Surgeons have some of the most amazing writing skills I have yet to read. They are keen observers, excellent historians, and duly self-reflective. This observation is based on notes about a patient that I had this week, one Ms. L., suffering from
pancreatic pseudocysts, who suddenly and unexpectedly began vomiting copious
[1] amounts of bright red blood
[2]. She was in absolutely critical condition by the time we got her to the ICU. Because I followed her there and participated in hanging her blood and plasma for transfusion, watched the
endotracheal intubation, etc., and since she and I had been chatting and laughing all morning before the incident, I was anxious to follow-up with her the next day. She apparently underwent surgery early Friday morning and the surgery notes represent a unique literary form that I wish would be published as general interest material. I'd quote from it, but that is not
HIPAA compliant, so let me just say to you students out there, if you want to learn in amazing detail and narrative about disease and anatomy, read your patient's surgeon's notes. Absolutely the best tool for learning I have been presented with thus far. (It will probably also be somewhat humbling in terms of differentiating the role of nurse from doctor. I'm just being honest.)
[1] 1000mLs* in about 60 minutes * class II blood loss at 1 hour.
[2] blood that would coagulate before we had time to rinse the basin.
Now from his breast into his eyes the ache of longing mounted, and he wept at last, his dear wife, clear and faithful, in his arms, longed for as the sun warmed earth is longed for by a swimmer spent in rough water where his ship went down under Poseidon's blows, gale winds and tons of sea. Few men can keep alive through a big surf to crawl, clotted with brine, on kindly beaches in joy, in joy, knowing the abyss behind: and so she too rejoiced, her gaze upon her husband, her white arms round him pressed as though forever.
