Agraphia Medical Tragicomedy

10Jun/11Off

Futile

It was a shitty day.

Some days are just like that.  Instead of humor and good outcomes, everything is pathos and tragedy.  Kind, sweet old ladies suddenly and unexpectedly die horribly painful deaths.  Young children are neglected by parents high on street drugs. An unexpected cancer diagnosis brings a grown man to tears.

In the midst of all this, TRAUMA CODE 1, coming by chopper.  A 50-something woman found out her husband was cheating on her and shot herself straight through the head.   For better or for worse the human body is resilient, so her heart was still beating when he found her in the bathtub.  Medics were clearly shaken by the scene when they arrived.

She rolled into the trauma bay a mess.  The room was abuzz with malignant energy.  Everyone knew something evil had happened here.

It was immediately apparent that she had no chance of survival; brain tissue was matted all over the trauma stretcher.  Traumas like this are formulaic.  Medics give report as a room full of physicians, nurses, and techs stand alert.  The patient is transferred over to the trauma bay stretcher, IV's are placed while an intern calls out a physical exam.  Clockwork.

A few minutes in her blood pressure started to drop, quickly.  It's a hallmark of severe brain injury and is usually easily managed if recognized early. Still, drops in blood pressure are a sign of badness, a portent omen of things to come.

"This is futile," said one of the trauma surgeons with a roll of his eyes, "she's fuckin' done."

Something in me snapped.  "There are still lives to be saved here," I snarled, "get your game face on or get out."

Everyone looked at me, taken aback.  I'm normally the champion for palliative and hospice care, and I'm a huge believer in one's right to die peacefully.  We physicians have a hubris about our capabilities that I find offputting; the human body is far smarter than we will ever be.

Quietly, I explained.   "She's got a pair of perfectly good kidneys, a liver, lungs, and a heart that can save the lives of several people today.  If she dies today, they do too."

After that the room silenced, and we got her to the ICU for stabilization.  She's on the transplant list pending final approval.  I hope that in her final moments she can help others, even if she couldn't help herself.

Some days are shitty. Hopefully there's a silver lining.

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  1. I admire your professional approach – thanks for setting a good example.

  2. 1)I am a pre med addicted to your blog.
    2)I work in determining donor suitability and recovery coordination for organ/tissue/eye donation.
    3)All of us who do this wish there were more doctors like you, since suitable organ cases are so rare. Thank you.

    These sort of cases, with suicide d/t a cheating spouse, are not uncommon. The ironic part is that he is probably the one who had to consent to having her tissues donated. So sad.

  3. Wow. As they say, “Like a fucking boss.”

    I can imagine it being very easy to get depressed with the job you do. But this is awesome.


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