A Good Amount of Art - SonoSite Ultrasound

00:02:17,174 - And I get off the phone, I'm like, 28 00:02:17,174 --> 00:02:18,655 she just thanked me for telling me, I, 29 00:02:18,655 --> 00:02:20,590 for me telling her that she had cancer. 30 00:02:20,590 --> 00:02:22,724 - We kidded around, and that's what I need. 31 00:02:22,724 --> 00:02:25,357 I need somebody that can say, "Yeah, 32 00:02:25,357 --> 00:02:27,577 "you're gonna need a good glass of wine tonight." 33 00:02:27,577 --> 00:02:28,974 - If I was not using ultrasound, 34 00:02:28,974 --> 00:02:31,068 she came in with her mammograms and ultrasounds, 35 00:02:31,068 --> 00:02:32,596 I would look at them on the viewbox, 36 00:02:32,596 --> 00:02:33,873 say, "Yeah, there's your tumor." 37 00:02:33,873 --> 00:02:35,314 But I can't feel anything, 38 00:02:35,314 --> 00:02:38,068 and the radiologist is gonna stick a wire there 39 00:02:38,068 --> 00:02:39,694 and we'll know for sure that we got it out. 40 00:02:39,694 --> 00:02:44,104 - She just was very sure of what was going on, 41 00:02:44,104 --> 00:02:46,081 and what was gonna happen to me. 42 00:02:46,081 --> 00:02:48,220 - Now what I can do is scan them in the office. 43 00:02:48,220 --> 00:02:49,293 She's here with her husband, 44 00:02:49,293 --> 00:02:50,733 they both see the pictures, 45 00:02:50,733 --> 00:02:52,132 they look exactly like the pictures 46 00:02:52,132 --> 00:02:53,823 that the radiologist took. 47 00:02:53,823 --> 00:02:55,881 And they know then that I'm gonna take this 48 00:02:55,881 --> 00:02:59,540 to the operating room, and actually remove 49 00:02:59,540 --> 00:03:01,106 what needs to be removed. 50 00:03:01,106 --> 00:03:02,791 - Milestones are really important to me. 51 00:03:02,791 --> 00:03:05,091 Like, let's say we're at doctor's graduation. 52 00:03:05,091 --> 00:03:07,241 - I love what I do. 53 00:03:07,241 --> 00:03:09,412 This is pretty much my life. 54 00:03:09,412 --> 00:03:10,433 - And like we were saying before, 55 00:03:10,433 --> 00:03:12,126 I guess I'm really just really thankful 56 00:03:12,126 --> 00:03:14,280 I was born in this time, 57 00:03:14,280 --> 00:03:16,218 that we have doctors that do what they do 58 00:03:16,218 --> 00:03:18,491 and medicine that does what it does. 59 00:03:18,491 --> 00:03:21,600 - The fact that I don't have to rely on a radiologist 60 00:03:21,600 --> 00:03:23,903 allows me to just do what I need to do, 61 00:03:23,903 --> 00:03:28,070 and I think it allows me to take better care of my patients. 62 00:03:30,757 --> 00:03:34,924 - It'd just be really grateful that I'm still here. 63 00:03:37,740 --> 00:03:40,096 - And that gives me actually a lot of strength 64 00:03:40,096 --> 00:03:41,749 and a lot of satisfaction to see 65 00:03:41,749 --> 00:03:44,271 what they're able to go through. 66 00:03:44,271 --> 00:03:45,745 I'm not sure I could do that. 67 00:03:45,745 --> 00:03:48,745 (alternative music) 68 00:03:53,939 --> 00:03:56,171 - Sometimes it's overwhelming. 69 00:03:56,171 --> 00:03:58,855 Some days we have patients sick everywhere, 70 00:03:58,855 --> 00:04:00,554 you have to prioritize who's the sickest. 71 00:04:00,554 --> 00:04:02,496 Your way of seeing life is different 72 00:04:02,496 --> 00:04:04,476 when you have a 30-year-old, 20-year-old guy 73 00:04:04,476 --> 00:04:06,293 that dies almost into your hands. 74 00:04:06,293 --> 00:04:08,230 You know, when you take your car and you go back home, 75 00:04:08,230 --> 00:04:09,880 you don't have the same way of looking at 76 00:04:09,880 --> 00:04:12,402 what you're doing or looking at your kids or family. 77 00:04:12,402 --> 00:04:14,504 Dealing with patients and their families, 78 00:04:14,504 --> 00:04:15,991 you see them happy. 79 00:04:15,991 --> 00:04:17,846 You have to pronounce people dead, 80 00:04:17,846 --> 00:04:19,292 tell their family. 