Monday, April 12, 2010

the ballad of the unsung hero

Many people probably saw this already, it was printed in The New York Times on April 9th, but just in case you missed it, I thought I should give it a little bump:

Doctors Remove Ammunition From Soldier’s Head

The reason I'm posting this is not because it's one of those "Ripley's Believe It Or Not" medical stories (even though it is), but it's because if anything redeems the much maligned field of anesthesiology from the jaws of modern day television, in which we are all portrayed as lazy, unfeeling, drunken, drug-diverting billionaires who don't give a shit about our patients and leave whenever the going gets rough, it should be a story like this.

An excerpt for those who don't want to click:



...[A]s the patient, an Afghan soldier in his 20s, was prepared for surgery, the chief radiologist, Lt. Col. Anthony Terreri, took a closer look at the CAT scan. Stunned, he realized the object was an explosive round, primed to go off.

“It looks like we have a problem here,” he announced.

To say the least.

Maj. John Bini, a trauma surgeon and a veteran of homemade-bomb injuries from two previous deployments in Iraq, immediately evacuated the operating room. Only the anesthesiologist, Maj. Jeffrey Rengel, who put on body armor, was left to watch the patient.

The surrounding hallways were secured, and a bomb disposal team was urgently summoned. All electrical monitoring devices in the operating room were turned off for fear of detonating the round. To keep track of the patient’s vital signs, doctors turned to manual blood pressure cuffs and a battery-operated heart monitor, and they began counting drips per minute to estimate the amount of the intravenous anesthesia they were giving the patient. “It was taking anesthesia back about 30 years,” Dr. Rengel said.

Within a half-hour, the bomb disposal team arrived and confirmed, based on the CAT scan, that the patient indeed had unexploded ordnance in his head.

“They said, the way these things are set up, this type of round has an impact detonator on the front of the charge,” Dr. Bini said. “They just said, ‘Don’t drop it.’ ”

With that for reassurance Dr. Bini put on body armor as well, and he began the process of surgically removing the round from the patient’s head, joined in the operating room only by Dr. Rengel and a member of the bomb team...

...Dr. Bini said he was unaware an unexploded bomb embedded in a patient’s chest had been the plot of a TV show — a two-part episode of “Grey’s Anatomy” in 2006... “None of that stuff you see on TV approximates reality,” Dr. Bini said.


Nice work, Dr. Rengel, we're all proud of you.

And also, you must shit ice cubes.

14 comments:

  1. hooooooooooly crap. and i have to admit that the first thing i thought about was that episode of grey's anatomy. it was so ridiculous that i stopped watching it. and now i'm going to be a surgeon! wheeee! and that's one hell of a smart anesthesiologist. i think if i got about 10-15 years into a career in anesthesia, i'd forget how to do things the "old-fashioned way"

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  2. "you must shit ice cubes."

    genius.

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  3. Anonymous2:28 AM

    you ever hear of the bk, oxygen? by carol cassella? randomly picked up.. so how often do the "shit ice cubes" moments occur?

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  4. Anonymous7:40 AM

    Unfreakingbelievable.
    Way to go docs.

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  5. Anonymous8:36 AM

    it was the radiologist who picked the bomb!

    (then didnt have to do anything more with the patient of course but still)

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  6. OH_EM_RES10:03 AM

    Wow, the original story I saw didn't have nearly as much detail as this... Basically just said that the anesthesiologist and surgeon wearing armor did the procedure. That the anesthesiologist basically got left alone with the sedated patient sans modern technology while they formulated a plan, IMO, that adds a whole new level of impressive.

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  7. Anonymous11:12 AM

    An FYI-- my husband, an orthopedic surgeon, was deployed with Dr. Rengel on his first tour to Afghanistan. For my husband's entire tour, there were only 4 days they did not operate, so things were pretty busy, and they apent a lot of time together both in and out of the OR. Apparently, he's a really great guy. (I'm an anesthesiologist though, so he kind of has a soft spot for us anyway.)

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  8. Anonymous12:22 PM

    The anesthesiologist and surgeon are clearly amazing. And, I'm glad they gave a shout out to the astute radiologist who was the first to realize how close they were to a disaster.
    (PGY-5 Radiology)

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  9. I wonder if not only does he shit ice cubes, does he create frost when he breathes?

    Cool as a cucumber. I knew I loved anaethetists for a reason!

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  10. VIPeds11:05 PM

    Wow, awesome article. And those radiographs are pretty cool as well. Amazing where that round ended up.

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  11. {{{...Dr. Bini said he was unaware an unexploded bomb embedded in a patient’s chest had been the plot of a TV show — a two-part episode of “Grey’s Anatomy” in 2006... “None of that stuff you see on TV approximates reality,” Dr. Bini said.}}}

    I'm sort of confused by this. They're saying it doesn't approximate reality, and yet this is essentially the same scenario as was shown in the show. Are they referring to the extent of precautions taken with electricity not approximating reality or am I missing the point?

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