poured out before bed
“Oh sure, that’d be great!” I hear myself say with an enthusiasm pulled from God knows where.
Good Lord, says that little voice from within. Did you just agree to do that hip injection? This is madness, Mullberry! You’ve only ever seen one done – and that was just 5 minutes ago!
Another voice counters, “Pull yourself together woman – just go with it!”
I nod to no one in particular, pick up a consent form and walk with an outward confidence I do not (at all) feel into the fluoroscopy suite, the resident at my heels.
A withered gentleman in a bright blue wheelchair grins broadly when I enter.
“Are you my doctor?”
“Oh, no sir, I’m just the medical student. I’ll be helping do your injection today. Our attending, Dr. Jones, will be supervising everything; this is Dr. Smith, one of the 3rd year residents, who will also be lending a hand. What do you understand about the procedure that we’re about to do?”
The little old man describes in surprising detail what will happen and the risks inherent in the procedure. It’s apparent he’s had a good number of these intra-articular steroid injections in past.
I laughingly ask him if he would like to do the injection, then recapitulate what will transpire and talk briefly about the risks of bleeding, infection, and contrast reactions – what to look for and when post-procedure, and what to do should he develop symptoms. We then all sign our respective spots on the form. A timeout confirms this is indeed Mr. White, who has no allergies, and whose left hip will be injected with steroids, and it is time to begin.
With the help of the resident and a little X-ray guidance, I mark the entry site, bewildered at how calm I feel. As I wash and glove my hands, I am shocked to find that they are not trembling in the least. I begin to label syringes and draw up the various drugs and am dumbfounded by my steadiness. There is not one jitter as I sterilize the site. Before I know it, I’ve injected the local and placed the needle, injected just a mollicum of contrast to be sure I’m in the capsule. It’s a surprising snap to inject the steroid and 8 hour anesthetic. Suddenly, I find I’ve pulled the needle, wiped away the beta-dine, and placed a band-aid.
I help the elderly man down from the table and get him re-positioned in his wheelchair. He squeezes my hand as I wish him many more dancing days, giving me the most endearing toothless grin.
As we exit the suite, the attending pats me on the back.
“Well done, kiddo. A hip injection on your first day, and a flawless one, at that! Why don’t you go on to lunch and I’ll see you back here in about 45 min?”
I nod and grin as I exit the fluoroscopy department, making my way through the old part of the hospital to the locker room.
I make it to the bathroom stall just in time to vomit my guts completely empty.
I flush, wash my hands, splash cool water on my face, pinch my cheeks. Then I grab my PB&J and head to noon conference.