And sometimes our patients die


Category : Medical Rants

The First Patient Death Leaves Its Mark

It is almost 15 minutes since he stopped breathing for the fourth time, and no heart sounds exist despite my aggressive cardiac massage. “Time of death — 3:33 p.m., record a flat strip for his file please,” the resident announced to the CPR team.

I have seen patients die before, but not under my very own hands. He was only 48. He didn’t smoke, he didn’t have diabetes, no hyperlipidemia, and no hypertension. What he did have was an inferior MI with extensive anterior ST segment depression on his ECG.

As opposed to this medical student, I have had many patients die over the years. Sometimes death represents peace and an end of suffering. Sometimes death seems most cruel (as in this patient).

As physicians we must learn to cope with both success and failure. The writer is obviously second guessing himself and his colleagues, although they likely did everything right.

We physicians tend to study harder through the retrospectoscope than necessary. We search for something that we might have done differently.

Sometimes after such an episode I will discuss my feelings the next day on rounds. As an educator, I should role model my coping mechanisms.

I emphathize with Ali. We have all gone through this. If I had magic words of advice, I would let him know. But there is no magic. Physicians experience loss differently. Your writing tells me that you have “the right stuff”. This remains one of the most difficult parts of being a physician. But all we can do is all that we can do.

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Comments (2)

As a young doctor, my girlfriend at the time (she’s now my wife) said something very valuable to me after I lost a patient younger than I was at the time. She said, “Remember, the patient is the one with the disease.” It took me a long time to process that comment, but it made sense later.

We are not the ones who cause such tragedy and illness. Rather we are lucky to be welcomed into others’ lives to help any way we can.

My surgery attending in med school used to say “you’re not the one who shot him. And it’s not your fault someone else did.” My medicine attending used the phrase “When God shoots, he usually scores.”

We do what we can and sometimes we can make a huge difference. The day patient’s death doesn’t bother you is the day you get out of the medical field.

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