Another thing I have never seen before.....

On call again this weekend...I have now come close to seeing just about everything, I believe. If this isn't enough to get me to put away the remaining Christmas decos on my front porch, well, then I don't know what would be! I saw an unfortunate individual today and yesterday for rather involved wound care. This wound is just huge. It's a cavern. When 85+ year old flesh is impaled on the steeple of a ceramic church, the flesh loses. The result is (roughly) a 6 cm x 4 cm opening appoximately 7 cm deep with very visible flesh, tendons and sinew on the inside of this person's upper thigh/lower buttock. It reminds me of what a losing bull-fighter may look like if the bull catches him as he is running away. This person would've had surgery were it not for the extensive lung disease. (Lesson #2: Never smoke.) Wound care has to be done with the pt. standing, because they can't breathe in any other position. Pretty much rules out surgery. The individual fell, landed on the church steeple, pulled himself off, and has an impressive wound to show for it.

Some of the comments going around as I was given report Friday:
1) Looks like God got the last point in the end.
2) God's right in the end.
And other sacrilegious things. Oh, if you want to know who the REAL idiot is......no pain medication from any of his physicians. I called Saturday, got the on call doc and received an aggressive order for 650 mg of Tylenol. Let me just take this opportunity to say how much I miss the physicians I worked with in the valley! They have an appointment with the surgeon on Tuesday, so my advice to them was to not leave without an actual prescription for at least something stronger than that even if only take before wound care, as that is the only time it hurts "20" on a scale of 1-10. Please, people! (And yes I know the potential risks of narcotic usage with lung disease, but for any of my medical buddies reading this, 10 mg of Morphine once a day? I guarantee respirations will still be at least 16!) If it were my family member.....well, it's not and they seem to be the kind of family that doesn't mind the described "old coot" being in a little bit of pain...they seem to be holding some grudges from somewhere. Just doing my job!