Wednesday, April 24, 2013

The Doctor's Paw



The Monkey's Paw is a short story by W. W. Jacobs about a gruesome talisman that grants three wishes.  The moral to the story is, "Those who interfere with fate do so to their sorrow". 

Modern medicine has a lot of parallels with The Monkey's Paw.  All the elements are theremeddling with natural order, unreasonable expectations and horrific consequences. 

Here's my medical version of The Monkey's Paw.  I'm calling it, The Doctor's Paw



Once upon a time, there was a man named, "Ernest".  He lived in a typical house in a typical town in a typical state.  He worked hard as a fireman, saving people and property.







Ernest married a wonderful woman and they had two adorable children.  He had a great life!






But Ernest grew older.






One day, Ernest couldn't get his breath.  Faint and gasping, he went to the hospital.







In the hospital, he met Dr. Duno Goode.






Dr. Goode told Ernest about a charmed amulet--the Doctor's Paw.  Dr. Goode explained that The Doctor's Paw could grant three wishes.  But the wishes would come true at a terrible price.









 Ernest was too scared to understand that.  He couldn't breathe!  He grabbed for the Doctor's Paw and made his first wish-- he wished that his breathing would be made easier.


He was placed on bipap at 15/8 with 100% bleed-in.  To provide nutrition, a stiff plastic nasogastric tube was poked down his nose into his stomach.  Sticky, smelly liquid was pumped into it.




 









Now, Ernest was very uncomfortable.  The bipap's strong air pressure felt like his head was hanging out of a space shuttle on its way to Jupiter.  The feeding tube down his nose made him gag constantly.

Once again, Ernest reached for the Doctor's Paw.

"I want this mask off my face and this tube out of my nose!"


Dr. Goode cut a tracheostomy into his throat.  A PEG tube was crammed into a hole sliced into Ernest's abdomen and stomach.


"I don't want to live like this!" he wrote in a shaky hand (he could no longer speak with the tracheostomy).  "Let me die!"


It was his last wish.







His code status was changed to "DNAR".   The hospital shipped him off to a nursing home where he lived for eleven years lying in bed on a ventilator, wearing a diaper, being turned every two hours and fed through a tube in his stomach.


The End
 
 
Nurse's Note:  evaluate your code status carefully

1 comment: