Awaiting the Chop

Feeble sunlight trickled through the dew-drenched windows. The patients were finishing their breakfasts. The medical student wiped the sleep from his eyes and followed the team into the next room.

“Dr. Randall, Mr. Jackson hears better on his left side”, the house officer volunteered the hard-won knowledge to his consultant. “Or should that be: worse on his right…”.

“Hello, Mr. Jackson.” Dr. Randall spoke with the uncommitted voice of a doctor trying to ensure a patient wakes up and responds, whilst trying not to startle him too much.

Mr. Jackson half-sniffed. His wrinkled eyelids stayed shut.

Dr. Randall paused before lightly grasping Mr. Jackson’s right elbow and with a gentle rocking motion loudly chirped, “Mr. Jackson, good morning!”

Mr. Jackson tilted his head back with a slight twist and a yawn, his eyes opened to a squint and he looked down his nose to see a young smiling geriatrician crouched at his bedside.

“Oh, morning is it?” Mr. Jackson replied, as if speaking over the din of the happy hour crowd at his local pub.

“Yes, good morning. I’m Dr. Randall, your geriatrician.”

“Electrician?”, Mr. Jackson shouted back in surprise.

“No, no, I’m a doctor who looks after the elderly”, Dr. Randall spoke as loud as he could manage without an outward show of strain.

Mr. Jackson’s quizzical facial expression was unchanged despite the clarification. The rest of the team stood silently behind Dr. Randall, half-awake but preparing for a long consultation.

“Well, I read in your notes that the urology doctors have already seen you this morning. What did they say?”. Dr. Randall was now bellowing at his patient. Yesterday the geriatrics team asked the urologists to give their opinion on what to do about an unsightly mushroom-like growth on Mr. Jackson’s penis.

“Who?” Mr. Jackson was probably the only patient on the ward who had not heard the question.

“The urology doctors!” Dr. Randall shouted desperately.

“Urology?”, Mr. Jackson shouted back with equal force.

“Yes!”, the geriatrician’s face was turning plethoric and had become grotesquely ridged by distended vessels.

“Oh them, they looked at my whatsit.” Mr. Johnson pointed between his legs.

“Yes, that’s right”. The words leaked from Dr. Randall’s mouth like air escaping from a deflating balloon. The last breakfast trays were taken away. Dr. Randall summoned up all his reserves for the final push.

“What did they tell you?”

“What?”

“WHAT DID THE UROLOGY DOCTORS TELL YOU?!”, a fountain of saliva sprayed from the doctor’s mouth.

“Who?”

“THE DOCTORS WHO LOOKED AT YOUR WHATSIT!”

“Oh them”, Mr. Jackson folded his arms.

What did they tell you?”

“You’re going to have to speak up. I’m a little hard of hearing you know”, Mr. Jackson leaned towards the exasperated and wilting doctor.

“WHAT – DID – THEY – SAY!”

“What did they say?… They said… they’re going to chop my knob off!”

Mr. Jackson’s voice echoed around the still ward. Everyone was wide awake.

Half of us are blind, few of us feel, and we are all deaf

Sir William Osler

Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the  Clinician Educator Incubator programme, and a CICM First Part Examiner.

He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.

His one great achievement is being the father of three amazing children.

On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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