Projectile vomitus

So, I'm the new lowly 2nd year med student on GM7 at Duke Hospital. GM stands for General Medicine. It's hard not to feel like a waste of space (and oxygen) when you don't know what you're supposed to be doing and everything is buzzing on around you. But once I figured out that I could find the stairwells by following the exit signs, things got a little better.

Here's a story. On my first day, we were on long-call. I'd been in the hospital since 6:45am. Come 11:30 pm, my intern and resident had to perform a paracentesis on a patient with massive fluid accumulation in her abdomen secondary to terminal liver cirrhosis. The room was small and a little warm in temperature, and it smelled of sweet urine. I was holding the patient's hands to prevent her from touching the sterile area on her belly.

The intern first gave some lidocaine injections and then whipped out a shiny foot-long bore needle for the paracentesis. He stabbed it straight into her protruding abdomen. It began to ooze blood. The patient cried out in agony and kept on mouthing words as if in delirium. Unfortunately, the needle clogged and had to be pulled out and pushed back in at many different angles to search for a viable fluid pocket, but to no avail. The resident then took out a scalpel to slice a larger opening at the puncture site. The patient kept on moaning in pain, saying "Please, stop, no no, please no more..."

The smell of blood began to permeate the room, and I began to feel a numbness creep over my hands and climb up my arms. I thought I could just shake it off if I concentrated harder... but then the numbness started creeping up to my head. I felt dizzy. I turned to the intern and whispered weakly, "I think I need to step out for a second..." Suddenly, I wake up realizing that I had just blacked out. The intern was yelling, "Shoshana, wake up! Wake up, Shoshana, wake up!"

It took me a second to realize that I was still in the same hospital room holding the patient's hands in the same position, only this time with the intern propping me up by the bedside. I thought I'd just woken up from a deep sleep. He said, "Shoshana, you ok? You can step out now." Stunned, I released the patient's hands and stumbled to the door. A split-second later, I bee-lined to the nearest garbage can and spewed out a projectile vomitus of gummy bears. Tragic, completely tragic. So much for my first night on call!

At least I got to mark my territory;)