured patient and me standing cluelessly just watching. I felt like a lonely idler in the midst of a check-list about to be crossed. ‘One day I will be expected to be doing these things that I can now only watch from afar,’ I told myself as I figured out what to do.
I got into consultation room 2 and got two doctors seeing patients. I requested to join them and was gladly welcomed.Their kindness warmed my heart and set the mood for that evening. I watched keenly as they were assessing patients, performing their rituals of physical examination and listening to the patient. “Listen to the patient, he is telling you the diagnosis,” this is a common aphorism that has remained the corner stone of medicine since the beginning of time. The two doctors had really mastered this art.
“Hey doc, I have a patient who has had trauma and has since been stabilised, could you do a suture for me?” the casualty nurse asked Dr Kamau, one of the doctors, in a fruity voice. How could you say no to such a beautiful lady with a nice anatomy and angelic voice? Dr Kamau loves women and he admits it openly, only that some times he sounds ” I love we men,” to dilute his statements just in case he found himself flirting with the wrong breed of women. He was hitting on this nurse, so he agreed to do it knowing very well that he was busy. “Oliver,come lets do a suture,” he said letting the nurse have her will.
Dr Kamau is a gifted surgeon. You can hardly tell this from his demeanour outside the theatre. He has no wasted motions. The eyes are steady like those of an eagle. His fingers are long and dexterous,a true surgeon indeed, not the clubbed fingers of one of my classmates who insists he wants to be a neurosurgeon. I once joked that he would raise a whole cemetery by himself if he took up surgery as a speciality. Dr Kamau can sustain a heated conversation while doing his suturing. His conversations are those you would wish to have every Friday to cheer you up after a tired week.
” How do you hold a lady when she approaches you?” he asks,
” by the waist of course, then I look into her eyes to see if there is fire,” I answered
” Exactly, that his the same way you hold a needle using a needle-holder, two thirds from the tip,” he said as pushed the needle into the skin.
After what seemed like eternity, I looked up at the clock, it had clocked fifteen minutes. Wow! Record time! I am sure in our absence he would have taken fewer minutes.
As we were moving back to our station, I saw a group of medics resuscitating an elderly lady. I decided to join them and see exactly how they were doing it. They were compressing the chest enthusiastically as they delivered air through the mouth. I reached out for the pulse on the left hand and was met with coldness. I had learnt of pulsus paradoxus, pulsus parvus et tardus, pulsus biefrens, pulsus alternans and many more but this was not among them. This was an absent pulse.The mood changed for a minute before normal activity resumed as if nothing had happened.
I went to Dr Kamau again and did a few check ups with him before being called again to the minor theatre for the same same procedure, suturing. He drummed it into my head that I had to learn this important skill that is life saving. After we were done, I left for the wards to observe more procedures before calling it a day.
On my way out, an ambulance came to a sudden halt at the entrance. The screeching of the wheels on asphalt was so sharp that I felt it in my teeth, the dentists know better why sharp sounds irritate the teeth. An elderly lady is wheeled out with great effort. The ambulance paramedic is sweating profusely, things are not going on well. The lady is heavy like a sack of maize, the long sacks, you know them. she fell with a thud just as I was getting close. I rushed and assisted to carry her up to the stretcher and then inside for stabilization. All I remember is that this was a case of pulmonary embolism. A clot in the lung. Non medics, these are basic terms, learn one or two.
I left quickly, I was getting tired, darkness had already set in and I needed to get to my room. I passed by the wards and bid Tom (not his real name) goodnight, Tom is a patient who when he discovered that we came from the same area, he burst out with joy and forgot that he had an injured leg. We will come to his story on a later date.No procedures in the ward. 9.30pm, my day ends. What a Friday!