Stan – Dr Bryan Walpole
The next day, at 8.30 a.m., Stan had not appeared at work. His home phone was not answering. At 9 a.m. the police rang to say he was dead. It was my first three months in charge of an ED, and there was already a resident medical officer suicide. It wasn’t even discussed at an administrative level but barely a month goes by without me … Continue reading Stan – Dr Bryan Walpole
Emergency at night – Dr Anselm Wong
Things don’t always go well. One night, an unconscious man is brought into the ED. His friend actually drags him into the department. He has no pulse; he’s not breathing. He is white as a sheet. We perform CPR on him, going and going until help finally arrives in the form of a GP specialist who has travelled from home. The half an hour we spend working … Continue reading Emergency at night – Dr Anselm Wong
Close to the bone – Dr Anthony Cross
The ambulance had radioed ahead: 32-year-old male, motorcycle vs truck. He was unconscious, with an obvious head injury. Vital signs were stable, intubated at the scene. The ambulance was five minutes away.
The team follows a well-drilled routine when he arrives. We transfer him onto the trauma trolley: careful with the breathing tube; keep the neck immobilised; watch out for lines. Everyone gets on with their job – calm, efficient… Continue reading Close to the bone – Dr Anthony Cross
On his own terms – Dr Stephen Parnis
I had found something that ticked all the boxes. I had a home, a team and more than enough variety to keep a generalist happy. There were plenty of opportunities for excellence. I even had enough time for a life outside of work. I remain very happy with the choice I made to become an emergency physician. I still love the challenge of diagnosis, stabilisation and treatment. I love leading the team, sharing the highs and lows with them. When I was training, the challenge for me was to become a good emergency physician. I think that happened somewhere along the way.
But now, there are other challenges and goals to face. Continue reading On his own terms – Dr Stephen Parnis
I can probably help – Dr Venita Munir
I’m on my knees in the wet sand, leaning over a woman younger than me. She’s clothed in jeans and a t-shirt, which has been pulled down to expose her chest. She is cold and grey. Her eyes stare, pupils huge and cloudy. My impression is she’s dead. I insert the airway tube and frothy pink water gushes out of her windpipe. She has no pulse. We strip off her wet clothes, trying to let the sun warm her.
The rip dragged her out. Continue reading I can probably help – Dr Venita Munir
Everything we can – Dr Simon Judkins
A needle goes into her leg for medications while we continue with CPR. The monitor shows no heartbeat at all. It’s a well-practised drill. We know what to do and we do it: chest compressions, adrenaline in, a tube in the airway to breathe for her, more adrenaline. A bit more of this, more of that. We go for twenty minutes, maybe thirty, there’s no heartbeat; we’re not winning. Ten more minutes . . . this is bad, very bad. Continue reading Everything we can – Dr Simon Judkins
Through the curtain – Dr Joe-Anthony Rotella
I meet them in the ED and wait with them in the line for triage. There’s an odd mixture of embarrassment and urgency when you wait in line in your own ED. You don’t want to be noticed, even though you are dressed in normal clothes and there isn’t a sign over your head saying ‘I work here!’, but that being said, you know what’s going on; you know there’s a real chance your loved one is sick and your ED will be able to care for them. Continue reading Through the curtain – Dr Joe-Anthony Rotella
No movement – A/Prof David Mountain
It’s 8 a.m. and once again, I’m back in paradise. As expected, I see the patient I met at the door last night – he is actually calm and settled this morning; the amphetamines washed out quickly. Unfortunately one of the security boys had his nose smashed over night – this patient thought he was being attacked by aliens and took a swing at him. Continue reading No movement – A/Prof David Mountain
Dignity – Dr Simon Judkins
Another cough. I look up from the care plan. There’s a look of distress. And blood, lots of it.
We stare at each other. It’s a brief glance, but also the most meaningful unspoken exchange. The sheepish grin turns to a look of fear, horror – finality.
He knows. I know. This is it; this is dying. Continue reading Dignity – Dr Simon Judkins
Places of refuge – Dr Georgina Phillips
She’s withdrawn and closed when I bluster in to the cubicle, and instantly I have to change demeanour. Close the curtain, low lighting, soft voice. Her friend is sitting quietly in the corner busily fiddling with her mobile phone, but listening intently.
‘What happened?’ Her partner assaulted her. They had been drinking; it was the early hours of the morning. Continue reading Places of refuge – Dr Georgina Phillips