The first patient was a heavily muscled U.S. Air Force member of Korean descent. I am not exaggerating about the muscle. He was so pumped up that his arms would not even come close to resting at his sides due to severely hypertrophied latisimus dorsi muscles bilaterally. We'll call him Sergeant Strong. He came to the hospital for abdominal pain and was found to have what is know as an ileus. This is when your bowels just stop moving. We do not know why he developed it, perhaps too many clean and jerks. The treatment involves putting a tube through the nose down into the stomach (NG tube) to suck out the gastric contents. Also, there is no eating or drinking for several days for "bowel rest". So, Sergant Strong had a tube jammed down his nose/throat and was not allowed to eat. He went along with it for a while, but pretty soon he got antsy and started walking the ward. Picture a pumped up Korean dude with a tube in his nose (which makes you talk all nasally) walking around the hospital in his Air Force physical training gear ... it was priceless. He came up to the nurses station and asked, "Can I have some roast beef?" Heck no!!! But, this was a legitimate question considering Sergant Strong eats over 5,000 calories a day in support of his weight lifting habit. He starts the day with 6 hard boiled eggs for pete's sake. That's a lot of protein! Anyway, Sergant Strong was a very good sport about it all and eventually things started working again for him. We brought him 2 hard boiled eggs for breakfast and he was elated. I discharged him from the hospital on quarters (barracks restriction) with gym priveleges for 72 hours. Keeping him away from his weights any longer seemed cruel and unusual to me. Rumor has it Sergeant Strong place third in the Bagram Air Field bench press competition last week.
Another great patient was a Greek officer who was medically evacuated to Bagram from a NATO base in Kabul. He had been playing an intense game of basketball and apparently went in for a slam dunk. Unfortunately, he lost control of his body, came crashing down, and slammed his head against the basket's supporting pole. He was knocked out for 30 minutes. Wow. We'll call him Captain Crash. In the Bagram ER he had a Head CT Scan done which looked okay. But, he was not doing so well physically, so I was asked to admit him to the hospital. Upon examination, I found a burly Greek man stripped down to his boxer briefs who was minimally responsive. I jammed my knuckles into Captain Crash's sternum and he barely responded. We admitted him to the ward. Six hours later, he was still very drowsy and was not making much sense at all even to the Greek doctor that came along to him. We had a heck of a time getting this mountain of a man into a wheel chair. Another Head CT Scan was done. This one revealed bleeding into the brain in multiple areas. He actually had scattered Subdural, Intracerebral, and Subarachnoid Hemorrhages for all you medical folks out there. I was astounded. Our neurosurgeon was consulted. Luckily, Captain Crash did not need surgery. He would likely get better without any intervention. We continued to watch him closely administering large amounts of morphine for his killer headache. Slowly but surely, Captain Crash came around. The only Greek doctor in Afghanistan stayed by his bedside the entire time. Two days later, Captain Crash was functioning normally despite a persistent giant headache. He actually spoke excellent English and I learned that he was an engineer. He was a heck of a nice guy. As we wheeled him off the hospital ward, he thanked us all profusely for his medical care. The greek military reacted quickly arranging for him to be picked up in Germany. We loaded him on a plane and sent him back home for further recovery. I am sure he is doing well back in his beloved homeland of Greece right now.
Sergeant Strong and Captain Crash were great patients. These are the type of patients that make medicine fun. Both cases ended up with happy endings. My hope is that experiences like these will keep me engaged and excited about practicing medicine for the rest of my career.
No comments:
Post a Comment