The Most Clever Gender

It doesn't seem to happen to women so much. I would even go as far to say that it may be a male genetic trait. If you are between the ages of sixteen and twenty-five, male and in hospital on a friday or saturday night, then there is a good chance you are an idiot.

Young Shaun had been having a good night out, until someone decided to smash a bottle over his head while he was walking home. "That's gonna need stitches" I said as I pulled the flap of skin back into place. I was examining the laceration on the back of his head and guessed three, maybe four sutures should do the trick. "Oh fuck, can't you just patch it, put a bandage on it. I gotta get going, I gotta get to bed." I shook my head. "Well, get on with it then, let's get it over with." Again I shook my head.

It was a busy Friday night and Shaun's wound would have to wait. Instead of suturing him up I placed some gauze over the wound and wrapped his head in a bandage. "I have some other jobs to do first. Shouldn't be too long" I said "What's your hurry. "I gotta go, I have to catch the last night bus home, I ain't got no money left" Shaun pleaded. He looked ready to cry. "I'll be back as soon as I can, don't worry, we'll sort you out" I promised and left to see my other patients.

Over the next half an hour I was approached four times by an increasingly impatient Shaun, desperate to get home. As drunk eighteen year old's go, Shaun wasn't too bad. He didn't swear too much, wasn't threatening, did as he was told, and wasn't bothering the other staff or patients and so I took sympathy on him. "Tell you what Shaun, if you wait until I can sort you out, I'll arrange for the hospital to pay for a taxi to take you home. We don't normally do this, but I can arrange it." Shaun didn't say antything, no `Thank you´ no sign of gratitude. He just shrugged his shoulders.

Half an hour later I returned to find Shaun's bed empty. The receptionist remembered seeing him leave out the main door, intent on walking home. Shaun was no longer my problem.

Half an hour later Shaun was brought in by Ambulance. "What the hell happened?" I asked Shaun as the paramedic wheeled him past me. "Got beaten up again" he said. That much was obvious as he now had two black eyes, swollen cut lips, and the bandage around his head was gone and his laceration was seeping fresh blood from under the paremedic's dressing.

Shaun waitied to be seen and treated this time. In fact he stayed with us the rest of the night and took up the offer of a taxi at seven in the morning, just as my shift finished.

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Ashtmatics Anonymous, part II

"Hold on a second, you come in here, two o'clock on a saturday morning, wheezing, coughing, smelling of booze, reeking of smoke and complaining that your asthma medicine doesn't work. And you say I'm judging you!" I only raised my voice a little. I could feel the adrenalin begin to surge in my veins, my haclkes beginning to rise, any thoughts of diplomacy evaporating. Darren began to protest, but I cut him off. "I then give you medicine, which you say doesn't work, and you say I've got an attitude." I turned my back on him, about to walk away.

"Hey, I'm sorry man" Darren called out. I turned around, looking at him expectantly. "I'm just so tired, sick of being sick" their was a note of desperation in his voiced. I softened my tone as I judged him ready to listen.

"How old are you?" I asked him. "Nineteen" he answered. "Do you live at home?" I asked. "Moved out six months ago. Living with some friends" he replied. "Were you always sick when you lived at home?" he shook his head. "How much and how long have you smoked?" I asked. He shrugged his shoulders, "Couple of years I guess, although only on weekends. That was when I was at home" he said. "And now?" I prompted. He shrugged his shoulders again, his body language trying to say, I don't care, but the incongruency between the visual and the spoken message was stark. "All the time, but it doesn' affect my asthma. The medicine just doesn't work anymore." I chose to avoid talking about the smoking for now.

"When did you last see your doctor. Maybe he could try you with some different medication?" I said. He looked at me in surprise "Two years, I think. What other medicine you talking about?" I went to the respiratory cupboard and took some of the various inhalers we had available and spread them out on the bed. "There's quite a few. Have you ever heard of a preventer?" He shook his head, "What exacatly do you mean by preventer?" I picked up the brown inhaler, "Just what it says, a medicine to help preventing you from having an asthma attack." He picked up the inhaler "It won't work on me. Nothing works" he moaned. It was time to get tough again.

