* * Anonymous Doc

Wednesday, March 9, 2011

Hard day. We lost a patient I'd come to really feel connected to. It's not that it was completely unexpected, but it was unexpected it would happen in the hospital, and certainly that it would happen today. We wanted to get him home. We thought we were going to be able to get him home, and we couldn't. Too many issues, one on top of the next, and it all went downhill very quickly. I'm beating myself up over things I could have done differently, but intellectually I know it was a losing battle, I know that even in a best-case scenario it was a difference of days, and maybe not even. I'm not cut out for inpatient care. It's one thing to know a patient is dying, or to know a patient has died. It's another thing to quite literally watch them die. To see the numbers on the monitor, to see the patient's pH dropping, to see the patient's very last breath.

As they wheeled him out of the room, I overheard the wife of the man in the other bed talking to her husband.

"They're moving him out. Now you'll get the window."

8 comments:

  1. "They're moving him out. Now you'll get the window."

    That's rather... Hitchcockian.

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  2. And life goes one.

    Life is cold like that.

    M

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  3. We're in a heme/onc unit now. One of our professors made me want to be an oncologist for all of 20 minutes until he told us about a 26 yr old patient who's dying. She came in to her doctors and said, "I'm 26, you can't let me die." I would be haunted. I hear you, I don't think I'm cut out to watch people die.

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  4. Oh, man. That last paragraph just gave me a total body chill. Are we really that cold? Sorry for your loss. Unfortunately, it never really gets any easier.

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  6. Reminds me of the pilot episode of "Only When I laugh" http://www.youtube.com/watch?v=MXiy07E3Cuo

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  7. "We're sorry. Your child can't get a liver transplant because he has a serious metabolic disease. You've neer heard of it. He doesn't have many symptoms yet. But it's fatal. And we can't give him a liver, because he will die anyway. Probably during the transplant operation. I know you think his only problem right now is his liver dying, but his brain is dying, too. Just slower. I know you had a normal child two weeks ago. I know that now he's not. I know you were hoping until the last moment that hes still normal, and it's just his liver, but it's not. We know you hate us now, and we understand. We know he's going to die within the week without a new liver. We're sorry."

    And we proceed to sign off on his chart, and his life, with simple words: "Neurodegenerative disorder. Does not qualify for liver transplant."

    And then people wonder why we don't sleep at night. Why we have nightmares. Why a healthy, stable resident starts having panic attacks. That's why.

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