So I'm shirtless and it's cold... almost time for a coffee. But before I could, I needed to check that I was really awake, that the reality does exist. I turned around and saw her: my beautiful wife, curled up on her side. It looked like she was smiling as you would when you have a pleasant dream and you mumble a few words at best, but they make no sense anyway. Then I knew I was awake - it was her hemiparesis playing up. That was confirmed by the spastic paralysis of the part of her forearm I could see - pronation of the proximal radio-ulnar joint and palmar-flexion at the wrist compounded with flexion of all proximal and distal interphalangeal joints. I was definitely awake now. The clinical mindset was established well before I closed the bedroom door behind me.
It's 0638 and the first lot of patients will be arriving at 0730. My sister-in-law drives the kids to school on Mondays because my baby can't anymore. The coffee's way too hot and it's almost 30 degrees outside. Monday mornings are always hectic because the practice is closed on Sunday. It's always the longest day of the week... always.
Working out what tie to wear with the shirt I snatched blindly out of the closet is the easiest decision to make for me: I just don't wear one. Fuck that. I can't be bothered working out what piece of material matches the other.
Good; I'm in my car and the time reads 0647 on the dashboard, which is fast... or my wristwatch is slow again. Time is always relative but regardless of whether I'm ahead or behind schedule, I'm still speeding. Traffic laws are made to obstruct traffic and some of us agree that they are made to be broken. Plus I've got patients waiting; they're probably outside.
The anticipation is always the same when I walk towards the front door - the receptionist has opened and patients are lined up at the desk; or I have forgotten my keys and people are waiting outside. Today was the former; always good not to wait awkwardly with patients outside. You know they are there to see you and somehow they all expect to be triaged while you're waiting for the receptionist to arrive. "First come, first served dude."
A few dozen patients later and the time is reading 1103, which means the drug rep will soon be around with some morning tea. As a doctor, my job was to eat their food and pretend to be interested on the outside; laugh out loud on the inside. Their advertising campaigns don't entice me, but I do enjoy their food.
Back in the office now and it's time to continue with the consults. I call the next guy in and walks awkwardly with a bag in his left hand. Adam has schizophrenia and he complains of a dry mouth. I tell him that this is common with his medications and that there's little I can do other than give him some drops or lozenges. My glasses remind me of my age and the use of my index fingers to type reminds me of my old-fashioned urge to toss the computer at the wall and write with a pen on a piece of blank paper.
While I'm tediously typing up his prescription, I hear a zipper that I presume is Adam opening his bag so that he can put the prescription away and so I continue swearing under my breath at the typo's.
All of a sudden *thud* - a pain on my back. Hmmm.. that's odd. Then *thud* and again *thud*. What the fuck is this pain all of a sudden? I try to ignore it while I type and then three quick ones...
*Thud*
*Thud*
*Thud*
I turn around and realise it's Adam and he's holding a knife that's dripping fresh blood over the floor. It's my blood. "Get away from me!" I yell and fall onto the ground. He advances towards me and I kick him back with my left leg. Adam stands still while I start gasping for air and he calmly picks up his bag and starts walking out of the room without the prescription.
"HELP! Stop him!!" I yell at the top of my lungs and realise they're probably collapsing. I shouldn't test them right now. The other GP comes out and sees the trail of blood off the steak knife Adam's holding. "Stop right there!" he orders and Adam, being a psychiatric case, turns around and says "Okay."
"Sit down and drop the knife!"
"Sure. No problems here."
The ambulance arrived and the paramedics rushed in to find me on the floor. The other GP was making other phone calls to the police and what not. I'm hoping he's calling my wife but I can't be sure. We're not on very good terms anyway. They help me up onto my own examination bed and start doing my vitals. My blood pressure's dropping and my pulse is going sky high. Typical signs of hypovolaemic shock and I'm still not feeling delirious - this sucks.
"Doctor, we've got some IV saline the ambulance that I want to hook up to you before we make our way to hospital so I'll insert a cannula."
"Just do whatever you need to do. You've got my full consent - don't stop to explain shit." The paramedic nodded and went to insert an IV line; he missed and it hurt.
He missed again and I'm wondering how much time has passed since I've started bleeding. Finally, on the third attempt, he flushed it through successfully. "I was just about to offer a hand," I said sarcastically. He laughed back nervously.
48 minutes later I was in the emergency department getting resuscitated. I remember all this because I didn't lose consciousness and was already hooked up to a bag of salt and water to calm my circulation's emotional response to this God-awful situation.
Next thing I know, I've got a few specialists lined up introducing themselves as a general surgeon from here, a vascular surgeon from there and a thoracic surgeon from up somewhere else. "Okay, can we get on with it?"
Then finally the chick that mattered finally showed up - the anaesthesiologist. "Fuck, about time man."
"Yes, we're wheeling you up to theatre now. I'll intubate you there. Here's some midazolam to sedate you now." Before I could say anything I was off in sedation land - a land established simply by a pause in the last thing you remember until you wake up. Incredibly confusing.
Waking up in ICU and realising I was the patient was quite interesting - I was wondering what the hell all the lines were on my chest until I realised that, once again, I wasn't dreaming. My wife was there with my eldest daughter. They were both smiling at me and crying... as they would.
I've been looking after God's work for 30 years; his creation that is people... his functional creation. Living an honest life, delivering care and raising a family are hard to juggle. My faith has only recently been shattered.
My wife had a stroke.
I diagnosed my father with Alzheimer's disease and my mother with end-stage kidney failure. She's on dialysis.
I've got 2 mortgages, 2 car loans and 4 children that go to private schools.
And now, I'm in a position where my whole life has to be put on hold and I am physically and biologically prevented - I cannot sustain my normal activities for now. Maybe never. Who knows?
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