My First Needlestick - Part 1
It's really amazing how much progress has been made in the treatment of AIDS. It seems like the only really sick AIDS patients I see now are street people who don't take their medications. But only 15 years ago, our ICUs were full of dying young men with ravaged immune systems; skeletal petri dishes clinging to life with glazed eyes and cottony mouths. Unfortunately, it was just such a patient whose blood touched mine early one morning.
He was 19 years old and probably weighed 100 pounds. His CD4 count was hovering around zero, and while we didn't test for viral load in those days, I'm sure his was maxed out.
I was the senior Medicine resident in the ICU, it was 0530, and I'd been awake for more than 24 hours. Most of that time was spent on high alert, putting out fires, juggling life and death.
But there was to be no rest for the weary that morning. Rounds were coming up, and this patient needed a central venous catheter pronto. His blood pressure was 60 systolic, and he was losing his battle with entropy. His femoral pulse was barely palpable, and his slight agitation made finding the vein difficult. After several attempts, finally I got it. I probably breathed a sigh of relief as I threaded a long wire through the 4 inch long 14 gauge needle, withdrew the needle over the wire and placed it down on the sterile drape where it disappeared, rolling unnoticed under a crease in the paper.
The rest of the procedure seemed like smooth sailing as I tried to make up some time. A third year resident is the master of central lines, and at that time I considered myself the best (I wish I was as good at them now as I was then). The lines were flushed, the pressors were started, the catheter was sutured quickly in place and adeptly dressed. I might just get to rounds on time after all, I thought.
After removing the fenestrated drape from the patient's groin, I wadded it up to throw it away.
That humongous bloody hollow bore needle had stuck me right in the palm. Sonofabitch.