81 00:04:19,292 --> 00:04:22,670 Young people, old people, you have to live with them 82 00:04:22,670 --> 00:04:24,602 these moments that are unique. 83 00:04:24,602 --> 00:04:27,944 And the arrival of bedside ultrasound in the ICU 84 00:04:27,944 --> 00:04:31,077 or any acute care environment is a revolution. 85 00:04:31,077 --> 00:04:32,486 But when you're at the bedside, 86 00:04:32,486 --> 00:04:34,425 you really wanna have an answer 87 00:04:34,425 --> 00:04:35,953 to a specific question, 88 00:04:35,953 --> 00:04:39,138 so you need to have something that will help you 89 00:04:39,138 --> 00:04:40,336 go a bit further. 90 00:04:40,336 --> 00:04:42,941 We image the patient and if we see something, 91 00:04:42,941 --> 00:04:43,972 or we don't see it. 92 00:04:43,972 --> 00:04:47,639 But when you find it, that's quite a thrill. 93 00:04:48,904 --> 00:04:51,297 So, yeah, so this 44-year-old guy was in the 94 00:04:51,297 --> 00:04:53,824 emergency room, has a big heart attack. 95 00:04:53,824 --> 00:04:55,763 He has three other sick vessels, 96 00:04:55,763 --> 00:04:58,868 so we send this patient for emergent bypass. 97 00:04:58,868 --> 00:05:00,516 He has four of them. 98 00:05:00,516 --> 00:05:01,766 He gets better, 99 00:05:02,622 --> 00:05:04,342 in the recovery room. 100 00:05:04,342 --> 00:05:07,309 He goes to the ICU, he's doing okay initially. 101 00:05:07,309 --> 00:05:09,000 And then a few hours after, 102 00:05:09,000 --> 00:05:10,899 he started having problems with his breathing. 103 00:05:10,899 --> 00:05:13,422 Short of breath, oxygen level going down, 104 00:05:13,422 --> 00:05:15,323 down, down, down, 105 00:05:15,323 --> 00:05:17,460 so we tried to stabilize him, 106 00:05:17,460 --> 00:05:18,867 but we cannot move the patient 107 00:05:18,867 --> 00:05:22,286 while they are on this high frequency ventilation. 108 00:05:22,286 --> 00:05:25,344 So I did a bedside ultrasound on him, of his heart. 109 00:05:25,344 --> 00:05:26,625 - At one point he just said to me, 110 00:05:26,625 --> 00:05:29,100 "Has he been on a trip recently?" 111 00:05:29,100 --> 00:05:30,717 - So because he has clots in the arteries 112 00:05:30,717 --> 00:05:33,600 of his lungs, the blood cannot go there easily, 113 00:05:33,600 --> 00:05:35,165 and the oxygen level is low. 114 00:05:35,165 --> 00:05:37,446 And the treatment is very different 115 00:05:37,446 --> 00:05:39,533 than what we were doing. 116 00:05:39,533 --> 00:05:43,369 So we had the suspicion of that with the bedside ultrasound. 117 00:05:43,369 --> 00:05:46,101 Sent him for the test, found that he had that, 118 00:05:46,101 --> 00:05:48,700 and completely changed his therapeutics. 119 00:05:48,700 --> 00:05:52,044 Four or five days after, he was off of the ventilator. 120 00:05:52,044 --> 00:05:54,812 He was extubated, talking to us. 121 00:05:54,812 --> 00:05:56,729 This guy has five kids, 122 00:05:57,945 --> 00:05:59,682 very charming wife. 123 00:05:59,682 --> 00:06:01,580 - And that's when I went, just went back to the hospital 124 00:06:01,580 --> 00:06:04,136 for a monthly blood test. 125 00:06:04,136 --> 00:06:06,695 The nurse said, "You're lucky you have Dr. Beaulieu 126 00:06:06,695 --> 00:06:07,598 "as your doctor." 127 00:06:07,598 --> 00:06:08,767 I said, "You don't have to tell me that." 128 00:06:08,767 --> 00:06:10,748 - When I saw him, two, three weeks ago in my office, 129 00:06:10,748 --> 00:06:13,423 he was coming back from Cuba, scuba diving. 130 00:06:13,423 --> 00:06:15,811 And I saw him, half-dead. 131 00:06:15,811 --> 00:06:18,378 One huge week with this guy and in the outpatient clinic, 132 00:06:18,378 --> 00:06:20,890 you're like, that's worth it. 133 00:06:20,890 --> 00:06:23,890 (alternative music) 134 00:06:31,510 --> 00:06:33,206 - [Voiceover] We had a 100-year-old guy 135 00:06:33,206 --> 00:06:35,312 come in at around midnight last night. 136 00:06:35,312 --> 00:06:39,647 He and his wife have been married 77 years. 