I fainted half a dozen times during my training. It’s a problem that worries quite a few people, so here are some of my fainting tales. They may make you feel better.
I should have known it would be a problem because during GCSE biology I was asked to dissect a cow’s eye. It slipped and rolled under my scalpel, glancing at me as it turned. My teacher asked me if I was alright. Apparently I had gone green. As soon as he said that I began to feel green. I lay my head down on the cool workbench and soon recovered. It was close one.
Then, before applying to med school, I spent a night in the local Casualty department. I watched a junior doctor try to prise a splinter from the hand of a young lady. It was hurting her, and she kept yelping. The doctor got irritated and said the anaesthetic ‘should be working’. He kept digging into her hand, she started to cry, I felt lightheaded, moved my legs to keep the blood flowing…and I was out. It wasn’t the gore, it was the negative emotion – I think. Anyway, they put me on a trolley, checked my blood glucose, and the same doctor told me the only explanation for such low levels was an insulinoma. I got home, looked it up, and for some months assumed there was something unpleasant growing within me.
So to med school, and the post-mortem. I had been really looking forward to this. The Professor of pathology lifted out a series of pre-mobilised organs and held them up for those of us in the viewing gallery to see. I glanced past his gloved hands at the cadaver, glimpsed the head, saw the juices drip off the liver…and down I went. As usual I came around immediately, to be told that when the Professor heard the thump he looked up and called out, ‘Will someone see if she’s alright?’
Then came venesection practise. My partner shakily inserted a needle into one side of my elbow vein and out the other, causing a ‘sixer’ sized haematoma. As it swelled I began to sweat, the edges of my visual field closed in and I immediately sat on the floor with my head between my knees. Another close one. However, come the first day of my third year as a medical student, entering the wards at last after two years of lectures, I did less well. We met the house officer (she seemed so grown up) and were told that it was our job to do the phlebotomy rounds each morning. She assembled a vacutainer set and asked me to roll my sleeve up. Pretending to take blood, she held the needle a centimetre from my skin. My brain said NO WAY, the sweat came on and clunk, I was down. The clunk was the sound of my forehead connecting with the edge of a sink. The rest of the day went fine, but the bruise took a week to settle.
I entered the operating theatre as a student on a vascular surgical firm with great trepidation. For some reason the blood and gore did not affect me as it did some others. I watched a consultant repair a ruptured abdominal aneurysm, observed the blood as it pour off the table into his white rubber boots, saw him curse as he nicked the spleen and was forced to remove it…but the fascination allowed no room for vasovagal syncope.
But I was not cured. For my elective I travelled to Nepal via Delhi. In a busy Indian market square I asked a cobbler to repair the soles of my shoes. He stuck strips of orange rubber onto them with stringy glue that he applied with a stick. His friend tried to clean out my ears with a cotton bud while I waited, but I pushed him away. I was pleased with the job on the shoes though. Anyway, come the first day on the wards in Kathmandu I was feeling a bit rough, having accidentally swallowed some tap water while shaving two days before. I stood in the breeze of an inadequate fan, watched a cat slink between the legs of a hospital bed and lick some organic fluid from the edge of bucket containing sharps…and there we go! I came to on a bed with ECG stickers on my chest. The Professor, a very serious man, asked me if I had a heart problem. I said no. What really upset me was the group of students and doctors at the foot of the bed peering at the soles of my shoes.
After that there were no more uncontrolled total faints. I came close during a stressful central line insertion as a senior house officer, but I think a hangover predisposed me to it. I slipped to the floor, put my cheek to the plastic tiles, sweating, the wire still sticking out of the patient’s neck, and fought it until a nurse brought a cup of ice cold water. Within minutes I was back on my feet, hands clean, fresh gloves on, ready to finish the job. I don’t think the patient ever knew what was going on.
Since then I have found myself in many faint-prone situations, but I am glad to report that it is no longer a problem. Blood, stress, chaos, suffering…none of it hits my pulse rate or blood pressure. Rest assured, if you are a fainter, it gets better.
[This article appeared in The Guardian online]
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