Tuesday, January 18, 2005


Back amongst the living.

Last time I mentioned needlesticks. I've had three, including the current one. I don't know if this is worse or better than average, I suspect it's worse. Most people I know have had one, most consultants have had several.

The first one was in medical school, final year. I was on the general medical team, with a small Asian man who liked listening to Amy Grant and a hatchet-faced red-headed woman who voted to send Asian refugees back where they came from and whose husband was going to reward her with ten thousand dollars worth of plastic surgery for finishing medical school (both of these are true - Amy Grant - I swear it).

Anyway, I had to take blood from an eighty eight year old English woman. She was normally very placid, but she had developed a urinary tract infection and was "confused". I use inverted commas because while we believed that her urinary tract symptoms on top of her pre-existing dementia had caused an acute-on-chronic decline in her mental state, she appeared quite confident in her facts.

"I'm having a baby" she informed me.

"How lovely" I said, readying the needle.

"Everyone will be very surprised" she whispered conspiratorially. "They'll cause such a fuss".

Well, it's good to have a fuss made of you, occasionally" I said. I had slid the tourniquet around her pale, narrow arm and now the cephalic vein was standing out, fat as a baby's finger.

"Oh, no. This won't be good at all. Mother will be terribly upset."

I nodded. "Now, I'm taking the blood now, Mrs Adams."

Holding the twenty guage jelco in one hand and tenting her skin with the other, I advanced the needle until it just about touched the skin. I always used to ask a question when I took blood, as a distraction from the pain. I fixed my eye on the soft, bulging vein and slid the needle forward. I think my peripheral vision picked up a blur of movement, maybe not. "Why will your mother be - "

And I screamed as the Mrs Adams whipped out a left hook and smacked me in the side of the face. Her engagement ring scraped along my cheekbone and one of her long-nailed fingers stabbed into my ear canal, drawing blood.

"Jesus - ah, shit!" I howled. I had jerked my head sideways and now the jelco was dangling point first from the webbing between my thumb and forefinger. "Shit!!"

"What are you doing to me?" she shrieked. "Nurse! Help me! He's hurting me terribly! Oh God, save me!!!" Concerned staff came running down the corridor, including the hachet faced intern and the small Asian man, while I stumbled into the washroom and washed my hands.

The next time I don't want to write about. Someone left a dirty needle in a pile of paper waste, I was cleaning up and the needle went into my thumb. I never found out who did it or from whom it came - everyone denied everything. Six months of worry, no bad result.

The last time (I hope) was a few weeks ago, trying to get a jelco into a patient who had had a seizure in a corridor. He was a large man, with a numerous tattos depicting the apparently vigorous and fulfilling sexual and social life of decaying reanimated corpses. He was considerably stronger than I was, and there were only three nurses, and it's a damn sight harder to hold someone still than it is to thrash about. In the middle of it all I got the needle in the end of my finger.

Anyway, I had to go off to the Royal to get seen by the Infectious Diseases Registrar, which was humiliating, and we had a long discussion about the risks, benefits and side effects of the anti-HIV therapy, and the incidence of HIV in the community, and took the appropriate action, and am still waiting and seeing.

I don't know if this should shit me more than it does. It is an occupational health and safety thing, obviously. If someone is having a seizure and you have to stop them - if you're a doctor with the right equipment and skills and so on, not someone at home. If it's someone having a seizure and you don't know anything about them because someone just shouted out and you came running around the corner and found him on the floor, you have to do something. Maybe it's meningitis or hypoglycaemia or something.

But there's the risk, and you can't talk about the risk without coming across as some kind of wanker. So, next time. Violence.


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