bear with me

In one of our duties last week, a man was brought in the ER one night due to difficulty of breathing. He was having a very severe asthma attack. Duke was our captain and we did all we could to save him. And we almost lost him that night. In fact, his respiratory muscles were so tired that for a few seconds, he just stopped breathing. Then, before he could be intubated, he started breathing again. Probably, the medications given started working or, it just wasn’t his time yet.

A few hours after that attack, he started improving. Before duke slept that night, the man was already talking, even smiling, although, he looked really exhausted. Day by day, we saw him recover. We saw what he really looked like, with eyes not bulging, nose not flared, neck vessels and muscles that weren’t too prominent. He wasn’t bad looking at all. Though there were still times he would suddenly have asthma attacks, they weren’t as bad as the time he first came in.

During one of our rounds, we asked him what he could remember the night he was brought in. We asked him if at one point, he saw a very bright light, like what others said they saw during near-death experiences. But he didn’t see anything. All he could remember was he was in the ER, gasping for every breath he could take.

On the day duke and I went back to manila, he was discharged from the hospital too, greatly improved. I wasn’t able to say goodbye to him before we left coz we were so much in a hurry.

This week, I went on duty on the same hospital, but without duke this time. On Tuesday morning, I heard a man shouting from outside the ER, asking for help. This man looked familiar and he was carrying, what looked like, a lifeless man in his arms as he entered the ER. He asked me to do anything I can to save this man, which was his father. But it was too late. The man wasn’t breathing and there was no heartbeat. But I started pumping his chest anyway and a nurse started to give him oxygen by ambu-bagging. I asked another nurse to insert an IV line but his veins were already collapsed. There was no way we could save him even if I intubate him.

As it turned out, this man gasped his last breath while on the way to the hospital that morning. He was having another severe asthma attack. And this was same man we saved a week ago, but this time, it was his time.


As the attending physician, I signed my very first death certificate. Obviously, it wasn’t a nice feeling. It is something that I don’t want to be repeated ever again.

I don’t think I’m really cut out for this kind of drama. I don’t think I’d want to be a doctor anymore.


Blogger duke said...

when you texted me about his death, i just couldn't believe it. i suspect it was the steroids not tapered properly and was abruptly stopped which caused the flare of his asthma. maybe we should have had taken the burden of instructing (again) him ourselves. i did it the night before. maybe we should have made orders in his chart regarding his prednisone. i did't want to overrule his consultant.

his is the first life i've saved without a superior. i thought i succeeded.

Aug 19, 2005, 3:50:00 AM  
Anonymous SilverMoon said...

Oh Sweetie,
((((Kero))) Huge hugs to you! I suffer from asthma but not that acutely. Please continue to give your gifts as a skilled doctor. I understand you not feeling like being one. That emotional first time will always be so hard, but so will the next times because you are a caring person who will never be hardened to human life.

I realize that it must have been and probably STill is devastating, to have seen someone die. Please remember that life is part of death and death part of Life. My thoughts are with you and his family. Take care, internet friend.

Aug 19, 2005, 7:43:00 AM  
Anonymous chie said...

I know how it feels friend. when i've helped patients, i have a smile in my face and life just goes on and i don't really think much of it bec that's my job.....to help people get better. when things go bad, i can't stop thinking what went wrong, what should or i should not have done....only to find out from my colleagues that i did nothing wrong.there are moments that i would want to quit too......i guess it's just the nature of our job...we deal with human lives and the emotions that goes with it, as what my friend told me, we will only be mediocre doctors without the challenge, we just have to move on and hang on to God. take care.

Aug 19, 2005, 7:43:00 AM  
Blogger kero said...

duke: i couldn't believe it too. you know what, he was already having attacks the night before he died but they didn't have the money to go back to the hospital. they thought he's going to get better in the morning but they were wrong, then it was too late.

silvermoon: i'll try to be the best doctor that i can be. but i still have to learn not to be too emotional or too attached with my patients.

chie: one of the reasons i don't want to go into IM (aside from the toxicity), is to avoid the heavy feeling in my heart everytime i would lose a patient...but then, i don't want to be a mediocre doctor too.
choices, choices! to be or not to be?...the ultimate question!

Aug 26, 2005, 2:16:00 AM  
Anonymous bugsybee said...

Hi Kero. I feel out of place here because it seems you're all doctors but if it's any qualification, my father was a good doctor and I also wanted to be a doc (but he said no).

Anyway, I've always wondered what it would have been like if I ended up a doc and had a patient dying on me. That's when I thank my stars that I was a teacher, not a doc. A student failing the board exams was bad enough for me (I'd cry for many hours till I run out of breath, I'm also asthmatic).

But I just wanted to write this comment to tell you to please not say that you don't want to be a doc anymore. Judging from the things I have so far read here, you'll be a good doc. We need more good docs here.

Thanks for visiting my blog. (I suspect you got the link from Doc Duke?) May I link you to my blog?

Aug 27, 2005, 2:10:00 PM  
Blogger kero said...

hey bugsybee, thanks for the nice words. don't worry, i'm not giving up yet. i wrote that entry when i was still a little affected by what happened. =)

you can link me to your blog, only if i can link you to mine too. =)

Aug 27, 2005, 6:53:00 PM  
Anonymous bugsybee said...

That'd be nice - link away and thanks!

Sep 1, 2005, 11:12:00 AM  

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