Agraphia Medical Tragicomedy



"I'm really anxious about this procedure," he said, "can't you just knock me out for it?"

He wasn't just anxious. His hands were trembling, the telltale shakes of the withdrawing alcoholic... perhaps a clue as to why he stumbled in the first place, shattering his ankle. The ankle was in bad shape - both fractured and dislocated - and needed to be fixed.

Setting this particular fracture is extremely painful, and he would need to be sedated heavily. The chronic alcohol use would complicate things, but he denied any other drugs except chew tobacco.

Airway equipment? Check. Monitoring equipment? Check. Orthopedic Surgeons? Check.

I start with a dose of Versed and Fentanyl and he goes glassy-eyed, until the orthopods start going at his foot like a pack of wild dogs to a hunk of meat. He starts howling and I quickly push more meds.

And then, something goes wrong. He starts gurgling and a thin, reedy trail of dark spittle traces down his cheek. The oxygen levels in his blood begin to fall, fast. My heart starts pounding. This isn't supposed to happen. This is never supposed to happen.

I reach for the breathing tube, pause, and think better of it. I check his mouth - pooled in the back of his throat is a copious amount of discolored saliva. He's drowning on his own spit. I've never seen this before, but he reeks of alcohol and nicotine.

I go back in for another look and suddenly it strikes me that there is something wrong with his lip. I swipe my finger between his gum line and promptly pull out a huge wad of dip. No wonder he was salivating like crazy. I've seen patients do some dumb shit, but this... well, this takes the cake.

They say nicotine kills. In this case, it almost did.

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  1. Great as usual. Thanks for sharing. It gives us lowly MD1’s something to look forward to.

  2. That is totally revolting. Thanks for sharing.


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