Newman's Notions | May 2010 | FREE
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Heroic measures

A locum tenens has a strange experience at a new hospital.

I was running short on funds again; it was time to go back to work. I'd enjoyed three weeks of extreme inactivity. Rested and relaxed, my vitamin D stores replete, I was ready to return to my true vocation. I called my representative at Loco Tenens, and told him I was available to leap into action.

The shuttle dropped me at the front gate of a hospital like none I had ever seen. The grounds were immaculate, the hallways polished, the windows gleaming. I was met by the chief of service. He looked askance at my grubby sneakers, blue scrubs and slightly worse-for-wear, off-white coat.


“We have a uniform for you,” he informed me coolly. I struggled into the uniform. Spandex? And why wear a gown? This wasn't an isolation ward. The chief met me outside the lounge. “That's a cape, not a gown, doctor.” My bad.

I entered the first patient's room. I recognized the square jaw, the wavy black hair, and the superfluous glasses. “What seems to be bothering you, Mr. Kent?” The patient squirmed in the bed. He complained of abdominal pain 10/10 for four hours. He had never felt pain like this before, or ever. I checked his vitals signs—super normal. But when I palpated his right lower quadrant, I knew I was in for a long night. He almost flew off the bed.

“Looks like a hot appendix, Mr. Kent,” I said. The phlebotomist couldn't draw blood: the needles kept bending. I knew a CAT scan would not penetrate. I asked him to look at his own abdomen with his X-ray vision. “Yes,” he replied in an uncharacteristically nervous voice when I pointed out the right place to look, “It looks red and swollen.” I started thinking hard: How would I operate on a man of steel? I called the OR and made a special request, and went to see my other patients while he was prepped.

I entered the next room. The patient sat up, lay down, paced quickly across the floor. He was hooked to a monitor that was beeping faster then I'd ever seen. Was the heart rate really 450 bpm? Impossible, but still the case. I looked at the man, and the lightning bolt across his gown. He seemed anxious. He looked at me. “It's been racing like this for a week. I am used to going fast but this is getting ridiculous.” I looked at the rhythm strip. It was regular, just flashing by at an incredible rate. I ordered an IV beta blocker, and a benzodiazepine, and checked his thyroid function tests.

The next room held another challenge. It was one of the new hydrotherapy rooms, and for this patient that was just the right thing. He sat there, his wavy blonde hair uncharacteristically messy. “Doc, I feel weak, too weak to swim.” The goldfish in the tank across from him was giving me a strange look. The patient turned towards the fish and told him to be quiet. I listened to his lungs; they sounded wet. But why? His lab showed a severe macrocytic anemia. Why were his red blood cells so large? I checked his B12 level and it was severely decreased. I had a feeling this wasn't garden variety pernicious anemia. But I had an idea. I checked his stool for ova and parasites. As I suspected, Diphylabothrium latum: fish tapeworm! He had B12 malabsorption from a parasitic hitchhiker. This was one I could cure.

Down the hall was another patient whose neck would spasm every few seconds. A tic disorder? But his complaint was a rash and arthralgias. It had started two weeks ago after a woodlands adventure. A rounded rash had developed, and then joint pains. How strange—The Tick had Lyme disease. I started him on doxycycline, told him to take a vacation, and discharged him.

By now the OR was ready and my surgical patient was draped and prepped. I had come up with a solution and had special-ordered a scalpel and needles coated with a very thin layer of Kryptonite. It was enough to slice through his skin but not enough to kill him. When the lead-lined box was opened, there was no need for anesthesia; he passed out cold. I held the blade in my hand. I breathed deeply then sliced through the skin and fascia. The hot appendix came out slick as could be. I closed the incision with a neat little S-shaped scar.

After rounds, I went to the post-operative area. My patient had not woken up yet. Strange, but not much I could do about it at the moment. My shift was coming to an end, so I ran through the patient list with my replacement, a Dr. Banner. As I prepared to leave, a call came from the nurse taking care of my flashy patient. His heart rate was down to 18 bpm and they wanted to place a temporary pacemaker. Suddenly, another call. The aquatic patient was having a transfusion reaction and might be in pulmonary edema. Meanwhile, the patient with Lyme disease had gone outside in the sun and developed photodermatitis. Then the SICU called: they discovered a piece of equipment was missing. I might have left the kryptonite scalpel inside my patient.

I felt like I had done a good job. And now: total havoc. I smiled at my replacement. “I guess your hands will be pretty full. Good luck.” I left before he could get mad; he was looking a little green around the gills.

How could I leave all those sick patients behind? There were no work hour issues, yet I still left. Where was my sense of duty and professionalism? As I said, I enjoy following my true vocation. I had done a pretty good job and accomplished my goals. I may not be a good doctor, but I am an excellent super-villain.