my fear of total carnage on starting nights in doctor changeover week was confirmed. fortunately the doctor covering before i began my shift is a bit of an old hand and was almost on top of everything but there was still a load of crap to do.
renal medicine is all about pissing. if you piss that makes us happy. in fact a lot of medicine is about pissing. it is guaranteed that very soon into their first job a newly qualified doctor will be called up at an unsocial hour with the (in)famous "you remember Mr Eriksson, the football manager who's had his stomach taken out today? well he hasn't passed any urine for four hours." this is very important because the amount of urine someone passes is a good indicator of how well hydrated they are and whether their kidneys are receiving adequate blood flow. so the appropriate response to that call is to make a full assessment of the patient and their fluid balance. i must add that it is the appropriate response. the reflex response might actually be tempted to say "well doctor here hasn't had time to pass any urine all day but no one gives a shit about him."
so imagine my frustration to be told that the ill looking young guy in the side room, yes the one who's kidneys not only failed years back, but his first transplanted kidney failed and has been admitted cos his second bloody kidney transplant is also failing because of roaring infection, has not passed any urine all day. "i told the doctors during the day" said the nurse "but i'm not sure if they did anything." un-fucking-believable. this is the bloody RENAL unit! the whole bloody point of him being here is so that we can SAVE his transplant. anyway i wasn't happy. though i think i was happier than his melting kidney.
i was also pleased to receive a torrent of abuse at 6am from the guy who was supposed to go to theatre today for his surgery. i was told by the day team "oh yeah, can you check his bloods early in the morning as we want everything to be OK for his op today." yeah sure guys no problem. oh yeah, you might want to actually TELL the patient, nurses, surgeons, anaethetists and theatre staff that he's supposed to be having surgery. does help in my experience. so i got a lot of:
"you fucking cunt, you can't just fucking swan in here to take my bloods and tell me i've got to got for an op when no-one's told me fucking nothing. you're all cunts. i'm sure i've got MRSA from you dirty cunts. i'm gonna fuck you all up"
and so forth. but, by this point, the sun was rising, i could hear the birds singing and i'd spent 40 quid on Amazon buying CDs so i wasn't offended.
[i am listening to Get Free by The Vines who apparently have a new album out soon]