"Darren, start acting like a bloody adult or move back home. Take some responsibility for yourself. Stop moaning and take some initiative. I'm not the person to tell you what you should do, and I'm not going to force you to see a doctor." Darren stared at me defiantly, "Fuck you. You can't speak to me like that?" I began to walk away again. "I just did. Get over it. Here comes the doc, don't be a stubborn idiot with him" I went over to the work bench and wrote down a number. "When you get out of here, this is the number for the asthma educator. It's up to you. Make the call. It may save your life. It's free as well" I handed him the slip of paper and left the room. I let the doctor know all that had happened.

Two weeks later, in a quiet moment in the emergency room, I made a quick phone call. "Who are you again?" Asked Sheila. "I'm calling from the emergency room. Just wondering if you've come across a guy called Darren Smith" I asked. "I'm not supposed to give out inforation" she said "Why do you want to know?" I briefly explained what had happened. "Yeah, I saw him, and I'll be seeing him again. He was a nice young man, he really seemed to appreciate all I did" there was a strange lilt in her voice, almost one of satisfaction, accomplishment, or maybe she even proud. "So you could do something for him?" I asked. "Of course. He was in a terrible way, but we've got him on the right track now." I thanked Sheila and hung up the phone.

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Asthmatics Anonymous part I

"It's always bad" Darren bent forward, hands braced on his knees, wheezed several breaths then continued, "The medicine never works." Not only was Darren's breathing wheezy and ragged, but
from the head down to his toes he looked unkempt, dirty, contagious even. His hair was greasy and uncombed, his face had at least a weeks growth. His clothes were covered with stains from at least several meals. Even his shoes had holes where his big toes were peering through.

"What medicine have you been taking?" I asked. He handed his ventolin (asthma) inhaler to me. "It's empty" he gasped "Ran out last week." I took a deep breath and sat down on his bed, a voice inside my head saying 'be patient, be patient' with the poor lad. "Ah, so your asthma has been bad for the last week?" I asked. He nodded his head. "And you haven't had any medicine in that time?" He nodded his head again. "Ah, can I ask why you didn't see someone sooner?" Darren kept his head bowed, unwilling to, or perhaps too exhausted to make eye contact "It's useless. Asthma medicine doesn't work for me." I placed a nebuliser mask over Darren's face, a mask containing the exact ingredients that he claimed didn't work.

Three nebulisers later and Darren's wheeze was much less audible and his breathing more relaxed. He was no longer sitting on the edge of the bed, hands on knees. He was able to sit back on the bed, although still in an upright position. A small victory, at least in the physical sense.

"I thought you said the medicine didn't work?" I kept my voice emotionless, as non-judgmental as possible. "The inhalers, they never work, I want what's in the nebuliser" he was able to look me when he spoke. "It's the same medicine" I replied "But you don't look like you've been looking after yourself. How much do you smoke a day?" His clothes reeked of smoke. "I didn't come here to be lectured. You don't know me, so don't judge me." Oh dear, to think I'm trying to be sympathetic, to think that this is his reaction to my nice side, how will he react when he sees my bad side?

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Surely I was never this stubborn???

I first met Shaun at seven o'clock the morning after his surgery. It was a Saturday and the ward was quiet, it looked like it was going to be a nice shift. When I saw Shaun he looked to be in pretty good shape as he was nibbling at something light for breakfast and keen to get moving. He seemed to have had no lasting side affects from his anaesthetic, in particular any nausea, and his pain seemed under control. This was a good sign, it's always good to get patients moving early, but I did warn Shaun to take it easy.

“Take it easy? The sooner I get out of here the better.” Shaun was determined to get out this damn place because it was “full of depressing old people.” I couldn’t do much about the fact that he was sharing a room with three older men, but it wasn’t so bad. Sure one of them had a touch of night time dementia and kept getting up during the night calling out for his long dead wife, but at least he wasn’t in the women’s room. Any time anyone walked into the women’s room Mrs Stewart, the 85 year old nun on prescribed bed-rest because of leg ulcers, kept on calling for us to stop touching her in naughty places.

The first thing that Shaun wanted to do that morning was to have a shower. “No problem Shaun” I told him, “but are you sure you are up to it? Why don’t you wait until a bit later in the day, you’ve only just come out of theatre.” Shaun was not going to wait. I then suggested that he use the large shower room that has a chair in it that he can use, but he would have to wait half an hour as other patients were booked in first. Of course Shaun was not willing to wait; he was determined to use the normal size shower with no seat inside. I suggested to Shaun that this was perhaps not the best idea as the shower is hot, steamy, cramped and with no ventilation, he would probably pass out. Shaun seemed to think that he knew what was best for his body and ignored my advice, he was oblivious to reason.

