As I started my shift in the emergency department after a long 2 weeks off work. Little had I known what was in store fore me on my shift as a senior. I picked up patients hour by hour and then there was a 58 year old woman with shortness of breath. I walked into the room, introduced myself as the resident taking care of the patient and found her inhaling the albuterol/atroven nebulizer. She said she was still short of breath after 4 nebulizer treatment. I took my history, listened to her lungs and she had some wheezing but no history of COPD/Asthma. she is renal failure patient on dialysis. I walked out of the room, thinking this lady has a pulmonary embolism but I could not confirm by clinical gestalt as she is allergic to dye.
I eventually realize the patients labs came back abnormal and slightly elevated potassium as she spikes a fever in the emergency department. I treated the patient with antibiotics, gave her tylenol, treated her with insulin and continued to monitor her progress in the ED. 3 hours later, her daugther came running to me, my mother is confused calling herself emily, thats not my mothers name! she yelled as she panicked and paced back and forth in the room. The husband spoke softly I am scared and i feel like passing out. I encouraged both of them as she will be ok, Her oxygen saturation started to decline while on full mask. My attending walked into the room and look at the patient in the face telling her, you are doing great, take deep breaths, you are looking the most beautiful woman in the world. The patient was looking better, breathing as instructed.
20 minutes later, the nurse overhead paged me to room as my patient started having agonal breaths. My patient’s heart rate droped to 40 and she had no pulse. The room was immediately crowed with nurses, doctors, residents, tech, intensivist. I quickly rushed the family out the room as we began to resuscitate the patient. We did finally got pulses back after 20 minutes, which felt like an hour. She was immediately rushed to the ICU where she died 20 minutes later.
I could not believe it! I was devastated. I thought of everything possible I could have done differently to save this patients life and I was drawing blanks. I felt deeply within that I failed. I could not sleep for 2 days. I prayed to God for help as I had no answers for myself. I finally came to the conclusion that death is inevitable regardless of the exit pathway for each individual. I quickly realize my limits as a physician, though I have helped many, I cannot save everyone including myself, as it is destined for a man to born and one day to die. But as a doctor, no amount of medical training can prepare for the end, nothing in this world can bring down more than to see patient talking to you 4 hours ago and die in your face. It’s facing death, that physicians realize we can only do so much. My attending patted me on the back and say, smile, you have to go see the next patient, this will happen to you more than you think, you just have to accept it and move on. As I walked to my next patient room, blanking in my memory and trying so hard to smile to the next patient who had no idea that another life just passed seconds ago before my arrival; which makes life so special and for I appreciate it more for everyday I am able to walk, talk and smile without a ventilator or life support.
This experience has humbled me back to knees. The chronicles continues…