!Trauma surgery
 --- 
agk's diary 
31 March 2022 @ 04:13
 --- 
written on GPD Win 1
in late-night quiet while my daughter breastfeeds
 --- 

Trauma surgery's a place to pause and heal a little 
after momentary lapses of judgment. Sliding glass-
doored intensive care unit rooms fishbowl around a 
nurse's station. The rest of the floor is progress-
ive or acute. 

Nurses here are particularly young, fit, and horny. 
Patients have wrecked cars and motorcycles. Their 
faces, bones, and internal organs are gunshot. They 
have dressings to change, metal in their bones, and 
swelling to assess.

Why do people wreck? Many reasons. A gastric sleeve 
surgery removed most of someone's stomach. Helped 
her lose weight, but she couldn't absorb B12, iron, 
potassium, etc. Anemic, fatigued, she hit a tree, 
had a heart attack. Someone rode his scooter home 
tipsy from his girlfriend's, got a brain injury.

> I invent fictional patients, based on a bunch of
> real ones. They ain't identifiable.

I listened to Claire's diminished lung sounds, had
her wiggle toes out the ends of her casts. I 
grabbed her external fixation rods and hefted her 
legs into a more comfortable position. I squirted 
enoxaparin in the trashcan, then checked---the 
right amount was left in the syringe.

I pinched up her belly where I alcohol-swabbed it.
"Ever give yourself a shot?" I asked as I gave her 
one. She had. "For what?"

"I guess for fun," she said.

Next time in her room, after I asked her to rate 
her pain, I asked about that. "You said for fun---
are you in recovery or still using?" She hesitated. 
"I'm not here to judge either way," I said. "I'm in 
recovery myself."

We talked about practicalities of parole, sober 
living, calling telephone meetings from bed, gett-
ing recovery literature to read. She wasn't afraid
I'd treat her worse because of what she was reveal-
ing. She knew I understood. 

I got an incentive spirometer to help her practice 
breathing deep enough to prevent pneumonia, coached
her with it, emptied dark urine from her foley 
catheter bag. I let her rest, and charted.