My First Clinical Rotation

Hospitals on TV are so unrealistic – it’s far more crazy in real life.

During my college years as a pre-med student, I came in contact with lots of wanna-be doctors.  Almost invariably these people would say that the TV show ER played a big role in their career decision.  Needless to say, it didn’t take them long to switch majors once they realized that organic chemistry wasn’t nearly as dreamy as George Clooney. I can’t tell you how many times I’ve heard a professor or doctor, in an attempt to discourage these people from wasting their time,  tell a group of students that the field of medicine isn’t anything like we see on TV.  And after experiencing life working in the hospital first-hand, I couldn’t agree with them more… 

Real life is far more insane.

For three weeks this summer, I rotated as a medical student in the trauma department of a hospital.  I got 100% full access to everything that goes on after the ambulances pull-up, and let me tell you that you’ve never seen anything like this on Grey’s Anatomy.  The following are all true stories of things that happened during my THREE WEEK rotation.  I can only imagine what the other forty-nine during the year are like. 

My first really "big" trauma was a gang member who got shot in the chest.  Pretty intense, but pretty common.  Honestly, things played out very similarly to how they do on TV, with one foul exception:  Gunshot poop. (I can say with all certainty that Dr. Kovac never experienced anything like this.) It’s a little known fact that people have a tendency to defecate when shot. So being the newbie I was, it was a fairly big surprise when the trauma shears cut off our patient’s pants and revealed a rather aromatic gift.  And I do mean AROMATIC.  If regular poop is a water pistol, then gunshot poop is bazooka.  Now add to that the fact that we needed to roll this guy over eight or nine times to check his spine, put him in the CT scanner, etc… After it was all said and done, I wasn’t sure if we had just saved a life or participated in a mud-wrestling tournament. Just like on TV, right? 

Another thing you never hear is that every time there’s even the slightest possibility of a spinal cord injury, a rectal examination needs to take place.  As daunting as this sounds, there is a silver lining to this dark cloud.  You see there’s comedy, there’s high comedy, and then there’s a shocked 20 year old screaming at the top of his lungs "OOOOOH!  WHY’D Y’ALL DO THAT FOR?  YOU DONE STOLE MY MANHOOD!  THAT’S WRONG!  THAT’S JUST WRONG!". 

Other interesting cases include…

The guy who was driving on the highway at 65 mph, who suddenly felt the urge to leap out of the car.  Can you say road rash? 

The badly beaten man whose last memory before blacking out was a guy on a bicycle and seven women. 

The prisoner who escaped from jail by climbing underneath a truck and hanging from the bottom.  He made it twenty miles before losing his grip.  The next morning he was found crawling along the side of the highway.  At that time, the police were still unaware he was missing.  After putting the patient in the CT scanner, we noticed an abnormality in his pelvis.  This convict also had a present for us.  No, not more gunshot poop.  This time, it was drugs. 

The man who somehow snuck out of his room, found a pair of scrubs, took the elevator to a different floor, and proceeded to pose as a doctor to other patients and ask for "sexual satisfaction". 

 The man who was shot twice, once in each leg, who managed to run from his attacker for five blocks before being pistol whipped.  When he arrived, he was asked to open his eyes.  He responded by saying that he couldn’t. We incorrectly suspected neurological damage.  To make a long story short, his glass eye was found at the scene of the crime the next morning. 

The guy who tried to hang himself, introducing me to yet another variation: Hanging poop. 

Apparently, throwing yourself from a moving vehicle is becoming a very popular thing to to, as it happened again.  This time, it was a heart-broken Ecuadorian soccer fan who couldn’t bear to go on after his country had been eliminated from the World Cup. 

The man who was dead on arrival, who we later found out was the second of three witnesses to a murder who had been killed.  Glad I’m not the third guy.

To keep this PG, I’m going to use the term "playing tennis".  Feel free to assume what I’m really referring to. You’ll be correct.  Anyway, a guy came in with a ruptured spleen after playing tennis with two of his female roommates.  How one ruptures a spleen while playing tennis, is still a mystery, but that’s what happened.  While recovering, the patient was visited by a resident who knocked on the door to his hospital room before entering.  Much to the resident’s surprise, the patient was once again playing tennis, this time with a woman who was not his roommate.

The man who allegedly was sucker punched coming out of a Subway by someone who wanted to steal his sandwich.

The guy who jacked a car using a sawn-off shotgun and subsequently crashed the car into a pole.  After fleeing the scene, it dawned on the criminal that he had left his shotgun in the stolen vehicle.  He quickly returned to correct his mistake, only to accidentally shoot himself in the foot with shotgun while running away. 

And as the grand finale to this experience, I was the lucky student on call when Gang War III broke out.  Due to a massacre that got national new coverage, we received twelve gunshot victims as well as several other injured parties in the span of two hours.  Talk about gaining experience quickly!  The two most notable events of the evening were the following:

1. Discovering the last member of the unholy trinity: Stabbing poop.

2. Operating on a guy who had been shot in the abdomen.  He was one of the first to arrive. So as we were patching him up, our beepers kept going off, alerting us of all the incoming trauma.  "Gunshot wound to the chest", "Stabbing to the back", "3 gunshot wounds"… 

Eventually, we had so many critical patients, that the attending surgeon had to leave to take care of patients whose lives were more at risk.  That left the resident and myself to close up the incision.  However, the guy’s abdomen had swelled so much from the trauma, that we couldn’t get his intestines all the way back in. 

The standard care in that situation is to slice open an IV bag and sew it over the open wound to provide protection until the swelling goes down.  Werid, I know.  But that’s actually what you’re supposed to do. 

The only problem with this is that it takes a long time to do, and time was of the essence.  As we were closing up, attending surgeons kept poking their heads into the room and yelling at the resident to hurry up because their were people were going to die if he didn’t get to them soon.  Eventually, this cause d him to drop the needle and say "I got to go. Somebody finish for me."

At this point, that left me.  I can’t sew. 

Thankfully, the anesthesiologist stepped up to the plate.  A good move, seeing as he’s actually a doctor, and I’m not.  So I got to hold the intestines in place while he finished up. 

Let’s see Noah Whiley do that!

Overall, those three weeks were an incredible experience.  I saw people whose lives were saved, and I saw people lose them.  But no matter what the outcome, every person who came through those doors got the best chance we could give them.  And that’s what makes you feel good at the end of the day.

In closing, I’d like to offer some advice to everybody who reads this.  About 90% of everyone who comes to the trauma service has had involvement with one of the following things:

1. Alcohol/Drugs

2. Gangs

3. Motorcycles

4. Ladders

So as a word to the wise, think twice before you participate in any activities involving those things.  And under no circumstances should you ever let a drunken gangster drive you up a ladder on a motorcycle. 

That’s just asking for it.

About Derek Hanson

Doctor by day, blogger by night, Derek Hanson is the founder of the Bloguin Network and has been a Patriots fan for more than 20 years.