As I dressed for work yesterday, I gave myself a little pep talk:
"Come on, it'll be good to see everyone there."
"I'm sure your brain hasn't really atrophied during your four weeks off work."
"It'll probably be an easy morning; stop getting your knickers in a knot!"
Armed with a suitably perky smile, I strode into work, greeting various other staff members, and replying that yes indeedy, my holiday HAD been good. Very good. Too good!
The morning was running pretty well, and I was beginning to relax, when I called in 'Jenny'. She looked uncomfortable yet sheepish at the same time, as she explained she'd had this chest and left shoulder pain since yesterday afternoon. "I'm sure it's just a pulled muscle, but, you know, dad was only 62 when he died of a heart attack".
Right. "Let's just go get you on some oxygen," I suggest firmly, leading her to a treatment room. In many ways, a patient having angina or a heart attack is a straightforward scenario to manage (unless they go into an life-threatening arrhythmia or actually arrest in the surgery- which luckily is not too often). You have a certain formula to follow - check this, give that. Of course, as a suburban GP, there is one vital action to be taken - something a good doctor learns early, something that requires great wisdom and intellect. Want to know this most important step? Oh, alright, I'll share the secret. In an emergency, the most crucial job is .... asking the receptionist to call an ambulance. Pronto!
The ambulance arrived, with two burly paramedics. I had been about to insert an IV, but seeing as the paramedics can do IV's standing on their heads, and considering I only insert an IV about once a year (if that), I let them take over. Unfortunately, Jenny had tiny veins, and when one of the ambulancemen tried to put in a drip in Jenny's hand, it went right through the vein.
Now usually I am not especially confident as a doctor, and I would never put myself forward to take over a situation. But it just happens that the one procedural skill I have always been good at is inserting IVs. Even as an intern, I would be called to do the difficult drips. Once, a third-year resident saw me passing near the emergency department, and despite that fact I was on a day off, and was wearing a checked flannel shirt, called me to try to insert a drip in the arm of a large Fijian lady who'd already been 'stabbed' by various doctors half a dozen times (I don't know what the poor lady thought of the lady lumberjack who was poking her with a needle, but I got the drip in!) So it was very unlike me, but when the paramedic started talking about trying another vein in a position where the drip will often block up or fall out, I tentatively approached. "What about this vein here? I could have a try, if you like", I offered. "Sure doc", one of the ambulancemen replied. Now I really felt under pressure. Trying to get a wide needle into a small vein - was I going to stuff this up, and feel like a real goose?
No! I didn't stuff it up! Hooray and hallelujah!
It's amazing what a buzz I got from such a simple task. I can't explain why I should feel so pleased about such a silly thing. I suppose when skills don't get used, you wonder if you still have the skills at all. But it's OK. I can still whack an IV in.
And all of you who have nodded off can now wake up. This post is over!