I start my Friday morning with a cup of my favourite espresso. Today feels a bit different from the usually days. Maybe because after a long time, I am going on a date.
Her name is Lama, she is Lebanese and I am quite fond of her. For a long time when I heard the word “date”, I automatically thought of the sweet delicious fruit that comes from the Middle East. That is how long I have not gone on a date.
It is 8:55 am and my pager is ringing. I go down to the ER, Emergency Room. I am briefed about the condition of Jerome, a 35-year-old, African American who is overdosed with cocaine. The ER team has given him activated charcoal, to reduce the drugs absorption. However, the patient's condition is not improving.
Despite being a surgeon, I always loved pharmacology, the study of drug actions. This case had was sepcially interesting because it involved both my loves — surgery and pharmacology.
Cocaine is a potent vasoconstrictive agent. That is, it cuts the blood supply to the major organs shutting them down one by one and leading to a condition that we call “shock”. If not treated the condition is deadly.
In the case of Jerome, his condition was worsening by the minute. The ER docs think that the problem is in Jerome belly. Cocaine may have cut off the blood supply to his intestines and if not operated upon, he could die.
I take my stethoscope and examine his belly looking for bowel sounds. A healthy intestine makes healthy “crackling” noises. In Jerome's case he had no bowel sounds. That is when I made my decision to operate.
In the operating room I make a ten inch cut starting from below his sternum (breast bone) all the way to near his naval. After I open his belly I practically take out his intestines and put them on the table looking for the potential dead areas. Soon I found it. An area that clearly looks black and definitely “dead”. I cut out the dead tissue and reconnect the healthy portion of the intestine back together.
In a matter of minutes Jerome's condition improves. I know once he is out of this hospital, he will probably take more cocaine. But I can't worry about people's actions. I should only do my job to the best of my abilities and move on.
I finish my shift at 7. I go home and look forward to having a date. I feel like an 18-year-old all again.
