My parents' last request before they went galavanting about Martha's Vineyard was that I should update them on the goings on of last week. I spent the last 2 weeks in the emergency department of the Mercy Hospital in Cork. It's a relatively small hospital in the middle of the city, and provides emergency care mostly for people in poorer sections of town. Not a ton of major medical or trauma cases, but very steady musculoskeletal injuries, asthma, COPD, abdominal pain, overdoses, and paediatric cases. It proved to be an interesting time. The two consultants in charge seem to enjoy their roles as teachers, and the registrars and SHOs did for the most part as well. The figures for the number of ER visits in America, Ireland, and the UK are all about the same, and end up with an average of 1 in 3 visiting and emergency department each year. That's astronomical. The Mercy is no different, though has fewer resources than many at it's disposal since most of its patients have public insurance which means inadequate resources. So the idea of the ER there was very much "first aid." Even if a patient had complicated or unknown medical problems, they wouldn't be sorted out in the emergency department. The role of the ER is to make sure the patient can breath, help a cut to heal, find the infected appendix, etc. While this is generally the idea of emergency departments in the States, the Mercy operates as an extreme example of it in order to stretch their resources as far as possible.

What did I get to do? During day shifts I was generally with one of the consultants, seeing patients or practicing reporting on patients to the doctor. The evening was when I generally got to do things like take venous and arterial blood sample, do ECGs, and suture wounds. It was educational and fun. Though lately I have been thinking more about intensive care as a future for myself, I appreciated the fast-pace nature of the emergency department. I got to work with doctors from all over the world, including Ireland, Malaysia, New Zealand, Austrailia, and Sudan. I got to see a little girl's hair used to hold togther a scalp laceration, and the finger of a sterile glove used as a tourniquet for a man who accidentally planed his finger instead of the door he was working on. I'm not sure I would have seen that if all of the doctors had been from fully industrialized nations with relatively adequate resources.

We also had a day of lectures about the fundamentals of emerency care, set up in the "ABCD" paradigm of medicine -- Airway Breathing Circulation Disability. The main speaker was the chief at the CUH, which is effectively the best ER in Ireland. A very cool man. He started the talk off with a picture of a man whose face had been shot off. A useful demonstration of the importance of a good airway, no?

I'm sorry to be moving on. Just as I was starting to get comfortable there and develop relationships with the nurses, doctors, medics, security guards, etc, it's time to move on to a dry couple of weeks discussing how and why to do research. I'll probably show up to the ER a couple more times to tie up looses ends, which will be nice.

In the mean time we're trying to have some fun when we can. Yesterday was beautiful (as is today, much defying the odds) so we lit up the grill. Almost felt like a normal person again.

TTFN