A good day means no pap smears. A good day means as little contact as possible with these residents and attendings for the next few days. Today a young couple comes into the clinic and she is five months pregnant with pain and a sore throat and she says she can't affort a small bottle of tylenol. I tell her I'm sorry and that we don't have any. She should go to Duane Reade. She's nineteen and her boyfriend says she can get the money from her mother. She denies the likelihood of these prospects. Its miserable and raining as it has been lately. I just saw googlewhack(www.davegorman.com
) in the Village Theatre a few days ago and I'm feeling inspired to get the hell out of this place and leave it all behind in pursuit of ridiculous shit for no reason. All of these doctors with there expressionless faces and stress cases are getting into my head. Dave Gorman is a wise man. Googewhack=a web site that can be found with the google search using only two words in the search and google only finding one site. ie type in two words and you come up with one website out of billions. Its a little harder than it sounds at first.
Manhattan is a million times dirtier when it rains and the garbage mixes with the water and spreads out over the concrete collecting in puddles. Some people come to the ER just to get off the street. They leave when we start sticking them with needles and making their lives as miserable as possible. If you've been in a busy city ER then you know what misery is.
This week a young woman walks in with the complaint of vaginal bleeding for the past few days. She is 15 weeks pregnant but the ultrasound shows a fetal size of 8 weeks and there is no heartbeat. She is diagnosed with a missed spontaneous abortion at 8 weeks. The fetus has been dead for two month and it is still inside her. Unfortunately it is our job to remove the dead baby from her uterus. Luckily one of the operating room techs speaks mandarin so we can explain to her the procedure. She seems confused and says multiple times in English "Baby Ok, Baby Ok." I wanted to say no baby not Ok but instead I let the tech continue to speak loud mandarin in a manner which appeared very matter of fact. Everything is matter of fact in a hospital and not because the staff and doctors are incompassionate by nature but instead it is how we cope with what we do. Mam your baby is dead so we are going to take it out. The complications are bleeding and unlikely, death. These are always the complications of a procedure, bleeding and death. You might get one, two or both. I will spare you the details of the procedure performed but lets just say it involved accessing the uterus through the vagina with a high powered suction device to access and remove the "products of conception."
The crowded subway is wet from all the wet people. Put on headphones and ignore everything and everyone. Go home.