‘Hannah, the ambulance is on it’s way with Mr. Green, DOB 23 July 1949, suspected to currently have a cerebral infarction. Time of onset 6.45AM. Room number 7. Get everything ready, he’ll be here in 10 minutes and he’ll be your patient’, the coordinator of the Emergency room informs me.

 

I’m Hannah, 27 years old and I’m a junior doctor at the emergency room. Coming straight out of med school it had been difficult to find employment, but luckily I was accepted here. I’ve been working at the ER for about 2 years now, which gives me enough stories to tell during boring birthday get-togethers….

 

‘Hannah, come on, I’ll help you set up’, Joyce my colleague brings me out of my reverie. Together we walk to the trauma room where I’ll be meeting my patient. Kathryn, one of the nurses that will assist me, is already walking through the room making sure everything is there and in place. I walk in, start checking the equipment and notice something’s missing, ‘Where’s the CoaguChek?’ ‘The one we had ran out of battery, so Jack’s getting another one’, Kathryn informs me. And true enough 2 seconds later Jack walks in with the CoaguChek. At the same time Joyce has already started gathering the information we have about my patient and writing it on the whiteboard, and it seems Mr. Green is already known with vascular problems. So far the information we have in our hospital files is that he’s known with myocardial infarction for which he received a PCI for a couple of years ago, hypertension and appendicitis which led to and appendectomy.

 

The moment I turn around the ambulance staff walks in with my patient on the stretcher, while Joyce slips out of the room. The nurse of the ambulance staff immediately starts her story. ‘Mr. Green, DOB 23 July 1949, already known with myocardial infarction and hypertension, had breakfast at 6.45AM, when suddenly he couldn’t move his right hand and had trouble finding the words he wanted to say. His spouse, who witnessed it all, called the GP who called our dispatch. Bloodpressure 158/80mmHg, glucose 5.7. He doesn’t use any anticoagulants.’ The moment she’s finished, Mr. Green is moved to the hospital bed and the structured chaos starts.

 

I walk up to Mr. Green, ‘Hello Mr. Green, I’m Hannah …, I’m one of the doctors here at the ER and I’ll be looking after you. Right now everything is going to be a rollercoaster ride, it’s best to just let it happen. So could you tell me your age?’

‘Age…. Eh…… Eh…… No’

 

‘Do you know which month it is?’

 

’…… tem… No…. s…s…. No’

While I continue to examine Mr. Green, Kathryn and Jack are checking his vitals, his glucose and make sure to draw some blood to send to the lab. The moment everything is done we continue to the department of radiology, just a short elevator ride away, for a CT-scan. On our way I already discuss Mr. Green with the neurologist over the phone: ‘Mr. Green is a 67 year old man, known with myocardial infarction and hypertension. This morning at 6.45AM his wife noticed loss of movement in his right arm en problems in finding words. Neurological exam shows a hemi paresis on the right side, aphasia and a neglect for his right side, NIHSS 10.’

 

‘All right, call me again when the scan is performed’, the neurologist responds and ends the call.

 

By the time our conversation is finished Mr. Green is already placed at the CT. Everyone walks to an area clear of radiation and I start to discuss the next plan with the nurse from the neurocare unit. Once done with the CT brain I check it and call with the neurologist again. As there is no bleeding, alteplase is started and Mr. Green is moved to the neurocare unit for follow up.

 

As I return to the ER, I finish my registration and continue my day with the other patients that arrive. As I finish up a report later that day of a woman who fell of the stairs and had her ankle broken (remind me to never by a house with stairs in it), I finally have time to chat with Joyce again.

 

‘So which concert were you visiting tonight?’ she asks.

 

‘One OK Rock.’

 

‘Who is that…’

 

Thinking for a second which song I should let her hear, in the end I decide on one of their latest English songs ‘Cry out’. However the moment I open the musicvideo, ‘Asian guys again!? What is it with you and Asian guys….’

 

I pout, ‘What… I like their music, and besides the drummer is kind of cute.’

 

‘The drummer….’ Joyce states as takes a good look at the screen. ‘Him!?! How could you call him cute! Haven’t you seen all that ink?’

 

‘Wait more important question, are they smoking?’

 

‘Yes, unfortunately.’ I shrug, ‘But it’s not as if they’ll quit when I, a nobody, simply waltz up to them tonight and tell them not to smoke. Besides it’s their lungs and they’re old enough to decide for themselves whether they want to ruin their lungs or not.’

 

‘Please tell me when you do decide to confront them about it, so I can tag along. It would be so funny to see stutter and blush to tell them to quit smoking, while trying your hardest to keep your fangirling at bay. I could use a good laugh.’

 

I roll my eyes, ‘Such a good friend you are.’

 

‘Well, let’s finish this and then go home,’ Joyce says, ‘it’s time for the new shift to take over and you’ve got a overly inked drummer to woo.’ I swat her across her head, ‘Stop dreaming.’

 

We quickly finish our reports and then head home, waving goodbye to each other.