Bloodlust

Okay so tonight's hospital was sixth floor of Batnah Hospital. The attendant greeted us in and chaperoned us to the last room where the doctors had gathered to perform a landmark-guided central line insertion in a lady with hepatic encephalopathy.

Wooh. Blood blood. Calm down, don't smirk excited, they might refer you to Psych.

The attending doctor was at the head of the bed in a sterile gown and all. I stood on the right side of the patient and halfway done was told to resume restraining the patient's arm.

So the question is. May I consider myself have assisted a central line insertion or not? May I tick in my Batnah student logbook? Haha.

Anyway, the procedure reminded me of a story Dr. Ayman Gado told us, about a resident in the ER flabbergasted when his young chest trauma female patient was asystole and he needed to give her adrenaline but the central line had somehow dislodged. Her big burly father was outside and menacing and if his daughter die, the poor doctor will be dead too.

"Ha'mil eeh ha'mil eeh!"

Give it through her ETT while waiting for a senior to set a new line. Need three times the normal dose, put some saline with it and proceed with ambu. Although the 2010 ACS Guideline says ETT route is dubious, alas, better than nothing.

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So tonight there was me Umair Syaimaa and Iskun. The three of us girls were in the same General Surgery class and so we made reference a lot to Dr. Refaat Afif while history-taking.

"You forgot to ask blablabla. You'd get slaughtered by Dr. Refaat."

"The other day we answered incisional hernia's types were paralytic and defective because we didn't remember the name of the second type but there was a defect in the wall so why not defective, and his reply was "What defective? Are you a medical student?" Hahahah!"

"Hey don't forget this point. I got killed the other day because I forgot this."

"Okay Umair present the case. I'll be Dr. Refaat."

"... living in Ain Shams..."

"And where was she born in?" With a soft but there was the unmistakable predatory tone.

"I forgot to ask, sorry doctor."

Strike one. And so forth we kept attacking and questioning our reasoning and ripping our basics apart to come out on the more enlightened side. Finally at the end of the night Iskun who was in another class commented that we had a really tough doctor in our class, as opposed to his.

"Yeah it's a real slaughterhouse. Join our class if you want, he teaches every Tuesday. Come before 12 though."

"Why?"

"He'll divide us according to beds available and you'll have like fifteen minutes to take the sheet. Then everyone will gather at the first bed and a person from the group there will present the case and then be killed. Examination and further killing. Discuss management. Move on to bed two and another person will be killed. A ward round."

Somewhat Dr. Refaat-obsessed. We were killed but we learned a hell lot and that's why he had such a huge impact on us "useless white-coated harmful organism" (quoting the epitome of legend Dr. Hosam Mowafy). I'm always a little scared at the prospect of his class but more than anything I'm looking forward to it. When else did you get the chance to really stand up to a doctor who will hit you with his best ques and you have to stand firm, remain calm with everything that you know. Take his shots with confidence however misguided for he will definitely guide you then. This is the time to die and resurrect again and again.

Definitely looking forward to it. I hope I still have plenty of lives left.