From past experience I knew to wait outside Shaun's shower cubicle. Five minutes later I heard a ‘thump’ followed by a squealing sound that comes when skin rubs against wet plastic. These were the sounds of Shaun first hitting the wall and then sliding down the wall to lie in a tangled heap on the shower floor. As I helped bring him round I conveniently happened to have a bowl in my hand which Shaun promptly threw up into. I popped him in a shower chair and wheeled him back to bed. He was so pale that he would have made a ghost look tanned and he had broken out into a cold sweat.

As awful as Shaun looked it was nothing serious although I made sure he hadn’t done any damage to his would. Thankfully he hadn’t but he was in quite a bit of pain, what a surprise. I didn’t even pretend to feel sympathy for him but did give him some paracetamol.

Even though an appendectomy is quite a minor operation, it still takes a toll on the body. Not only have you been sliced open and had some innards taken out, the effects of a general anaesthetic can take its own toll on the body, even if you feel well. I have not had this problem with older men or woman of any age as they seem to listen to advice.

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Young men and other idiots

It is not too often that you come across young men or teenagers in a general medical or general surgical ward, but it does happen, and it usually happens for quite different reasons than those of a more mature age.

If you are between the age of sixteen and twenty eight, male and in hospital, then there is a good chance that you're an idiot. If you are between the age of sixteen and twenty eight, male and in hospital on a Saturday night, then you are definitely an idiot. It wouldn't surprise me that one day scientists discovered a gene for male stupidity in the hospital environment. Most times this seeming inborn idiocy is a great source of humour for hospital staff, but unfortunately these outbursts of idocitic behaviour are not always humorous because sometimes they cause harm.

As a general rule most people don’t really know exactly what to expect when they end up in hospital, and teenagers, and slightly older but still young males, are no exception. The lads don't really have a clue what to think as they sit in their bed surrounded by veterans from world war two. They even look slightly out of place. But it is sometimes nice to have a young patient in your care, as they do tend to be much more independent and mobile, and do not have the often heavy needs of an elderly patient. But they still need to be watched carefully, as they pose their own unique hazards.

Shaun was eighteen years old and had presented to the emergency room with generalised abdominal pain. He had a fever and as time went by the pain gradually became more severe and it also done something rather strange; it moved to the lower right side of his abdomen. At this stage a diagnosis was pretty easy to make and anyone with even a little medical knowledge should know what was wrong. At ten-o'clock that same night Shaun was taken to surgery where the surgeon opened him up and snipped out snipped out some innards. The surgeon said he was a very lucky young man as his appendix was very close to rupturing.

I first met Shaun at seven o'clock the morning after his surgery. It was a Saturday and the ward was quiet, it looked like it was going to be a nice shift. When I saw Shaun he looked to be in pretty good shape as he was nibbling at something light for breakfast and keen to get moving. He seemed to have had no lasting side affects from his anaesthetic, in particular any nausea, and his pain seemed under control. This was a good sign, it's always good to get patients moving early, but I did warn Shaun to take it easy.

“Take it easy? The sooner I get out of here the better.” Shaun was determined to get out this damn place because it was “full of depressing old people.” I couldn’t do much about the fact that he was sharing a room with three older men, but it wasn’t so bad. Sure one of them had a touch of night time dementia and kept getting up during the night calling out for his long dead wife, but at least he wasn’t in the women’s room. Any time anyone walked into the women’s room Mrs Stewart, the 85 year old nun on prescribed bed-rest because of leg ulcers, kept on calling for us to stop touching her in naughty places.

The first thing that Shaun wanted to do that morning was to have a shower. “No problem Shaun” I told him, “but are you sure you are up to it? Why don’t you wait until a bit later in the day, you’ve only just come out of theatre?” Shaun was not going to wait. I then suggested that he use the large shower room that has a chair in it that he can use, but he would have to wait half an hour as other patients were booked in first. Of course Shaun was not willing to wait; he was determined to use the normal size shower with no seat inside. I suggested to Shaun that this was perhaps not the best idea as the shower is hot, steamy, cramped and with no ventilation, he would probably pass out. Shaun seemed to think that he knew what was best for his body and ignored my advice, he was oblivious to reason.

