4 NEWS
4 NEWS
11 OCTOBER 2024 ausdoc . com . au
My most memorable day as a doctor ?
This is what happened …
February / March 2002 Dr Rachel Glasson
Sydney , NSW
1985 Dr Ralph Vida
GP , Gold Coast , Queensland
I CANNOT now recall if it was a full moon , but that night , the unusual cases piled up on my house-call locum shift in the badlands of housing commission in northern Adelaide .
One visit I remember vividly was to a dishevelled middle-aged woman who sat perched on her filthy sofa and presented with a recent onset of bleeding gums and skin sores .
As I cased the room from habit , spying some cooked pork sausages and Diploma skim milk powder boxes on the kitchen bench , along with an extra-large bag of Kibble dog biscuits at her feet , I innocently asked : “ Where ’ s the pooch ?”
To which she replied : “ I don ’ t have one .” “ So , why the dried dog food ?” I continued . “ They ’ re for me . I enjoy them .” “ What else do you eat ?” “ Sausages and milk .”
I spied Kibble dog biscuits at her feet and innocently asked : ‘ Where ’ s the pooch ?’
I paused for a moment : “ Anything otherwise ?” “ No , not for past six months ; I ’ m poor .” The vitamin deficiency was the least of her problems , I thought , as I made a mental note to ring her GP in the morning .
I WAS a junior resident on a cardiothoracic ICU team .
It was a rather boring weekend night shift with nothing much happening , but while we were sitting in the tearoom complaining about this in a low-key sort of a way , the trauma page went off . On our arrival in ED , we were met with an incredible sight . Earlier that night , a young man had come stumbling out of a nearby park , hailed a taxi and said : “ Take me to the nearest hospital !”
He was then driven into the ambulance bay , with the taxi driver leaning on the horn to attract attention .
The resident who responded was annoyed to see an unconscious young man in the back seat with vomit all around , thinking , “ Just another drunk .”
But then he noticed the young man was unresponsive and not actually breathing .
The surgeon incised the pericardial sac to reveal spurting blood that hit the wall on the opposite side of the room .
This set off a panic in the department , and the patient was swiftly conveyed to the resus bay , where he was found to have a single puncture wound to his left chest , fourth intercostal space , anterior axillary line .
The surgical registrar who was currently on every Friday night shift happened to be doing a cardiothoracic research term that involved thoracotomies on sheep . So when he arrived and realised the likely cause of the patient ’ s collapse — acute tamponade due to a laceration of the left ventricle — he responded accordingly .
The sight that greeted me and my registrar was the surgeon spreading the ribs of the patient and incising the pericardial sac to reveal spurting blood that was hitting the wall on the opposite side of the room .
Someone said to me , “ Squeeze this !” So I applied myself to the bag of IV fluids with which the patient was being resuscitated and watched as the surgical registrar calmly plugged the hole in the left ventricle with his finger and then stitched it closed .
The patient spent the rest of the night in theatre , but was ultimately discharged home three weeks later , fully recovered .
If not for that particular registrar being on duty on that specific evening , the outcome would have been very different .
Every time the trauma page went off during the remainder of that term , my heart skipped a few beats at the memory of what we had witnessed .
2012
Dr Sue Beutum
Perth , WA
I HAVE a friend who is a dental veterinarian , and after a discussion about his work at various zoos around Australia , he arranged for me to join him at Taronga Zoo , in Sydney .
Expecting to be an observer at his vet hospital , I was surprised during one of his consultations to be asked to leave the mouth end of his sun bear patient , Dunbar , and go to the other end of this beautiful animal , who — apart from a terrible dental issue — was apparently infertile .
Once there , I was asked if I could get an endometrial sample .
Shocked , I explained I was a human doctor , to which the retort was that humans are just animals on two legs . It seemed a reasonable argument .
An ultrasound revealed a diploid uterus . A sun bear ’ s cervix is miniscule , and there was no way I would even attempt a biopsy .
However , I suggested that a biopsy may be possible with the assistance of an ultrasound , suggesting a specialist fetal / gynaecology ultrasound could be done .
So the head vet at the zoo organised the gynaecology head at Sydney University to attend at a later date .
A sun bear ’ s cervix is miniscule , and there was no way I would even attempt a biopsy .
The biopsy with a bent sampler succeeded , and it was discovered that , in fact , the issue was not Dunbar ’ s problem at all but her mate ’ s , Mr Hobbs . The thrill of being able to think laterally and use human medicine to assist with this gorgeous bear was a truly amazing and unforgettable experience .