July 12, 2006, 12:21 pm

The Tears of A Clown


Okay, I have an admission to make.

I know it will seem heartless.

This is the hokiest poster I’ve ever seen.

I know it’s the Red Cross and all, but he’ll die if she fails to do what?

Use her lap for a pillow?

I’m embarrassed to say that my nursing history could use some touching up, but just what could nurses do in World War I?

I feel guilty for even entertaining such non-compassionate thoughts but this poster is really over-the-top drama-wise.

As a deep-thinking philosopher once said:

Gag me with a spoon!


Speaking of drama, here are two vignettes that I believe are…well…dramatic.

They are also embarrassing to me.

I’ll tell you why at the end.


Vignette Number One


An older man, maybe in his late ’60s, arrives at the emergency department after sustaining a head injury. He is slightly disoriented when assessed, but alert and recognizes his family members.

The ED doctor notices that the patient experiences abdominal pain when the wife goes to hug him. The patient believes it unrelated to the headache, but admits to a history of colon cancer. An x-ray proves that the cancer is back.

A consult by Stereotypical SurgeonGod is obtained.

The patient is given two months to live if he does not have additional surgery. It is not known how long or even if the surgery will prolong his life.

He has been estranged from his daughter for years and has never seen his grandson. I believe the reason for the estrangement is that daughter’s sexual orientation does not meet patient’s approval. The daughter is there, with reservation.

Now another doctor in the ED, a cool cookie with a great Jamaican accent, who happens to be the ex-wife of Stereotypical SurgeonGod (twice), believes that the patient should have a head CT before surgery. She orders it herself but Stereotypical SurgeonGod takes the patient to surgery anyway.

The patient returns to the ED.

(I know, stay with me here.)

The patient survives surgery but is discovered to have a subdural hematoma.

Immediately after the CT results are presented to Stereotypical SurgeonGod and before anything can be done about it, the patient seizes, comes out of his post-ictal state long enough to see and acknowledge his grandson who is now at his bedside.

The patient’s eyes roll back in his head and he is declared deceased.


Vignette Number Two


A thirty-something single woman who is 33 weeks pregnant with an IVF pregnancy presents to the ED with left lower quadrant abdominal pain. She is seen briefly by the Sexy Hunk Surgeon and then two “fifth-year” medical students are told to “babysit her”.

Now one of these med students appears to have what is a very mild case of cerebral palsy that doesn’t affect his manual dexterity with any degree of difficulty, and he uses a wheelchair.

Many comments are made about this.

The patient is scared, as she wants two children, sees no man in her life in the foreseeable future and is worried about her baby. She bonds with the medical student with CP.

Her ultrasound shows a left ovarian torsion caused by a dermoid cyst. Off to surgery, with the med student in the OR suite because he promised he would stay with her.

During the surgery, Sexy Hunk Surgeon is flirting with Beautiful Female Surgeon over the operating field but everything is okay, the dermoid is removed, the baby is fine and the patient is taken back to some area that doesn’t look like a recovery room. Her med student stays with her, and the second med student hangs out, too.

Then, what initially seems like post-op pain becomes regular and it is obvious this patient is in labor. Med student with CP calls Sexy Hunk Surgeon who is at a bar with Beautiful Female Surgeon and is told “you can handle it”. Click.

Now said patient is 7 weeks premature and is told by med student that 33 weeks is okay.

Med student with CP doesn’t know how to measure dilation. Other med student throws a ruler on the gurney.

(Stay with me, I’m not joking here.)

So, patient labors standing up, no monitors or anything, hops into the gurney in time to deliver an approximately 15 pound 3-month-old who wasn’t even wet, did not need suctioning, oxygen, stimulation or anything.

Midwife (who was working at the Family Planning Clinic; not sure how she got to the hosptial) decides to pop in at that time and take the baby off to the the nursery, because of the prematurity. Routine, you know.

Medstudents are proud of themselves. Mother is happy. Baby is biggest premature baby ever born in history.

But then Mother starts to hemmorhage. Other med student reads from manual and massages fundus after starting oxytocin, while med student with CP is trying to pack vagina and then realizes the patient needed sutures. I’m not sure what he was trying to suture “in there”, but he manages to get in two….

