Cautionary Tales

For the past few days, I've been shadowing the dietitian who does the GI and post-surgical floors and the surgery/trauma ICU. It's definitely been the most challenging rotation so far-- these patients are very sick and very complicated, medically and nutritionally. We did a followup on a patient today following his indirect calorimetry test--turns out he needs 3300 kcal a day, which is just mindblowing considering he's intubated and doesn't have a head injury. Yes, he weighs 500 pounds and has been in the ICU weeks as various organ systems shut down in turn, but still...

One of my favorite parts of working in the hospital is hearing all the crazy stories about patients. Today one of the consultants told us about a couple of recent patients he'd seen: The first was a man (I'm not sure his age) who decided it would be a good idea to let a friend light a firecracker (a small one) while it was in his mouth. Something went wrong after it was lit and he ended up swallowing it. Somehow, it did not explode his throat or gut, but all the fumes given off went into his lungs and messed them up something awful. He may or may not survive... Yes he had been drinking.

Another guy was having a reunion with some old college friends with whom he used to snort cocaine. He doesn't do coke anymore, but didn't want to have to fess up to his friends, I suppose, so he raided his wife's stash of Splenda and snorted that instead. Turns out that if you look at Splenda under a microscope, it looks like little balls studded with spikes. Not good for your lungs and nasal mucosal membranes. Everytime he sneezes his nose bleeds and he's having some other problems as well.

So in case anyone was considering doing any of these things, don't!