The Doctor Will See You Now [Non-Fiction]

Chapter 35: Surgery

I was in my first month of being a doctor on the general surgical ward.

The crash alarm went off at the end of the working day. Three colleagues -- same rank as me and equally (in)experienced -- and I rushed to the patient in question. Alan was a middle-aged man admitted for stomach pain. After endoscopy, he was found to have a duodenal ulcer (an erosion in the part of the gut after the stomach) after years of using anti-inflammatory drugs for joint pain without concomitant use of stomach-protective agents, so the anti-inflammatories damaged his gut lining. I'd taken blood from him earlier that day.

Alan was vomiting blood profusely, his face chalk-white, and clammy all over.

My colleagues and I, all of whom were no doubt terrified, leapt into action. Two nurses jumped in to sit him up and get the observations, like blood pressure etc. I tried to get a cannula into him, but he was peripherally shut down because of blood loss and super cold and clammy. Another colleague grabbed the cardiac arrest trolley in case he further deteriorated. A third colleague examined him as we'd been taught in Basic Life Support -- ABCDE. The fourth colleague spoke to him, explaining what we're going to do, and then left to call a senior for help.

Alan continued to throw up blood. It meant either the ulcer had bled (bad news) or it'd broken through the lining of his gut and he now had a perforation (even worse news).

After a few units of blood transfused and my registrar running to see him, we managed to get Alan stabilised. He'd stopped bleeding. His top was soaked in blood and he was still pasty white, but at least his blood pressure was stable and his heart rate less crazy. He had a cannula in each hand and foot.

He had a scan to see where the bleed was and the artery contributing to the bleed was coiled -- it was blocked off -- and hopefully that marked the end of any dramatic bleeds like that one.

I next saw Alan on our ward again three days later, walking about. He looked like a normal guy, much improved from the pasty, clammy man puking blood a few days prior. He thanked me and my colleagues for our roles.

It was one of the most satisfying moments of my life.