What we go through
There was this lady in her sixties. She was admitted just before my 15-hour long shift started. On the wee hours of a Saturday morning.
There was already talk about her even before I met her, as the first most important patient of the morning. Severe bilateral community-acquired pneumonia with a fast downward spiral.
Put on BiPAP, 10/4 setting. A femoral artery stab for blood gases, because her radial pulses were already too weak. Another 18G cannula into her veins. 1 litre of 0.9% sodium chloride solution, stat. The glucometer read 2.0 mmol/L — give her 20mL bolus of 50% dextrose intravenously, now. And an indwelling urinary catheter. Two doctors and three senior nurses danced around her.
Her husband sat beside, in the corner of the room, silent.
And I realized how used to all of this I am already – even joking sometimes as we flashed needles around, shamefully forgetting how scary, and confusing, it must have been for him.
She had a good pre-morbid status, so she would be a candidate for the Intensive Care Unit. We spoke to the ICU consultant. He was a staunch man with a deep voice and a strict face, who hasn’t slept for more than 24 hours. It had been an absolutely crazy Friday night and Saturday morning that we walked ourselves into. He promised an ICU bed for her — but then a child was wheeled into the Emergency Department very sick, and priority was given to the child for the ICU bed, as less would disagree with. The bed was taken. She was now at the ceiling of her care. No more escalation.
We told her husband about this. It was difficult.
And I wondered… how did he think, to know that his wife was terribly ill, and the one thing that would sustain her if she deteriorated — a mechanical ventilator in the Intensive Care Unit — was just not accessible, as the Intensive Care Unit was already full?
What would you think – when you are helplessly slipping towards crossing the moment between having a life partner and no longer having one?
Is this it?? But yesterday she was still fine! I’ve only just done grocery shopping with her yesterday!! Am I not going to see her again, for ever??
What would you say to your life partner during his or her last moments?
Recount all the good times?
Recount all the regrets and mistakes?
Say the things you never could say? Does it still matter?
Promises of satisfaction
Have you ever looked around and realized that the world is just replete with promises of satisfaction? Think about it!
Blockbuster movies, parties with friends, breakaway shopping sprees, travel trips, hunting for music, chasing good books, enjoying food, and all the colorful product advertisements everywhere – do they not all target at our search for satisfaction? And the world is just full of such promises of satisfaction – that it is blinding.
Many of them are short-lived. Some of them are lies. We all know. Yet it is easy to get lost, and in the process, all we end up thinking and speaking of is about ourselves. All of this is like “a chasing after the wind”, as the book of Ecclesiastes aptly puts it.
There is much more to say, but I’ll stop. It actually takes some effort to think about this in the context of our personal lives (yours and mine)! But tell me what you think.
Four o’clock in the morning
Four o’clock in the morning.
Five hours into the night shift. It has been so stressful.
I almost entered a cold war with a nurse (How embarrassingly childish, I know, sigh…).
My hands shook like a wimp when I threaded the ET tube down the bougie into the
lady’s trachea.
I felt like a complete idiot after speaking in circling thoughts to the medical registrar.
I found I had nothing to offer at all, having just certified an old woman dead with her husband
sobbing harder and harder beside. I’ve never even known what to say in these situations.
This is totally not about the grandeur of doctors realizing how little humans can actually do,
But rather how little I know – how unable and how incompetent I am,
And how frighteningly unloving, unjoyful, unpeaceful, impatient, and unkind I can be,
When dealing with all sorts of people, in all sorts of situations, four o’clock in the morning.
In between the days and nights when things are going smoothly and happily,
I really thank God for this realization.
It makes me go back to Him.
–
( 3am in the hospital corridors, on a less eventful night! )
-
oming to you
from a junior doctor who is color-blind, cleft-lipped and left-handed — this is where
I largely write about my
somewhat weird and wonderful encounters in Medicine. I wish,
though, more often than not,
that I could rather spend my days
drawing colorful pictures and bringing stories to life...... -
Search
-
ALL IMAGES AND TEXT CC 2004- JOSEPH SIA.
POWERED BY WORDPRESS. | BACK TO TOP ↑
