Balls and Walnuts
more than you ever wanted to know
Blood from a stone
I learned a lot of things in training. Learned to develop a thick skin, for one thing. (Interesting how it protects me from the outside barbs, but not the inside barbs.) Learned how to function on two hours of sleep or no hours of sleep. The worst, by the way, is one hour of sleep. I would rather have no sleep than one hour of sleep. One hour of sleep is an absolute misery.
Someone told me on my first or second day of internship that I would learn to get blood from a stone, and it was true. “Stones,” in this case, are IV drug abusers who have shot all their peripheral veins. I could always find the femoral vein, of course — that was my preferred last resort, since I never was too comfie with subclavian sticks. Not to mention jugular lines — Yeesh! But I always tried to find a good peripheral vein, because the big ones are riskier and they bleed like stink if the patient yanks it out.
Veins do seem to roll away from you, and they also seem to go into spasm and disappear altogether. I say “seem” because who knows what they really do. One minute they’re there, the next they’re not.
Those first few days on Urology were brutal. To the patients, I mean. (Never get sick in a teaching hospital in July. That’s when all the noobs come on board.) Couldn’t do much but practice on patients until I got it right. I remember the learning curve being pretty quick, though; my first day, I turned an old Hispanic guy into a pincushion, but I don’t remember too many traumatic sticks after that.
Infants and children are a different world. The stress on the doc, me anyway, is indescribable. The tissues are pristine, but the vessels are tiny. I guess the worst case scenario would be an 18-month-old IV drug abuser, but fortunately I didn’t meet too many of those.
In med school, I learned how to do arterial punctures and set arterial lines. Most people would consider these to be more difficult procedures than drawing blood or setting IVs, but for me that pulse had become a beacon. Back again to my first day on Urology: I remember thinking, “How do I find it without a pulse?”
I wonder if I would have made it through internship if I’d had any idea what I’d gotten myself into.
You learn, too, that your patients are forgiving. People forgive a lot when they know you’re trying your best.
D.
I’ve donated blood regularly (mostly) since I was about 18 (I don’t think they’ll accept blood from anyone under that – at least they didn’t when I was 18) and the absolute best were the nurses in the traveling blood donor clinics. Tie, breath and suddenly the needle was in, with nothing that could even be called discomfort.
Of course, it helps that I have big veins.
Big veins do count for a LOT 🙂
I passed out the first time I donated blood. Apparently, it’s not an uncommon reaction for first-timers; perhaps the body has to learn how to react to a sudden drop in blood volume. I remember them telling me something about blood donors surviving trauma better than non-donors. I’ve always meant to look that one up and see if it was real . . .
Are the patients really forgiving, or just too scared to death of what might happen when you’re not trying to not to hurt them, as might be the case if they tick you off by saying something? 😉
I follow a philosophy of trying to be very nice to people that bring you your food or probe you with medical instruments. 😉
Donating blood is my only charitable activity, but I make a point of doing it as often as I can. Even with all the various prescriptions I know take, they are still happy to have me, my O+, and my big veins. My husband, an AB+, refuses to do it. Not sure why. Predictably, we have one A+ and one B+ son (never remember which is which).
Giving blood is easy. It was having that IV in my hand during the C-sections that reallly sucked. Ow, ow, ow! And when they couldn’t get my epidural in….
I remember one clinic where I was in good shape and pumped out a litre in about 3 minutes. The tiny woman beside me, who’d been grumbling about the pain in her whatsit (the place where the needle goes in has a special name but I don’t remember what it is, or maybe it’s the needle assemply itself? Anyway) though that I had a better machine than her.
The nurse explained to us that big guy=big heart=big volume, which is a plus in the donor clinic, and a very sharp minus in a serious accident. “Guys like this will often bleed out and be dead before the ambulance gets there,” she said.
So I drive carefully.
It’d probably take me a week to bleed out, even with every major artery slashed – it takes me well over an hour to donate a pint.
Oh, the joys of having a BP of 90/60 …