Friday, June 10, 2011

my gray's anatomy moment

no, this is not a post about steamy call room sex, but i did have one exhilarating moment when, with only the right background music, it could have been a scene straight out of gray's anatomy.

i was on the nephrology consult service.  we were making our afternoon rounds, following up on labs and tests, and checking in on patients.  we came into the room of a young man who had had a biopsy of his transplanted kidney earlier that day.  he was lying quietly in his bed.  he looked a little pale.  actually he confessed, he was having  pain in his left side and it was gradually getting worse, is that normal?  as we helped him sit up to listen to his lungs, he fainted.

the kidney is a hard working but delicate organ, filtering up to two hundred quarts of blood each day, keeping the good and allowing the bad to pass through to the bladder as urine.  i think of it as one of those finely strung fishing nets, the fish stay in and the flotsam and jetsam pass through. or you could think of it as the person in the back of the goodwill, accepting all the donations then sorting through them, keeping the good stuff to display in the store and tossing the rest in the trash.  because the kidney is so richly vascular, a biopsy is a tricky thing.  passing a needle through some one's flank to take a sliver of kidney carries a real risk of hemorrhage.  and that is exactly what our young man was doing.

we miraculously had on the floor a handheld doppler, so we used it to confirm our suspicions.  somehow, as we were pressing the transducer against his abdomen, we realized that with the right amount of pressure in just the right place, he stopped bleeding.  that is where i came in.  we needed to get him to the OR quickly and with the least further blood loss possible.  i was the smallest one there, so i climbed onto his bed kneeling next to him and holding pressure against his abdomen as we rushed him and the whole giant entourage that had now formed to the OR.  we raced down the hall, my hair blowing back away from my face, my eyes bright with just the right mix of fear and determination.  okay i'm making that last part up about my hair and my eyes, but either way, it was quite a sight.  and more importantly, our patient did fine.

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