Day 7 - Fri, Jun 13, 2025

Every day you finish and go wtf, it couldn't possibly get any crazier.  But then it does. 

So today, Brendan, the other guy in the medical program who is a first year student, wanted to do triage so they put me back in the ED.

When I got there, it was me and one other doctor, and two nurses.  They told me there was a woman in labor in the operating room/l&d room/lunch room, so I went down to watch (hoping I could tap in). Well shit howdy, I'm not even sure I can put the visual image into words...

First, maybe one or two of the nurses had gloves on. I don't think anyone, including the doctor, had a mask on.  There was no monitor on the mom, or the baby, no actual equipment in the room, and for all intents and purposes she might as well been having this kid in a field. 

When she had a contraction, a nurse would get on a step stool and literally push down from the top with all her weight, almost like CPR.  The doctor was trying to dilate her with his index fingers, which pretty much looked like he was trying to make her cooch smile. Her whole family was in the waiting room, which had a big picture window and front row seats to the action.  😳

I went back to the ED, and shortly after the doctor left.  Then both nurses left.  I went down to the OR, and sure enough everyone was there giving their opinion on how to pop this kid out.  Now the actual obstetrician was in there, who is a short little Peruvian lady shaped like an egg, and she was in street clothes balanced on super high heels.  No gown no mask no gloves no nothing.  And she was doing an ultrasound, but based on the sounds and where she was putting it, I'm pretty sure she didn't know how to use it.  She was waving it over this poor woman's stomach like a magic wand, and she was granting a wish...

Back to the ED, a patient came in and I was pretty happy I was going to treat her by myself.  She had severe abdominal pain, and I checked her out and landed on pancreatitis.  Which was great, but I didn't have any actual meds there to give her, or any way to get them... And her fever was about 102.5. 

Then an older man came in, and his foot was about four times the size it was supposed to be... And I might have been surprised except this was about the 10th patient I've seen like that.  I checked him out and diagnosed untreated diabetes. 

I was running back and forth between the two of them, and now a third one walked in, a teenage girl with abdominal pain but high in the center.  She went down as gastroenteritis, but once again no antibiotics or pain meds available. 

I ran down real quick to the OR (it was only about 50 ft away) to see if this woman was any closer to having her baby, and every real doctor in the clinic was in there and the woman was squatting on the floor over a gym mat.  No idea if it was clean or if someone just ran and got it at the middle school.  It was one of those things you just can't unsee.

Back to the ED, the pancreatitis patient's temp was up to 103, the GI girl was crying, and the guy with the foot might be drunk. Then a fourth one came in, a woman in her fifties with pain in her lower back, and after her eval I land on a UTI.  

So now I'm running between four patients, and keep in mind there's only four beds so any more and they're going to be sitting in the hall.  This went on for about a half hour, and the pancreatitis lady was up to 103.5.  There was now the possibility of her seizing, and it's going up every minute, and I'm starting to get a little tense.  I wiped her down with rubbing alcohol, mostly because I'd really hate to lose one on my first day. 

Finally, after about a half hour, the nurses start trickling in and we get meds going. It doesn't really matter what I diagnosed, because everybody gets pain meds and antibiotics irregardless 🙄.  But fortunately that's what I ordered.  About then I see the doctor walking down the hallway, with the pregnant woman who is still very much pregnant. I asked him what happened, and he said the baby's head was too big and she's going to need a C-section.  Apparently they can't do actual operations in their operating room.  Which means she now has a 5 HOUR DRIVE OVER A S*** ROAD WHILE SHE IS IN FULL LABOR.  And yeah, it's a Peruvian ambulance, which means a Toyota Tercel collectivo.  So they loaded her up and off they went ... I felt really bad for her.  But at least they sent a nurse with her that had a backpack.  I have no idea if it was a trauma kit or her lunch. 

zoom in and the ob is on the far left 

Bigfoot

Peruvian ambulance service