Silent Night
Off at 6pm as the Jew who covered Christmas Eve for the group
All hell broke loose at 6pm.
During the day gas was brewing as subcutaneous emphysema of unknown origin in the chest wall in a patient with a C1-C2 fracture ? It puzzled me
At 6pm she was getting head with and without contrast , and a c-spine, chest CT ?. and I thought let me just take a peak ?
Finding ? Michelin woman
Air all over the place in her subcutaneous tissues
?Bubble bubble boil and trouble?
A posterior membrane tracheal tear likely from traumatic intubation became the clear origin of the air likely caused by a traumatic intubation by those who were protecting her spine during the intubation ie suboptimal conditions for them ? could not flex her neck as is needed and usual
Did a wet read ? and called the intern who had no clue ?
Her fellow nowhere around ? The ICU attending de jour ? on a plane somewhere singing Christmas carols and the ICU attending coming on ? researcher not yet available and probably singing or whistlin (he does that) Xmas carols too
?Call the CT surgeon? was my parting advice
Was at a friends home joining their Xmas celebration ? a radiologist from Norwood group ? and among the noise of Silent Night he asks ? ?is that not your beeper going off? (still had it on me and did not expect any call) I said ?no ? must be the microwave- not on call ?
?No no your beeper ? he says ? and sure enough it is the thoracic surgeon
I was singing hymns Davidoff ? what do you want?
?Oh just some bread and butter CT case? Dr CT surgeon
C1-C2 with an odontoid peg fracture with a large posterior tracheal tear
?What is the odontoid peg? ? he asks?
Poor guy ?The rest (must have) happened at midnight? on a not so ?silent night? when all was not calm
All in the life of medicine ? never dull