Early Sunday Morning It is a little after 5 in the morning and I am finishing up my third of four nights at work. It has been a pretty average weekend so far. Thursday night was quiet with no cases. Friday night I had a student working with me and we were busy most of the night. We started out by finishing a case started by the evening shift. It involved a 50 something year old man who had lost the blood flow to his left leg. The major artery to the leg was full of plaque and blood clots and could not be cleared. The surgeons took a large piece of vein and used it to "bypass" the clogged part of the artery. Circulation to the leg was restored so he will probably get to keep his leg. Our second case of the night involved a 9 year old boy who had been hit in the left eye by a rock thrown by another boy. The eye was badly damaged but the eye surgeons thought that they could save it. Three hours later we woke the boy up. He will need further surgery to completely restore the sight in the eye but the surgeons were very pleased with the initial surgery. We finished the night by working on the badly broken leg of a 44 year old idiot. I shouldn't call my patient an idiot but he decided to get drunk and then take his motorcycle for a ride, at night. In my book that makes him an idiot, but hey that's just my opinion. Its kind of like the guy I worked on last year who thought beer and wood chippers made a good combo. Any way the surgeons said this man will walk with a pretty good limp for the rest of his life to remind him. Tonight my student and I have only done one case. It involved a man with a perforated stomach ulcer. Unfortunately the man waited at home in fairly severe pain for three days before coming to the hospital. By the time he came in and was brought to the operating room his abdomen was severly infected. His temperature was 103, his heart rate was in the 130's and his blood pressure was low. We got him to sleep and the surgeons went to work. They found a hole in his stomach about 3/4 of an inch in diameter which they were able to repair. Because he was now fully septic we decided to leave his breathing tube in place and put him in the ICU. Hopefully they will be able to stop the infection with IV antibiotics and he will recover. Well the day shift will be here in about a half hour. One more night to go.

The Weekend So Far It is Sunday night and I am starting my 4th night at work. Thursday and Friday nights were mostly quiet. My student and I started an organ harvest at the end of our first shift. The patient was a 64 year old man who had suffered a brain hemorrhage that had caused brain death. The surgeons were planning on taking his liver and both kidneys for transplants. Friday night was completely quiet with no cases. Saturday night made up for the quiet of the first 2 nights. We ended up doing 5 cases. The first involved a cute little 8 year old girl who had been in a car wreck. She had no internal injuries but there were several severe, deep lacerations on her face and the side of her head. We put her to sleep and the plastic surgeons cleaned out and closed the facial wounds. They said she would have several significant scars on her face but that they would work on her again later to try and minimize the scars. Our second and third cases of the night were both young men with abdominal stab wounds. The first mans wounds turned out to be mostly superficial with no internal injury. The second young man was 17 years old and his single stab wound had hit his liver. There had been a lot of bleeding. We ended up giving him 8 units of blood products to replace what he had lost. The surgeons were able to stop the bleeding and he should fully recover. Our fourth case of the night was a young man who had been beaten out side of a bar. he had multiple skull fractures and was bleeding in his brain. The surgeons removed pieces of his shattered skull and were able to stop the bleeding. We left the breathing tube in at the end of the case. It will be several days before it is known whether he suffered permanent brain damage or not. Our final case involved a 22 year old women who had suffered a miscarraige. She was bleeding a lot from the uterus and the surgeons had to go in to stop the bleeding. We are 2 hours into our 4th an d final night and so far it has been quiet. We will see what happens.

Pain in the Neck!! Thumper and I went for one of our longest motorcycle rides today. We went over 110 miles total. We wear full gear when we ride including kevlar laced pants, boots, gloves, motorcycle jackets with armor pads and full face helmuts. The only place on my entire body that is not covered is the little bit of my neck below my helmet and above the collar of my jacket. So why is it that I got a bee sting on my neck just to the right of my adam's apple? It was bad enough getting stung but we were doing about 50 miles per hour when it happened. We stopped at a gas station about a mile down the road and Thumper dug the stinger out of my neck with her fingernails. We were able to buy a small bottle of calamine lotion at the gas station but it hurt for a while and it is still swollen and tender to the touch tonight. Other than the bee sting it was a good ride.