minutiae

Whoever said 'the devil is in the detail' could have had my job in mind. Patient has INR (International Normalised Ratio-a measure of bleeding time) of 9.0 (9 times normal). Easy - give him intravenous vitamin K. But it falls to me to put in the intravenous cannula. He has tiny, delicate veins and paper-thin skin. Every time I put the needle in, it draws blood, and then, he squeals with pain, moves, and the needle goes right through the vein, leaving a haematoma the size of a golfball. Seven purple golfballs later, the cannula is finally in and I write up the prescription. "Thank you, doctor," he says. Not at all.