Sunday, April 29, 2007

am sad! wrote a whole post on A&E rotation and it poofed into thin air. rubbish!

anyway will attempt to recap what has undoubtedly been the learning experience of my whole rotation.

was happily clerking and examining patient in resus room during a lull in the evening on wednesday, when we were yelled for to standby for a collapsed case.

by "we", i mean the rest of the very well-prepared team. i stood in a corner and freaked out, not quite breathing, and trying to make myself as invisible as possible. if you've figured out that i'm quite useless at cpr, you're definitely right. the life saving course we took has left me scared of performing cpr, especially with the admonitions about how i would cause the patient to have massive fractures and liver lacerations.

thank God my seniors, x and y, were around. they were so excited, yet so calm about it. it wasn't their first cardiac arrest case, but they were by no means experienced either. they noticed me quaking pathetically in a corner, and y came over to ask how i was doing, and tried to help me overcome my fear.

the patient was rushed in with EMTs in tow, he was an old man who was roughly, oh, twice my size. and i'm not anything like those skinny waifs you see on the runways, to put it nicely.

he was asystolic, and the team instantly bagged him and intubated him, pumped him with drugs. it was so fast i barely noticed anything, they did it with such confidence and experience.

x heroically performed compressions whilst y tried his best to allay my fears, talking me through each one of them. after succeeding in calming me down and telling me it'd be best if i tried sooner rather than later, i stepped up to take x's place. the poor guy was sweat soaked and exhausted, yet still managed to yell encouragement to me.

y located the spot for me and cheered me on as i started compressions, telling me to look at the defib monitor to see how i was doing. x felt the femoral pulse and nodded his affirmation that i was doing right.

and boy, it was surreal. the feeling of pumping someone else's heart, of holding someone's life in your hands, it's incredibly surreal. everything kind of faded away, nothing mattered but the monitor and the compressions. it was as if i no longer had any fear, i was born to do this. i was calm and composed and knew what i was doing. it must have been the change that everyone talks about but you never think will happen to you.

y took over when he saw my rhythm was faltering, and between the 3 of us, we must have kept it up for about 20 minutes. each time we stopped to check the rhythm, we were full of hope that we might bring him back. but each time, it picked up hopefully, only to slow down into a flat line.

the decision was made to stop him after the 8th time he flat-lined.

i was rather disconsolate, to say the least. yet x and y took the time to comfort me, to tell me that we'd done all we could for him. it takes a miracle to bring a patient back usually, they said. he just wasn't meant to have a miracle maybe. plus he was really old.

the doctors even came over and told us we did well, and thanked us for helping.

only later did we find out that he had been unconscious for nearly an hour before he was rushed in. his family had thought he was sleeping as usual. so our efforts were as good as no efforts, we couldn't have done anything to save him, it seems.

that went a long way towards making me feel better, and i could see the relief on x and y's faces. so they too, felt some measure of relief.

sometimes, you do everything you can, but it's not enough. God gives and God takes. and who are we to fight that? it doesn't mean that i feel no sorrow, that i'm dehumanised. it just means that i choose to accept what happens. i do feel sad, i wonder how his family feels. it's the most terrible thing in the world to lose someone you love. i know how that feels, personally, and wouldn't wish it on anyone, ever.

but i'm really thankful for the 2 wonderful seniors who were so concerned about me. these are people i know i can trust in the future, they'll make wonderful doctors no matter which field they choose. these are people whom i respect.

and i've realised cpr isn't that hard after all, it's actually manageable on a real patient :)

as for the patient, may he rest in peace. at least he felt no pain. thank you.

1 comment:

Xavier Emmanuelle said...

I'm sorry to hear about the patient. It's wonderful that you got over your initial discomfort about performing CPR though! It sounds pretty exhilirating