Thursday, April 21, 2011

Dreams, Part II (or Heartburn)

I haven’t been sleeping well lately. Again. Maybe it’s because work has been especially demanding these past few days. And it’s in the throws of those sleepless nights that my dreams become so vivid.

The other night I dreamed I was a trauma victim. I saw myself there, on the gurney, with tubes and lines and monitors all hooked up to me. I wasn’t in any pain, but I was fully aware of my predicament. In the dream, a couple of members from the trauma walked up to me to check things over, like we do on every trauma patient, several times a day. But they were unusually hesitant. I looked up at them and uttered “it’s different when you know the person, isn’t it?” They were silent, and tried to go about their business. Just then the situation changed. Alarms sounded. My pulse shot up, and my blood pressure dropped – I was struggling to breath now. Somehow I knew – like can only happen in a dream – that I was having a tension pneumothorax. This is when air escape the lung but stays inside the chest. The air expands, and pushes your lung and heart to the other side of your chest. It can be rapidly fatal, as it collapses your arteries and veins and allows for no forward blood flow. The only solution is to decompress the chest with a needle, and to release that air. My friends stood motionless as I thrashed on my bed and somehow found a large, 14 gauge needle. I unsheathed it, and held the tip of it right between my second and third rib spaces on my left – just above my heart. I took one frantic look at my friends who nodded their approval. With only a tad of reluctance, I stabbed myself.

And then the pager went off. I was awake. I clutched my breast to make sure there wasn’t anything sticking out of it.

The page was alerting me to a new trauma. A guy ran a red-light and then attempted to avoid being pulled over from a police car and had managed to flip his vehicle in the chase. He had suffered some obvious orthopedic injuries to his lower extremities. Likewise his passenger suffered injuries to her legs. What became apparent, though, through some questioning, was that this gentleman ran from the cops because he didn’t want his wife to find out that his passenger was actually his new girlfriend. The plan didn’t work out too well, though, because while he was lying there in the trauma bay his wife was notified and she immediately came in. And so she saw the both there – her husband and his girlfriend – lying side-by-side in the trauma bay. With their matching lower extremity injuries and all.

Running away – it just always has a way of making things worse.

I finished my work and pulled myself back to the call room and hoped to get another hour or two of sleep. But just as I shut off the light and put my head down I felt something very unusual for me – heartburn. Massive, burning, nearly incapacitating pain like I have never felt before. I was literally writhing in pain. I imagine the pain was located somewhere between where I was going to stab myself and where our new patient’s wife was feeling her own hurt.

I searched high and low, but there were no antacids to be found. I settled for some crackers and milk. What could have been a nice two-hour sleep turned into a thirty minute nap.

I hope I don’t dream again tonight.

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