It looks like torture

I was browsing through the  NEJM clinical medicine videos (yes, out of post test boredom…) and I stumbled across this one, a video about tympanocentesis. Yikes. They didn’t even sedate that kid, they just restrained her and went on with the procedure. It was rather uncomfortable to watch her squirm and scream (there was’t any sound but you could see her chest expanding).

This sort of touches on an issue that’s been bothering me for a while – somehow, I don’t like the thought of needing to ‘hurt’ people to make them better. Of course, I’m not worried about things like venapunctions, that also hurts a little, but it’s different from a bone marrow aspiration or something like that. I’ve also observed coloscopies and bronchoscopies – I don’t think I’d be able to do that, sticking a tube down someone’s throat while they are coughing and scared they’re going to choke.

During my primary care internship I’ve observed how the doctor removed a piece of ingrown nail. The maximum dosage of anesthetic had been given, but the tissue was inflamed so it didn’t work as it should and I could see the patient squirming  etc – and, combined with the grossness of nails being removed, it was apparently enough to make me faint.

Yep, I fainted. Fortunately, I didn’t fall over but I realized too late what was going on (I thought I was going to be sick due to the stomach flu or something like that so I just tried to be brave and continued observing the doctor) so I still lost consciousness for a few seconds. I didn’t faint because it was too bloody, I was mainly getting unconfortable because the patient was uncomfortable (alright, I don’t like anything that has to do with removing nails but still…).

I’ve asked the doctor* about it and he reassured me that the bit of adrenalin you feel when actually doing a procedure, prevents you from even thinking about fainting. He said that, of course, from my position as an observer, I could be really attuned to the patient and think about ‘what must she be going through’ but if you’re busy with trying to get that piece of nail off, you’ll be distracted and therefore not be worried / uneasy.

I hope it’s like that, I wonder what I’ll do when a patient is screaming in pain (worse than just the little bit of squirming that our patient did) and I don’t have another option apart from going on with the procedure…

*It was an ‘internship’ but I don’t think he’s a preceptor or an attending so I’ll just call him doctor. Whatever. As you see, I need to get used to blogging in English 🙂


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