I once lost a 25 year old on a cardiac shift. Later, after the shift ended, I was thinking of his whole life gone and wondering if I could have done more, performed more excellently. I wondered if another resident would have lost him if in my place.”
“I had a woman in her 40s’s in the ICU who was very sick and dying. After days of discussion, the family decided to terminally extubate her around midnight. I watched them hug her, whispering loving words as they cried over her body. Then they turned around and hugged and thanked me. It was a very touching scene. It’s both shocking at times, as well as rewarding to be part of something so intimate and personal – death and dying.”
“Normally [in a code situation] the family stands together at the foot of the bed and watches. In this instance, the son of the patient went up to his mother and held her hand as we were doing compressions. He did not say anything. He simply held her hand while we continued the code. I vividly remember attempting to hold back tears as the code went on. I’m usually so caught up in the code and don’t realize or internalize the family being there. This really humanized the entire process.”
“I got to know her and her family during that long time and it was hard to see her worsening regardless of our efforts and ultimately die, leaving her husband behind.”
“I remember seeing the elaborate eyeshadow coating her eyelids. She had done her makeup for a Saturday night out. She went to a club with the expectation that she was going to dance, laugh, maybe meet a boy. Instead, she was shot in the neck by a stranger and killed in an instant. She laid there motionless as we prodded and poked, placing chest tubes and attempting intubation. She had become a ragdoll. Her friend in the stretcher next to her, with a gunshot wound to the femur, cried her name, asking over and over again if she was “okay.” Nobody in the room knew how to tell her that she was not.”
“I had a patient in the PICU… who failed a test and ingested cleaner fluid that ultimately caused brain death…The dad would show me pictures of the patient’s sweet 16 almost daily. If the patient had some eye blinking, the mom and dad would start talking to her and telling her to open her eyes. This case affected me because of how innocent that child was and how that one decision had changed everyone’s lives. I always pictured my dad in her dad’s shoes and can’t imagine how he could ever deal with that.”
“I saw a 29yo who presented in arrest on a shift and I have a lingering image of holding his hand right before the attending pronounced him. I was only doing it to move the cord of the ultrasound probe from under his arm, but now I can’t stop thinking about the gesture.”
“She was completely confused and just did not believe this could be a tumor. It was a tough situation – I had to field questions I did not feel equipped to answer at all.”
“Now deaths during codes feel so routine that the same deep sadness doesn’t occur to the same extent. I wonder if it is burnout or just the natural progression for our profession.”
“Witnessing two deaths in people younger than me was tragic and eye opening and affected me more than any other cardiac arrest since. These two experiences within 1 week really took a toll on me. I called my family just to tell them I loved them. I make it a point to do that now much more frequently than before. Life is short and can be taken away in an instant. We do everything we can but we can’t save everyone.”
“It’s frustating to always have to take abuse and be the “bigger person” when patients mistreat us.”
“I keep thinking about a case where a patient and her daughter had their heads beaten in with a hammer. Forced me to come to terms with the darker side of humanity. It exists and is part of the human condition.”
“I made the call that a patient needed drainage of her inection and brought her to IR. En route the patient coded…This resonated with me for a long time and still does. I’ve lost sleep over it and had a constant globus sensation in the back of my throat for awhile. What I couldn’t shake off was the possibility she may have done better had I just waited it out — but I made the call not to do so.”
“No, I haven’t and this bothers me a lot. I feel I can connect with a patient on a superficial level, enough to build confidence, but I feel no emotional connection or investment. On one hand, I believe this allows me to take a locial approach to patient care without emotions clouding by judgment; while on the other hand, can one really be fully invested in holistically treating patient without some underlying emotional connection?”
“As an MS4, my resident brought me into the room to tell a newly diagnosed pancreatic cancer patient that he would likely die from his condition. This happened to occur within a few days of my grandfather passing away. Perhaps this was my way of releasing emotion…this transference of my own situation onto the patient and his family.”
“I was called to the trauma bay. My patient was desatting with two nasal trumpets, the cardiac resident doing a jaw thrust, the angry cardiac attending waiting. Realizing we have just as much potential for harm as we do for healing, realizing my own limitations…far more devastating.”
“I had a patient in the RICU who was very sick. He survived and was extubated after I left the RICU. I visited him one day and it was great to see him better. An overall emotional but reaffirming patient experience.”
“This case touched me because it showed me that medicine brings us in touch with people we otherwise would never get to meet. Also showed me that people who seem very different to us may actually be the same at heart.”