From past experience I knew to wait outside Shaun's shower cubicle. Five minutes later I heard a ‘thump’ followed by a squealing sound that comes when skin rubs against wet plastic. These were the sounds of Shaun first hitting the wall and then sliding down the wall to lie in a tangled heap on the shower floor. As I helped bring him round I conveniently happened to have a bowl in my hand which Shaun promptly threw up into. I popped him in a shower chair and wheeled him back to bed. He was so pale that he would have made a ghost look tanned and he had broken out into a cold sweat.

As terrible as Shaun looked it was nothing serious although I made sure he hadn’t done any damage to his wound. Thankfully he hadn’t but he was in quite a bit of pain, what a surprise. I didn’t even pretend to feel sympathy for him but did give him some paracetamol.

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GDGAPW Syndrome

GDGAPW ??? Well it's a very common syndrome affecting young males, especially those in their teenage years. I've seen so many teenagers with this syndrome that I'm beginning to wonder if it is genetic, although I must say that I must be missing this gene. So what does GDGAPW stand for?

Get drunk, get angry and punch wall syndrome. The W can also stand for window. We had an eighteen year old boy come in one Friday evening after punching a window. You would think that the window would come off second best, but you'd be wrong. He suffered a very small laceration to the inside of his wrist. It was such a small cut that he wasn't going to come to hospital, except the sensation in his hand had changed. Little did he know that his budding career as a rugby professional would come to an end.

The thing about rugby is that you need to be able to catch the ball and this young man was left with little-no sensation in a large part of his right hand. He will still be able to play rugby, but probably not at the top level.

The hardest part about this whole episode was watching as this realization came to him. As hardened as we nurses often come to alcohol related injuries and the stupidity of the average male, I couldn't help but feel deeply sorry for this young man. We've all made mistakes, and most of us are lucky. This young man said he had never done something like this before, and that he never would again.

It hurts when we don't get a second chance.

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Punch up in the ER

As I jumped onto the back of one of the biggest guys I've ever seen, I wondered if I was going to make it out alive. But the guy had my friend and colleague, Damien in a headlock and was going to ram him into the wall.

Forgotten was the fact that this was a hospital, that this was the emergency room where we are supposed to help people, save lives and all that other wonderful stuff. This was a damn brawl like you'd see in your average pub on a friday or saturday night.

The good news is that the giant released my friend, the bad news is that he went for me.

I'm not afraid to run, and so I did, straight behind the ranks of security guards. "Why the hell didn't you help me?" I shouted at them. "We're not supposed to use force" was the reply. Meanwhile, the giant could see that he was outnumbered and bolted for the door.

His timing couldn't have been better because he ran straight into half a dozen friendly police officers. Thank goodness the receptionist had phoned the police at the first sign of trouble.

And how did it begin, well it was the usual story. Alcohol. The giant that the police were escorting away had got in a fight, received some nasty laceration which would need some sutures, and called an ambulance. He was angry at the paramedics for taking so long, (they were there in seven minutes) and when he came into the emergency room he didn't like being told that he should stop using the F... word, even when I explained that we had young children here who could hear him.

Hopefully he'll spend some time in jail, and maybe even have to pay us some money.

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Tips for young, male adults in hospital

If you are a young male adult in an emergency room, then there is a good chance you're an idiot.

If you are a young male adult in an emergency room on a friday or saturday night, then you're most definitely likely to be an idiot.

But there are a few rules that young males can follow to make their stay easier:

1. Don't chat up the nurses, you are most likely drunk, or sick, and definitely not looking your best
2. Never grope, grab, fondle or otherwise get too close to a nurse as we can and will add an extra medication that totally kills your sex drive.
3. Do not invite your girlfriend to join you in bed for a quick romp, as this is gross and it is offensive to the other patients in the room.
4. Don't bother saying you are afraid of needles. Your body is covered in tattoos in some of the most sensitive areas, and besides, no one likes injections, so get over it.
5. Never threaten, or use bad language We will take you to court.
6. Act like a normal human being for once in your life and be nice. Being nice makes it easier for everyone, especially you.

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