I work night shifts this month. That means, I walk into a nearly empty hospital at 7PM and leave at 7AM when everyone else is coming in yawning and puffy-eyed! So far, I’ve been able to leave in a fairly decent mood in part because of the high that 6AM coffee gives to my sleep-deprived brain. But, last night was different.
I was finishing my shift and it was almost 6AM. I was carrying, along-with my regular pager, what we call the “Code Pager” which is a dreadful gadget that only rings when someone in the hospital “codes”, meaning comes very close to or is on their way to death. We got paged for a new patient who had just rolled in from one of the hospitals nearby. Of course he was sick. But we didn’t know just how much, and that caught us off-guard.
He had come in unconscious, breathing heavy and in that moment, for all that I knew, with a very little chance of survival over the next few hours. We gave him all that we could, but he wouldn’t improve. It was twenty minutes to 7AM.
I, like almost every other doctor in the known universe, hate it when a patient dies under my care. This one was terminal (a term we use to label those who are beyond medical cure) and dying in all probability. I felt a sudden chill, fully aware of this fact, as I stood a few inches from his body. I don’t know if it was a minute or five but the hands of the clock on the wall directly opposite to his face had never moved slower; may be they were giving it all they could to prolong his existence.
I kept looking at his monitor, alternating between his heart rhythm, respiratory rate, and oxygen in blood. I took off my watch, and moved myphone from my shirt to the back pocket so that it wouldn’t fall on the patient if I needed to do a CPR. I looked over my shoulder to check if the door was open, just to save a few seconds for other people to rush in, if need be.
Something inside that room was making my heart beat faster. I checked the clock. It was still 15minutes to 7. Sound of his heavy breathing and monitors beeping filled the room. I stood still. I was afraid that if I took a step out of that room, this guy would crash. Not because I think of myself as lucky, but because I believe in Murphy’s law (If something can go wrong, it most likely will!).
A few seconds later, my senior who was in-charge of everything going on with the patient, called me out for help. I walked away from the patient scared that this might be the last time I saw this person alive. Before I left, I shook him and called his name multiple times, as I tried to wake him up. All I got was some grunting that had nothing to do with what I had done.
A few minutes later, I was going through his records, ready to run if he coded (technical term for when the heart or lungs stop working). I continued to keep a close eye on every movement in that room as he was prepared to be wheeled for a CT scan for a suspected brain bleed. It was one minute to 7.
Honestly, it was not one of the longest minutes of my life. I was completely occupied with so many thoughts, watching him get unhooked from the monitor to be put on the transport bed. I was with one of the most amazing residents I’ve met and two of his most-trusted nurses, all working at their full capacity after a grueling twelve hour shift. So, I must say, I wasn’t feeling as nervous as I should have as an intern (first year).
As if some great artist was painting a work of art, an efficient team worked away and our patient, still unconscious, still breathing heavy, still as close to death as before, was wheeled out of our sights.
I looked at the time. It was 7:03AM. I had finished my shift a few minutes ago. I asked my fellow co-intern to handover the pagers to the next person on-call, and sat down besides my senior. I wasn’t exactly happy or sad. I had to finish typing in the workup for the patient, and to be honest, I was glad that I wasn’t preparing the “death packet”(a documentation of all the events around a patient’s demise) instead.
As we worked, my senior and I discussed what had happened and wondered what was going to happen next. Five minutes later, he got an urgent call from the lab saying patient had critically low glucose in his blood.
A series of phone calls followed, and two minutes later, a nurse was down in the CT room injecting the patient some vials of concentrated glucose solution.
I finished my work and left half an hour later. As I got ready to sleep around 9AM, I got a text from my senior saying, he’s alive and talking. I have never slept better since starting my residency.
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