tales from the nsicu

Hey. Sorry for the lapse in my blogging, not that I was ever very routine, but it's been a while. Most to blame is my new job as a Neurosurgical Physician Assistant, which is what prompts today's post. Since, starting this job 3 months ago I've already experienced first hand the sadness of telling someone they have an incurable cancer or treating them emergently to save their life. There is a sadness in this job when you treat a large group of people with cancer, often which is fatal, regardless of if we treat them or not. So, when we find any humor in this job we tend to latch onto it, albeit some dark humor at time.

Which brings me to the story for this post. We were consulted by the trauma team about 2 weeks ago regarding a 21 year old female who had been in a motor vehicle accident; which was very likely occurred due to her intake of heroin and cocaine. It had been a prolonged extraction on scene by EMS and Fire and by the time she had arrived at the hospital she had a Glasgow Coma Scale score of 2 (normal is 15) according to the ER resident freaking out on the phone with my attending. The pt had pretty normal appearing CT of her head and her low GCS could also be due to the large amount of illicit drugs she had taken. So, the recommendation was to let her go to the OR for her ruptured spleen to be taken out and then see if she wakes up after the surgery. If not, then she may need a vetriculostomy (read - tube in head to relieve pressure) placed to relieve any pressure on her brain.

Now, jump forward to this past week. Pt now is awake, spleen-less, and her mom is visiting her in the Neurosurgical ICU. The trauma team is rounding on their pt's and as they come by the mother recognizes the trauma attending physician as the same doctor who save her life when she crashed her car, all hopped up on drugs, and almost died about 3 years ago. So the mother is singing the doctor's praises and introduces her boyfriend; a very active Pagan (a motorcycle gang here). So the mom and scary motorcycle gang member boyfriend are talking to the doctor about how they almost lost their little girl (the 21 year old pt) last year when she took some bad heroin which was laced. The mom proudly boasts that that drug dealer is dead now, he "drowned" *wink, wink*.

The trauma team is is trying to continue on their rounds and the pt's mom thanks the trauma attending one last time saying that she is so great now that she is even back to work. That's great say's the trauma doctor......what doe she do for work you might ask? She's a stripper. Who happened to have one of her legs amputated 3 years ago in her drug-induced car wreck. A one-legged stripper whose stage name is, "Feather". Whose motorcycle gang boyfriend kills people if you give his girls laced heroin.

Sometimes I think advanced medicine gets in the way of natural selection.