![]() ![]() I wonder if the best video game might just emulate what happens whilst at a hospital monitor, which probably sounds a bit crap. ![]() Or make the internal dramas external, animating medical note-writing with the anime flourish of a Death Note sentence scrawl.īut whatever happens, do make sure to nail the sense that the stuff of medicine isn't always obvious or elicited in the moment, but often sounded out and shaped, shuffled and dealt and interpreted and changed. Or capture the slight give as you strike into a vein, with a tremble of HD rumble and a Vein Get! voice sample. You could let players perform some verbal surgery, that slicing just-so between two possibilities with a precise, well-chosen question. You could make a game out of any of this stuff! (Note: I have never made a game) Then it irks and bugs and niggles away until you ring up to ask an on-call colleague if they wouldn't mind double (triple) checking it's not something serious. The oh shit what if it was encephalitis self-doubt as you're driving home, as the details of the day settle like sediment in a glass, so different and clear when unstirred and afar. Worse is when these invisible, internal pivot moments don't even happen in hospital. Also this gas is the worst gas I've seen and this patient is really young and no wonder they were breathing so fast. ![]() Or is it by the blood gas machine afterwards, idly standing whilst the printed result curls out like a receipt: then a quick grip of pre-panic and focus as you realise just how low the patient's blood's pH is and that yes, they must be in diabetic ketoacidosis - their sugar levels so high and their Insulin so low that their blood has turned acidic. Is the 'real' drama at the bedside, easing a needle into a difficult vein and hoping for the happy thrill of red 'flashback' in the chamber? Part thinking, part writing your way to something neat and treat-able. Or is it when you go away to take stock and zoom out, writing up the notes with an order and shape that will hopefully justify - to yourself? to colleagues? to the General Medical Council? to the universe? - a differential diagnosis and a plan at the end. Is it the stuff when you first ask a patient questions, knowing where to add the stresses and leave the pauses to carve their experience into a story you can work with?Īnd what about the pain changed, to make you come in today? There are so many instances of on-the-fly translating, re-ordering, re-appraising, sense-making. It's actually harder than you think to pin down where and when exactly the stuff of medicine happens. But sometimes I wonder: Is it just the case that's so affecting, or the recounting? The story or the telling? The day job (often, the night job) isn't to emote in the moment, it's to help. You're casually recounting something in the kitchen - I don't think it has to be the kitchen - and suddenly out of nowhere there's a slight shake in your voice. The nose starts sniffling and the eyes start prickling and now: warm tears in front of the telly, now something's happening between me and the screen that doesn't happen between me and a patient.Īn A&E consultant once told me that the emotion of a case could catch up to him later, unexpectedly. The settings and stories are all familiar, but here they're framed from afar and from after: with montage and music and they survived?! surprises. Sometimes I well up a bit whilst watching 24-hours in A&E, which I never do during my actual, real-life job in A&E. ![]()
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