…when in walks Chief Surgeon God who immediately yells at med students and rushes the now unconscious patient to OR, where she goes into cardiac arrest, but manages to survive with a hysterectomy.

Med student with CP must tell her of the hysterectomy.

Now, med students should not be left without supervision and Chief Surgeon God wants to know if Med Student with CP called his resident. Other med student saw him call.

Med Student with CP does not rat on his resident. Says he never called him. Says he thought he/they could handle it. He couldn’t suture fast enough, he realizes.

Realizes at that point that his dreams of being a surgeon have just been extinguished.


The preceeding stories were not true.

They came from a BBC soap opera called “Holby City Hospital”.

I watched it at the hotel in Shannon.

Why do I find them embarrassing?

Because by the end of the hour I was crying my eyes out. Bawling like a baby. Howling like a wounded wolf.

A stupid, one-hour soap opera I had never heard of or seen before and probably never will again had me blubbering like an emotional wreck.

What was really embarrassing was that my husband caught me sniveling.

How was I supposed to explain that to him?

I couldn’t even explain it to me!


  • Hannah

    July 12, 2006 at 2:10 pm

    OMIGOSH!!! …and I thought “American” soaps were bad.


    who was at the birth of 37 week, 4 day twins this week who weight 5 pounds, 6.7 ounces and 5 pounds, 7.4 ounces!

  • may

    July 12, 2006 at 3:10 pm

    kim, the very reason you are bawling is that these stories are so ridiculous. glad to be of help in figuring a woman’s brain and our ever useful lacrimal ducts 🙂

  • Becca

    July 12, 2006 at 4:24 pm


    I must admit I recognised it as Holby City when you mentioned the medical student with cerebral palsy and it all started making sense. Their plots are bonkers in terms of medical details and hospital protocols and the soap is very soapy.

    However, the reson the patient returned to the same place after surgery is that Holby is not actually set in an ED, it’s set partly on a cardiothoracic/surgical ward and partly in a Medical Assessment Unit (MAU/MASU). MASUs are relatively new creations, set up in response to the four hour admit/discharge targets for A&E in the UK. Patients generally only spend a day or two there before beng discharged or moved to a normal ward.

    I think the MASU in Holby City looks a bit more like an ED because they tend to tell the story as though the patient had just arrived to give neater plot development.

    Holby city is actually a spin-off from the BBC series Casualty, which is set in the A&E of Holby City hospital.

    The family planning clinic does seem to be in the hospital, this is not the normal arrangement in the UK and I think it must be for plot convenience purposes.

    Love your blog, btw.

  • Peggy

    July 12, 2006 at 5:15 pm

    My twins (fraternal) were born three weeks early and weighed 5/13 and 5/14.

    I love this blog, but don’t know why medical people seem to like the medical soaps! I can’t stand soaps, period! My mom, who was an RN, loved them all.

  • Lizzie

    July 13, 2006 at 2:18 am

    I watch Holby City and Casualty for amusement purposes, unfortuantely they’re not as good as they used to be since they started focusing more on the contrived character arcs and less on the people being brought in. Many a happy Saturday evening was spent watching the first 5 mins to try and work out which member of the feuding/happy/fractured/controlling/hippy family/group would get killed/injured and how it would happen.

    If nothing else they can be very funny. The old ones (Casualty goes back to the late 1980s) are very slow. Like ER on sedatives. Even St Elsewhere (A new favourite of mine which is being reshown on satellite in the UK at the moment) which was earlier makes Casualty look boring in the early years.

    I’m glad our TV managed to entertain you anyway 😉

  • Bob

    July 13, 2006 at 7:58 am

    Sounds like all medical drama shows (the fictional or “ripped from the headlines” ones at least) tap into the same Well of Cliched Medical/Hospital Situations. Nowadays that well is probably a web site, subscription required and restricted only to screenwriters’ guild-certified persons. Probably even has a search engine – type in your desired character, symptom, disease, or outcome, or some combination, and it comes back with an outlandish scenario just ripe for sensational “a very special episode” use.

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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