Tuesday, November 2, 2021

The End of the Awfultopsy

     Yesterday late morning I walked into the gross room for frozens - I had earlier learned I was on call this week and there were 200 blocks so it was already a hectic day. Jessica was in a frenzy. There's an autopsy! Good god, I sighed and she must have noticed I looked like a deer in headlights because she immediately said, it goes to Hal. You did the last one Christmas Eve. That's how long it has been. Didn't we get rid of these in the new contract?

    We did, I said, but the logistics have not yet been set up. I'm having too crazy of a day to even get involved. Just talk to Hal. Can you ask Shaver? He's off, she said. I'd better stop talking and go do the frozen. I cracked her up with a story of it - Peter Kim, who I was friends with before med school he did my dad's hiatal hernia repair years ago and married a pediatrician named Elizabeth, was doing a Whipple resection. He needed the pancreatic margin. The margin was negative and the tumor was two cm from the margin grossly. I called the OR bat phone to tell him and the nurse said Oh! Let me go tell him you have the frozen results. 

    WTH? I told Jess. Does she think I have all day to be on hold for a frozen? Put me on speaker immediately like the rest of the world. She came back. Tell me, she said, and I'll tell him. Oh lord. Damn travelers, like Bandy said. I heard her say SHE SAID THAT THE TUMOR IS NEGATIVE. I yelled into the phone no! no! That's not what I said. I repeated the diagnosis like three times before she finally got it right. 

    Hal tried to come talk to me about the autopsy over lunch but I was having a hard, intimate conversation on the phone so I told him I couldn't help him he needed to figure it out. Let's just say when your kids aren't all right you aren't either. I almost chartered a plane to Fville yesterday. When we got off the phone I called Jessica and said if Hal wants me involved it's not happening today tell him not to bug me I've got a family emergency. I shut the door and locked it and worked for two hours.

    When I came out Hal was checking billing charges and I apologized and he was like no, I get it. You were shaking. His son Michael, who was born on the same day as Cecelia, decided to join the special forces of some military unit I forget. Halfway into training, he broke his foot. Now he's out six to eight weeks in some med unit and won't be home for Christmas. He has to resume his place with a new unit. That's good he doesn't have to start over, I said. But I bet he's sad he can't graduate with his class. He's making some of the best friend of his life, Hal said. And they take away their cell phones. He's allowed to call once a week, and if I miss the call I miss it. I'm now married to my phone. 

    While I was locked in my office Brent managed to call UAMS and get transportation and billing and logistics for the body. Jessica was on cloud nine. She was talking to the nurses in the ICU and a PA contact at UAMS. Today I went into the gross room around three to do five Sims frozens and a sixth one for a new doc Bareto that Laurie said was real nice. Jessica was problem solving - UAMS wanted a negative Covid test on the patient within the last 14 days and he had been in our ICU for 30 days and hadn't been tested since day one. What do I do? She asked. I'll help.

    I took her to Amy in micro and we got a swab and she gave us a verbal order form and we went down to the morgue - I hadn't been there since Christmas Eve and was glad Jessica was with me I always get lost going to the morgue. I was kind of excited to be a part of the last experience there. We denied a bunch of Covid autopsies bc there is no negative pressure and it hasn't been updated since the 60's. Becky was the one who gave me the idea to ship them to UAMS years ago - she got their accrediting organization to ding them - but after three years of trying I gave up and trashed my research.

    I can't remember if I told you about an autopsy I did - can't remember which one - where the rusty circular bone saw broke while we were cutting the skull and the saw part flew off of the base and hit the wall. If this was just a regular wall it would have stuck, but it was a tile wall so it bounced off and skittered all over the morgue before it expired. Someone could have been seriously hurt. 

    Sarah, the morgue attendant had opened the bag of our patient in the cooler just enough so we could get the swab into his nose. Jess and I gloved up and she started trying to break the swab in half (think glow stick - I guess this activates it?) and I said I think you have to remove the plastic seal first. She struggled with this for a while - I said it's probably at the non-swab end so you don't contaminate it. I struggle with those too, take your time. Then she spent almost a minute twisting it in half. How far do you put it up? She had asked Amy earlier. Until you hit resistance. At least he won't complain, we joked. He had a sweet face, and I silently prayed for his peace in resting.

    I told Jessica, well for one thing you can be certain Baptist won't be rotating you on the swab station. Sarah laughed. I had a late possibility of frozen with Sims but just got cleared yippee. Watching Clickbait on the recommendation of Alyssa highly recommend. Eureka was wonderful but I tested gluten - could not resist the perfectly toasted English muffin and the soft creamy butter served to the Sara Bernhardt suite (hell it rhymes with Amelia I was close) and paid for it dearly for the past two days almost to the point of passing out from dehydration. Canceled dinner plans tonight. Need to relax. Happy Tuesday - hope yours is a good one. Much love, Elizabeth

No comments: