These past few days have been an emotional trainwreck full of firsts for me, but today is the first “first” that I’ve had to share with a group. The class was at the hospital waiting to be tested on exploration of the abdomen, and the first student had just started when the doctor was called to a code across the room. The code was for an infant who couldn’t have weighed more than 3 kgs whose heart had stopped.
He quickly intubated as a nurse started a cardiac massage while another injected adrenaline. After a while he decided to perform a venesection of the left exterior jugular vein so that the kid might at least have a snowball’s chance, but the vein was too fragile; had he kept on trying he would have most likely bled out. While all of this was happening the child’s heart stopped 3 time and another 6 doses of adrenaline were applied, but after the first event one look at the pupils and you knew.
The doctor left a nurse to apply pressure to the vein so that he would not bleed out and informed the parents. No more could be done. He told us that the infant had come into the hospital with a terrible outlook - he had a slew of malformations, not the least of which was that he only had half of a heart. The parents had already been informed that the odds of their being able to take their child out of the hospital were slim to none, but that did not make things any easier for them. As I walked out I could see them in a corner of the hallway, huddled in each others arms. I walked by and said nothing. What words could I offer to the parents of a child who was now for all intents and purposes dead.
This has not been a particularly good week.
life is hard sometimes but if you think about it you’re nothing more than a big colony of cells who are choosing to cooperate for the moment and there’s nothing REALLY stopping them from all scattering apart so if you can even read these words and make sense of them in your still functioning brain then in a sense today was a win for you
Last Friday I was in a pretty dark mood, and going to the hospital for class first thing in the morning with no breakfast did little to help out. I was just about to start the physical examination of my patient when some nurses kicked everyone out (never got to ask why). My classmates and I went to talk about what we’d gathered from our patients, and he told us “Before we get started, I’d like all of you to go see the girl in bed 219.”
I just wanted to double-check — are you SURE I need to go to the hospital?
40-something male with a badly-infected finger (red hot “sausage” finger, tendons obviously involved, pus oozing around nail, pain up to wrist, fever) + no health insurance…
… who returned to the front desk of my Urgent Care 2 hours after I discharged him to go to the hospital, where the orthopedic surgeon is (hopefully) still waiting to evaluate him and possibly take him to surgery right away.
Did he relate what he had done that started him down this horrible path of bad decisions?