137 00:06:39,647 --> 00:06:41,835 Very pleasant, friendly guy, 138 00:06:41,835 --> 00:06:45,186 with a horrible wrist fracture. 139 00:06:45,186 --> 00:06:47,302 As an anesthesiologist, immediately when you meet someone, 140 00:06:47,302 --> 00:06:50,227 you think, what's the anesthetic I'm gonna do with this guy? 141 00:06:50,227 --> 00:06:51,627 As I'm talking to him, I'm thinking, 142 00:06:51,627 --> 00:06:53,649 I'm running through the options in my head, 143 00:06:53,649 --> 00:06:54,803 the more I thought, you know, 144 00:06:54,803 --> 00:06:58,186 I think my best bet here is to give him nothing. 145 00:06:58,186 --> 00:07:00,506 And I'm just gonna block the arm. 146 00:07:00,506 --> 00:07:02,696 I want him as lucid as possible, 147 00:07:02,696 --> 00:07:04,845 and I wanna be able to wake him up. 148 00:07:04,845 --> 00:07:05,917 We went into the operating room, 149 00:07:05,917 --> 00:07:07,322 and I looked at the guy. 150 00:07:07,322 --> 00:07:09,426 Normally I would do an infraclavicular brachial plexus block 151 00:07:09,426 --> 00:07:10,909 which goes through all the muscles, 152 00:07:10,909 --> 00:07:12,192 you're close to the lung, 153 00:07:12,192 --> 00:07:13,675 you're thinking about all those things. 154 00:07:13,675 --> 00:07:15,615 And he was kind of slouched in like this. 155 00:07:15,615 --> 00:07:16,771 So I thought, okay, this is gonna be 156 00:07:16,771 --> 00:07:18,586 a little more technically challenging, 157 00:07:18,586 --> 00:07:21,353 and I got him on the table and took a look. 158 00:07:21,353 --> 00:07:23,624 And he, amazingly enough and thank God, 159 00:07:23,624 --> 00:07:25,933 he had this beautiful artery that I could see, 160 00:07:25,933 --> 00:07:27,417 and gorgeous brachial plexis. 161 00:07:27,417 --> 00:07:28,988 I could see all the cords. 162 00:07:28,988 --> 00:07:32,045 So I could see it just flooding the lateral cord. 163 00:07:32,045 --> 00:07:34,237 The posterior cord, and the lateral cord. 164 00:07:34,237 --> 00:07:35,433 You know, we did this all on the gurney 165 00:07:35,433 --> 00:07:37,583 before we even transferred him over to the OR bed. 166 00:07:37,583 --> 00:07:39,523 Cause I asked him preop if he had any pain, 167 00:07:39,523 --> 00:07:40,843 and he looked at me and he goes, 168 00:07:40,843 --> 00:07:43,448 "Not as long as you don't touch it." 169 00:07:43,448 --> 00:07:44,724 And I said, "Okay, don't worry about it. 170 00:07:44,724 --> 00:07:45,755 "We're not gonna touch it." 171 00:07:45,755 --> 00:07:48,015 So I didn't move him at all, we did the block, 172 00:07:48,015 --> 00:07:50,158 I said, "Does it hurt now?" 173 00:07:50,158 --> 00:07:51,888 And he looked at me, and the orthopedic surgeon 174 00:07:51,888 --> 00:07:53,536 was there too, and I was like, I paid the guy 175 00:07:53,536 --> 00:07:55,307 a hundred bucks, and he goes, 176 00:07:55,307 --> 00:07:58,242 "No, feels a whole lot better now." 177 00:07:58,242 --> 00:07:59,314 And I looked him and I said, 178 00:07:59,314 --> 00:08:01,126 "You just made my day! 179 00:08:01,126 --> 00:08:02,691 "That was great!" 180 00:08:02,691 --> 00:08:05,691 (alternative music) 181 00:08:11,344 --> 00:08:13,511 - I see tragedy every day. 182 00:08:14,629 --> 00:08:17,023 You could say it's a specialty of tragedy. 183 00:08:17,023 --> 00:08:18,915 - People are sort of at death's door. 184 00:08:18,915 --> 00:08:21,271 - You've got people yelling and screaming, 185 00:08:21,271 --> 00:08:22,446 and in that type of environment, 186 00:08:22,446 --> 00:08:26,254 you've gotta tell somebody about your personal history, 187 00:08:26,254 --> 00:08:28,149 about personal things that you don't talk about 188 00:08:28,149 --> 00:08:30,705 with everybody every day. 189 00:08:30,705 --> 00:08:33,432 And to get somebody to talk about those types of things, 190 00:08:33,432 --> 00:08:37,071 cause they're very important in treating a patient, 191 00:08:37,071 --> 00:08:37,904 is an art. 192 00:08:37,904 --> 00:08:40,085 - You see the fabric of society. 