It was a routine hip replacement surgery, but this poor man had bled badly on the operating table. He was a Jehovah’s witness by faith and therefore, declined to receive blood transfusions both during and after the surgery was over. By the time I saw him, he had had several days of severely low hemoglobin levels and his chart stated that he had multiple watershed infarcts. When I first met him, his wife was in the room sitting dutifully at his side.
It was fall of 2020 and COVID was at the peak of it’s notariety. I had been working in the COVID ICU for several months now. My patient was an indian woman in her early 30s. She had just given birth a few months prior when she contracted COVID. She had been separated from her newborn baby for months while fighting for her life in the ICU. Medical personnel had to help her remove and throw away her breastmilk.
I had an evaluation order for a new patient who was admitted to the ICU for COVID. He was a very fit, middle aged man. When I was assessing his mobility and independence, he was pretty much independent except for being extremely short of breath at every movement and needing a high flow nasal cannula to maintain his blood oxygen level. He told me he was the principal at a Christian church in his city and loved to go camping and backpacking.
This patient had just been discharged from the ICU. We were so happy. Our survival percentages were pretty bleak at that time and this was one of our survivors. He was a young guy in his 30s, completely covered in tattoos. He was a real edgey guy, was an avid surfer. His wife had been prodded him to get vaccinated but he just didn’t end up doing it. They ended up catching COVID together.
After applying for per diem hospital jobs for a solid year, I FINALLY got hired! This particular hospital was a county hospital in a neighborhood notorious for crime and violence. Let me mention, I grew up in a upper middle class, very safe neighborhood. As my coworker put it, me starting this job was like putting a puppy in an alligator den. The VERY FIRST patient I had on the very first day was a man who was shot multiple times in a liquor store.
In spring of 2023 I gave birth to my first child. It was a beautiful experience but also harrowing as I had a very dangerous form of preclampsia and needed an emergent induction. I was at risk of organ damage, seizures and hemorrhage. Working at the hospital, you would think I would be comfortable being admitted as I knew the general ebb and flow, knew some medical terminology and medicines, walked a similar hallway 5 days a week.
I honestly don’t remember the primary diagnosis of this patient, just that her poop was runny and black like some sort of smelly, cursed volcano lava. The skin on her butt started becoming raw from all the wiping and bedding changes so the docs decided to put in a rectal tube. In case you wanted to imagine it, a rectal tube is basically a ball connected to a tube connected to a bag.
code brown “Code Brown”: the one code in the hospital that you won’t find typed within the code list on a hospital badge or in a training manual. It is a code that you learn by experience unfortunately. It doesn’t denote just any sort of poop either, only the biggest, wettest and messiest ones. It’s a poop deserving of a code. I have wiped many butts in my years of service, but one particular instance comes to mind.
I was engaged with about 5 months or so before my wedding date and was working in the ICU. There was a lady in her 20s admitted to the hospital because an organ was failing and she needed medical support while waiting for an organ transplant. As that primary organ failed, other organs started having issues as well. She was intubated and placed in a medical coma. The day I saw her for an evaluation, she was extubated and the doctors started weaning her sedation.
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