Funny Night

It was a busy night on call. This hospital that I am currently working in was the first hospital in Scotland which adopted the "Hospital Emergency Care Team" at night. The team includes 2 nurses, 2 medical doctors, and 2 surgical doctors, who were responsible for any emergencies or problems that occur either in the wards or the receiving units.

It is scary, trust me. It was only my 1st week in general medicine, and I am apparently, "the second most senior medical doctor on call?!" Yikes!

Anyway, the night started off pretty busy. There were a number of patients who were unwell, you know, the usual chest pain, shortness of breath, abdominal pain, malaena and haematemesis. One of the patients in particular was really funny, but annoying.

He was in his late 30s, with alcoholic liver disease. I was called urgently to see him, as he started to scream in pain suddenly. I rushed off to see him after reviewing a patient with saturations of 88% on 3 L of oxygen. Just as I pushed open the double doors, I could hear him screaming in pain. The nurses looking after him looked pretty stressed.

I went to his bed....and there was jaundiced man clutching his tummy and moaning in pain. I asked him what was wrong...and he didn't answer. I asked him where exactly is his pain...again, no answer. Instead, he took my hands and rubbed them on his tummy. He has a distended abdomen, which apparently just developed over the past 2 days, according to the nurses. I continued to fire him a few questions, but I never got an answer from him. All he did was scream in pain.

During this entire conversation, I heard a voice of another man in the background. This man was saying, "It is all in his head, he does not have any abdominal pain, he needs a psychiatry assessment." I looked at the nurse who was assisting me with this patient. She smiled and whispered, "Don't worry...it is the patient next to him. He is a retired GP, who is likely to be suffering from Korsakoffs."

Right.

The voice continued, "Tell him to shut up and he will be fine." "He does not need anything for the pain. He is disturbing everyone...and now I can't go to bed."

A few minutes later, he suddenly appeared behind the curtains and said, "I can help. Is that the doctor (while looking at me)? Tell her if she needs advice, I would happy to give some." He had messy hair and was walking around the ward with sunglasses. It is amazing how he could find his way around the room, as none of the lights were switched on, apart from the bedlight beside the man in pain.

I could not help smiling, and it was difficult to stop myself from giggling. The man in pain continued to moan despite morphine. What I found funny was why he did not talk...I mean, come on, no matter how painful you are, you would be able to give me at least 1 word answers. Once the morphine started to kick in, his moan kinda slowed down... So I thought I would go and reassess him.

Unfortunately, when I appeared at his bed, his moan grew louder. Again, I attempted to ask him a couple of questions, but my efforts proved futile. Somehow, I felt that he was "at it." The nurses told me that he normally speaks and has not known to be a difficult patient. Strange.

I could not be any happier when I handed my on call pager to the person in the morning!