193 00:08:40,085 --> 00:08:43,097 - And you see people and how we treat each other 194 00:08:43,097 --> 00:08:43,930 in real life. 195 00:08:43,930 --> 00:08:44,786 - My neighbors always ask me, 196 00:08:44,786 --> 00:08:45,619 "Did you see anything cool?" 197 00:08:45,619 --> 00:08:46,452 I'm like, 198 00:08:47,479 --> 00:08:48,427 "I don't remember. 199 00:08:48,427 --> 00:08:50,163 "It was just a blur." 200 00:08:50,163 --> 00:08:51,192 - To save that person's life, 201 00:08:51,192 --> 00:08:53,215 I don't have time to call the radiologist 202 00:08:53,215 --> 00:08:55,485 who's probably at home at 4 o'clock in the morning, 203 00:08:55,485 --> 00:08:57,751 say, "Can you come and do the ultrasound for me?" 204 00:08:57,751 --> 00:08:58,784 - [Chris] If you could look right through the body 205 00:08:58,784 --> 00:08:59,653 at the organs you're interested in, 206 00:08:59,653 --> 00:09:01,142 why the heck would you not do it? 207 00:09:01,142 --> 00:09:04,065 - I'm sure he would really be happy if he could say, 208 00:09:04,065 --> 00:09:05,384 "Dr. Saylor, why don't you do that, 209 00:09:05,384 --> 00:09:07,243 "and save the patient and let me know 210 00:09:07,243 --> 00:09:08,938 "how it turns out in the morning?" 211 00:09:08,938 --> 00:09:10,259 - [Chris] There's been a lot of moments like that, 212 00:09:10,259 --> 00:09:13,092 with ultrasound where I say, "Wow. 213 00:09:13,941 --> 00:09:15,459 "This guy would have died." 214 00:09:15,459 --> 00:09:18,520 Or, as a physician you think to yourself, 215 00:09:18,520 --> 00:09:20,620 "I almost killed this lady." 216 00:09:20,620 --> 00:09:23,508 - But now you've got a patient here tomorrow. 217 00:09:23,508 --> 00:09:25,943 Are you gonna be able to save this person's life tomorrow? 218 00:09:25,943 --> 00:09:28,671 - Just the other day, I had a tragic drowning case 219 00:09:28,671 --> 00:09:29,791 that I was involved with. 220 00:09:29,791 --> 00:09:33,958 An 18-month-old that was found at the bottom of a pool, 221 00:09:35,094 --> 00:09:39,014 and we were able to get her heartbeat back. 222 00:09:39,014 --> 00:09:40,043 The child did die. 223 00:09:40,043 --> 00:09:43,224 - I've gotta be just that much better tomorrow. 224 00:09:43,224 --> 00:09:45,922 Because something else is coming through that door 225 00:09:45,922 --> 00:09:47,149 that I may need it for. 226 00:09:47,149 --> 00:09:51,742 - As a specialty, we get it right about 80% of the time. 227 00:09:51,742 --> 00:09:53,481 We're sort of 80%-ers. 228 00:09:53,481 --> 00:09:56,979 And a lot of people aren't comfortable 229 00:09:56,979 --> 00:09:58,594 not getting to 100%. 230 00:09:58,594 --> 00:10:00,808 And so that drives some emergency physicians crazy 231 00:10:00,808 --> 00:10:01,641 and out of the field. 232 00:10:01,641 --> 00:10:04,021 - As a father and with many other people 233 00:10:04,021 --> 00:10:06,544 in the resuscitation team that were parents, 234 00:10:06,544 --> 00:10:08,853 to see that sort of case, 235 00:10:08,853 --> 00:10:10,186 that was pretty, 236 00:10:12,166 --> 00:10:14,642 that was a big impact case. 237 00:10:14,642 --> 00:10:16,745 - And, at the end of the day, 238 00:10:16,745 --> 00:10:17,737 can you sit back and say, 239 00:10:17,737 --> 00:10:20,213 "I did everything I could for that person?" 240 00:10:20,213 --> 00:10:21,536 - Within minutes, I have to then go back 241 00:10:21,536 --> 00:10:22,777 and see a sprained ankle. 242 00:10:22,777 --> 00:10:24,929 - Hopefully I have a good outcome. 243 00:10:24,929 --> 00:10:26,536 - Hmm. 244 00:10:26,536 --> 00:10:28,453 Is it more outer signs? 245 00:10:30,005 --> 00:10:32,194 It's a good amount of art. 246 00:10:32,194 --> 00:10:34,999 It's a good amount of art. 247 00:10:34,999 --> 00:10:37,416 (rock music) "/>