Halo Man

It was an hour before departure. The cruise ship was full to capacity. I was on my way down to the Infirmary to meet the medical crew I would be sailing with for 3 weeks through the Panama Canal.

I was flabbergasted when I saw him, a 6'3" skinny old gentleman in a metal Halo walking toward the elevators with his wife. I walked into the infirmary, introduced myself to the physicians and lead nurse, and said "Were in trouble. I just saw an old man in a Halo walking the halls. Who in the hell let him on this ship?" The passenger physician said "No way!". The crew physician said "What's a Halo"? The lead nurse got on the phone to the ship Captain. After a lot of talking the nurse got off the phone and said "he's staying". You don't argue with the Captain.

That evening I was "on-call" for any medical situations. The ship entertainment hadn't even begun when I was paged "Man fell in the showroom". I grabbed my medical bag and went. Sure enough there was "Halo Man" as we endearingly began to refer to him. He was sitting in his seat with trickles of blood running down his forehead from two Halo screws. His wife said "He's OK now. The ship swayed and he fell over". I can see it. This tall, skinny, wobbly old gentleman with

12 pounds of metal on his head gets tipped off balance by a wave and down he goes. Yep, were in trouble. He looked at me with a blank stare and smiled. I cleaned him up, put a little triple antibiotic cream around the screws, checked his pupils, gave him some commands to follow and called the Doc to fill him in. All was uneventful the rest of the night.

Next day, same scenario only out on the deck this time. The passengers watching were pretty freaked out at the site but again...all checked out. We asked his wife to stop by the infirmary daily to let us keep an eye on him. She was more than happy too. A few more days went by and when she brought him to the infirmary the areas around the screws looked red and somewhat swollen. Antibiotics were now in order. While in the Infirmary she shared with me "He has Sundown Syndrome and at night he fights with his Halo and tries to wrestle it off his head" I couldn't stop myself "Why would you bring him on a cruise for 3 weeks?" Leave it to the nurse to finally address the obvious. Her response..."Oh he's a tough one. This is not the first time he's been all broken up. Do you know what he did for his 80th birthday? He went dirt bike racing and broke C-2!! I'm so sick of this I could just kill him. He thinks he's that Evil Kinevil guy. He's broken everything in his body twice over". I was in shock. Poor lady! She's been a 24 hour personal nurse for too many years! "I decided I needed a vacation and he couldn't be any worse than he is at home so I signed up for the cruise".

Halo Man's cellulitis used up all our IVPB Levaquin. And with all his wrestling at night it wasn't improving like we wanted it to. The physician called it....he needed to disembark and go home. Great! This poor wife is the one who deserved a halo! Granted, all the travel arrangements were made for them but now this little old couple was getting off in Nicaragua of all places to catch a northbound plane.

But before she left I had a chance to sit with her and talk about putting hubby in assisted care. They were in their 80's and SHE needed a break. She gave me a hug before they left the boat, and I gave her an old Irish travel blessing.

TOYS: Christmas Hazards

Working the holidays has it's pros and cons.

On the positive side all the "extra" people are gone (administration, students, JCAHO prep teams, extra visitors). The overhead announcements have quieted. The team that is working seems more relaxed. Family members treat you as those "Angels of Mercy" who sacrifice to take care of their loved one on Christmas and there is always too much food.

On the negative side.... you have to be away from home when it feels like everyone else in the world gets to be with their children, the staffing is pretty thin and if your in the ER...nobody told the public to stay home, not drive drunk and not to get in fist fights with relatives.

And then there are the toys. The least of the recognized holiday dangers. A young Dad limped into the ER holding his side. His story: "I came down stairs and the kids had their toys everywhere. All over the living room, the hallway, the kitchen..everywhere. I told them to pick them up then went back up stairs. When I came down again my son hadn't picked up any of his stuff. I tripped over something and fell onto the coffee table. I think I broke a rib."

An hour later we admitted him to ICU with 3 fx ribs and a torn spleen. He was hemo-dynamically stable but he was in shock at what we had found. He kept shaking his head saying "What were the odds?". In no time at all his children had arrived to be at his bedside with Mom. I felt really bad for the 7 yr old boy hiding in the corner. I knew it was his toys.