There aren’t many patients in the hospital, but they are all demanding our attention this morning. Ward round is disjointed, and the doctor sends me to assess patients and report back just so we can get them all seen. There are patients coming in and patients being shipped out – the one pair of ambulance officers seems to be constantly marching our halls.
An obese woman presents to casualty with 9/10 retrosternal chest pain. She came last night and was given antacid and sent home, but the pain has returned and now nothing is helping. The doctor is busy, very busy, so the patient is mine. I take her history and discover that, but for the fact that she’s never had heart problems before, she has EVERY SINGLE RISK FACTOR ON THE PLANET for a heart attack. Diabetes, hypertension, hypercholesterolaemia, obesity, family history, and of course she’s a smoker. Still I’m not sure – she has a long history of gastro-oesophageal reflux, and she says her pain is alleviated by sitting up and (eeew) burping, so maybe it’s the same old thing?
I ask the doctor what to do but he is still very busy, and he tells me to do the full workup and then come back. So I examine her and find nothing remarkable, place the most beautiful cannula (I'm so proud) and take some bloods, and do an ECG. Her troponins come back borderline, but the ECG shows ST elevation in the posterior leads. The doctor sees this and suddenly she’s not my patient anymore, she’s Priority 1, she gets morphine and maxalon and clexane and she’s sent away with the Flying Doctors to the city.
But for that brief moment, she was mine.