New Medical Noir: Broken Bones

I wanted to do something different.

I’ve written medical essays just for random fun (The Most Unfeeling Doctor in the World). I’ve written about medicine and women and sex (Fifty Shades of Gray’s Anatomy). I’ve written about surgery (The Unfeeling Wannabe Surgeon) and medical school (The Unfeeling Doctor, Unplugged). I’ve written about medicine and Buddhism (Buddhish: The Unfeeling Doctor’s Freefall into Buddhism, Grief and Grace), my own struggle with infertility during my father’s cancer diagnosis and treatment (The Unfeeling Doctor Betwixt Birthing Babies: Poems About Love, Loss, and More Love), and travelling to Africa (The Knowledgeable LionPoems and Prose by the Unfeeling Doctor in Africa). Now what?

It came to me while I was editing out the swearing. Patients swear a lot in the emergency room. I swear under severe pressure, like when they’re dying on me. And it occurred to me that I didn’t want to bleep out the curses for this book.

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I wanted to write about the underside of the ER. No more cute, no more hee hee, no more family-friendly rating. Well, I still have my family, and I always try to laugh. (“I like that doctor. She smiles!” announced one patient.) But more gritty and realistic this time. More blood and barf. Medical noir, to coin a term.

So Broken Bones is about breaking bones. And bleeding brains. And broken people, really. Maybe including myself. I still think it’s sort of funny, but often, I laugh and no one else does.

Caveat emptor.
brOKEN bones with subtitle short
E-book and print available. Audio coming soon!unplugged cover tintin-200
This is the most downer essay in the book. The rest are about medicine and, er, the naughty bits.

unfeeling surgeon doll BROWN EYES

 

betwixt cover black-200lion africa cover big 72 res daishoP.S. I’m back from my secret deal! I got to hang out with beautiful people and try zip lining 14 stories high at the CNE. I will spill every bean on September 5th. Pinky swear.

My new favourite medical show

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People used to ask me, “Is ER realistic?” and I’d say, “Kind of.” I only watched it a little, but they cut out the boring bits (“Two hundred! Three hundred! Three sixty!” when resuscitating a patient in VFib who didn’t come back right away, and I was like, “Where’s the CPR? What about the drugs?”) They added human interest elements, like educating kids about sex in the middle of the ER, that just don’t happen for me.

I did like Grey’s Anatomy, but the medical part never convinced me. Once I rewound three times to look at a CT and complain to my husband, “I don’t think it shows a bleed!”

I liked Nurse Jackie the best, but obviously, she was over the top. That whole flushing a patient’s ear down the toilet thing should have tipped you off.

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But Emergency Room: Life+Death at VGH is the real deal.

It should be. It’s a documentary. But this one captures the stories, from multiple angles: the patients, the doctors, the nurses, the respiratory therapists, the social workers. Patients die. (On dramas, so many patients survive miraculously just in time to close out the show, and I kind of roll my eyes.) People and staff aren’t always gorgeous, although I have to say that Vancouver seems to be filled with beautiful people. Crap happens: multiple trauma patients. Multiple bariatric patients. But they also cover less dramatic stories, like a cut hand and a girl with a connective tissue disorder.

On a medical geek level, I really like that the patients give a bit of history, and then the diagnosis flashes on the screen. For me, I can mentally compare my diagnosis with theirs, like a medical game show. I see a knife in the chest and think, “That’s a surgical case,” or I think, “Why would you airlift those fingers?” and give myself a checkmark when they agree with me. And when they show X-rays, the humerus really is broken. It’s not just something the prop people whipped up and might have gotten wrong.

It’s also a great peek into another emerg. I work in two community hospitals, not Level I trauma centres, and even when I did, the Montreal General Hospital was more like car crashes and that sort of thing. VGH regularly handles stab wounds (no gun shot wounds so far, though), ski accidents, and “ped strucks,” pedestrians struck by cars. (Made me realize how much people drive around here, instead of walking, although, to be fair, it’s snowing again.)

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I, too, was amazed by the intensity of their cases. My friend Cara used to say to our friend Anna, who now works at VGH, “Anna, I feel like you’re in university and I’m in kindergarten.” But I was also envious of their personnel and organization. Excellence all the way. “Activate the trauma team.” I am the trauma team. I mean, me and the nurses, the ERA’s until 10 and RT until midnight, but we don’t have dedicated specialties in-house in the middle of the night. We are it. My smaller hospital has only one doctor and one nurse in the ER for the night shift. So if you’re wondering why you have to wait, that’s why.

VGH actually has a protocol for a lock down during violent cases, which sounds like a good idea. And all they have to do is say, “We’re on lock down.”

Emergency Room: Life+Death at VGH also captures the little things beautifully: a shrug, a raised eyebrow, a resuscitation room empty except for a few gloves littering the floor. The jokes (“I had a woman who vomited into her hands and then ate it.” “Hey, why waste it?”) Their philosophies (“I think of the emergency department as a living organism.” One doctor said that working with patients was sacred).

As a writer, too, I love seeing how the show draws you in, spins a story out, and makes you care.

When my kids grow up a bit, I might try and renew my privileges at a tertiary care centre. In the meantime, I’ve got to watch four more episodes of Emergency Room: Life+Death at VGH.