Well that was not how I intended to start out this post but rather tell a few funny stories from the hospital. I apologize if you find this too vague or too medical but I will do my best to make it relevant. My first month in New Jersey was spent doing neurosurgery, for some reason this month everyone in New Jersey (or so it seemed) decided to pop and aneurysm in their head. Almost every night we would have a new admission of someone who had a ruptured aneurysm. I learned an enormous amount about the treatment of this disease, which is very complicated to manage. In medical school they just breeze over this stuff but when it comes to the day to day of managing these patients in the ICU it is very complicated. Most of the patients end up needing to be in the hospital for 3 weeks, so I got to know them very well seeing them multiple times a day.
One lady was already in the hospital when I arrived and she had an ACOM aneurysm (don't worry about what that is) but It is near the frontal lobes and as most people know from TV this controls your impulses so she became impulsive and would say anything that came to her mind. Everyday we would go into her room and ask her similar questions to see how she was progressing, things like "What is your name? What is the date? Where are you and Who is the president?" It seemed like every day her name changed a bit as she added a new name to the end of it. The funniest thing happened when she need to have a drain put in to her brain because she was developing hydrocephalus (water on the brain). This procedure can be done at the bedside and is relatively simple. After numbing the scalp an incision is made and the skull is exposed. You then use a twist drill to drill through the skull until the dura (membrane around brain) is exposed, a cut is made in the dura and then you pass a tube into the ventricle (water collecting area). Patients are awake for this or slightly sedated. She was fully awake and as the chief resident drilled through her skull she looked up and said "Heyyyyy now...are you drilling in my head?" we simply told her we weren't and she said ok and continued to watch tv.
A few weeks later another woman was in the unit with the same problem but she had an attitude to put it nicely. Everyday when we woke her up at 6am she would yell at us and tell us we were rude for not letting her sleep. When we asked us to show her two fingers (seeing if she can follow commands) she would always flip us off with both hands. She accused one of the interns of being a lesbian for touching her. She also had a slight crush on one of the other interns.
Woman: "Hey can you do me a favor?"
Intern; "Sure, What do you need?"
Woman in a raspy voice: "Smile"
To appease the woman he smiled
Woman: "You are one sexy bastard"
The intern left the room to her yelling, "You know it, You know it, You know it"
Then there was my favorite patient she came in late one evening cussing up a storm the only words she could say were shit and fuck (we call this an expressive aphasia). She ended up having a left MCA aneurysm this artery supplies the language areas. When the family arrived they told us that sounded like her and weren't surprised. She ended up having the aneurysm coiled and having a drain placed. Slowly as she recovered she would try to talk but all the came out was "ughhhh" and "mugggh" followed by giggling. "Mrs. So and So what is your name?" she would respond "mugggh" and would laugh. She was very frustrated that she couldn't understand or speak, but would try and laugh to play it off. He facial expressions were priceless when I would come in and see her. I actually caught her and her husband flirting one day, which made me really happy.
Then there was the most awkward thing I have ever seen. A 90 year old nun came into the ER after having a massive stroke. We went with the attending to examine her and write our consult even though we knew she wouldn't be a surgical candidate. When examining a patients neurological status we need to know about their strength, pain sensation, vibratory sensation, ability to follow commands and other things. In order to test patients pain sensation we will pinch their skin, stick them with safety pins press on certain nerves etc...however, when a patient is stuporous to try and arouse them we will do a sternal rub or twist their nipple. The attending decided to see how she would react he would twist her nipple. Watching a late 60's man twist a 90 year old nun's nipple was probably the most awkward thing I've ever seen. I couldn't help myself by thinking "that's probably the most action she has ever had"
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