It's that time again: time for another post about stupid doctors! This time, you may be surprised that the stupid doctor is a trauma surgeon. You may be even more surprised to learn who the stupid trauma surgeon is:
Ok, granted, I wasn't a trauma surgeon at the time, I was still a doctor-in-training. So I can at least use that as an excuse. But it was one of those moments in my professional life when I deserved a well-earned slap to the forehead.
I had only been a doctor for about a year and was rotating through the intensive care unit, trying to learn how to take care of the sickest patients. Heart transplants, sepsis, strokes, heart attacks, surgical catastrophes, you name it. These patients are the worst of the worst, the sickest of the sick, and many of them never make it out. The patients who can't breathe on their own need mechanical ventilation, and this can be very uncomfortable and disorienting for them. Many of these unfortunate patients can become severely agitated, and sedation often isn't enough.
One such patient was an elderly woman who was having an exacerbation of her emphysema. She was intubated, on the ventilator, and fighting it furiously. The nurses had to attend to her constantly in attempts to calm her, but she seemed to be inconsolable, banging on the bed rails, pulling at her IV lines, and generally being a pain in the ass. All of the nurses had had it with her. Around 10 PM as I was making my nighttime rounds, she seemed particularly disturbed. I looked at her chart and noticed that her name looked German. All of a sudden a light bulb turned on - perhaps the nurses were having trouble calming her because she didn't speak the language. I studied the German language for four years in school, so perhaps I could talk to her in her own language! I could be a hero!
I walked timidly into the room, and her fierce blue eyes immediately narrowed and locked onto mine. I took a deep breath, racked my brain for the right words, and started telling her that she was ok, everything was fine, and she needed to concentrate on her breathing. She immediately calmed down ever-so slightly, and her eyes opened wide. She understood! I continued talking to her in very soothing tones, explaining in very broken German that her lungs were sick, but we were giving her medicine to make her better. At least I was pretty sure that's what I said...either that or I said that her lamp cow is sad yesterday and need more painted Wednesday.
Anyway, by the time I was done, she was perfectly calm, she was breathing more easily, and she actually had a hint of a smile on her face. Three of the ICU nurses watched open-mouthed as I strode confidently out of the room. "WHAT DID YOU SAY TO HER?" one of them asked. I simply told them that I explained her situation to her in her own language, and I continued on my rounds.
When I came in the next day, she had clearly gotten better because she was no longer on the ventilator. She was breathing on her own and looked much more comfortable...and still calm. I walked into her room and re-introduced myself, and after I finished my examination, I asked if she had any recollection of our conversation. I wasn't surprised to learn that she didn't (the sedatives can often interfere with memory formation), so I filled her in on the details.
"But I'm not German."
What? What do you mean, I asked her.
"I'm Norwegian. My husband was German. I don't speak any German at all."
Um...well then I guess her lamp cow really was sad after all.