There comes a time when everything is not going to be alright. Today, I had to learn the dark side of medicine. The side of death. The side where the patient doesn't get to go home to their wife and kids.
Several weeks ago, I met a patient. Him and a relative had been in some sort of explosion. I walked into the room to help the nurses move him onto his bed. He had been sitting in the chair while they did his wound care. He was a lively character, constantly making jokes and keeping the nurses in good spirits. His positive attitude was inspiring. He even made me laugh a few times. I noticed some pictures on the wall. There was a photograph of him and his little girl. She looked to be around 4. I kept looking from the photograph to the patient. It was hard to see the resemblance with all of the burn damage.
His breathing was labored. We discovered that this was due to a pneumothorax, a collapsed lung. However, the amazing doctor came in with some of the younger ones he was teaching and they aimed to fix it. It was amazing to watch. They used a huge hollow needle to puncture into the lung which guided a tube. Once the tube was in place, they could connect it to a syringe and pull out the air. It took a few tries but they succeeded.
I was fascinated. This wasn't like changing a light bulb or fixing a flat tire. This was fixing someone's lung. This was saving a life.
A few week or so went by before I was able to go back to the unit. This time I was able to work on the previous patient's relative. He was in bad condition. He was connected to a ventilator and had tried on numerous occasions to pull it out. This was quickly corrected.
He had recently had a skin graft on both of his legs. I had never seen the finished product of this procedure so fresh. It was like a patchwork quilt that your grandmother would make you; however, instead of being filled with little girls, flowers, or names of people in the family, it was made with patches of skin of varying colors. There were purple colored patches, pink patches, white patches, all connected with staples.
I had to hold his legs up while the nurse wrapped the new dressing from around his foot, all the way up his thigh to his groin. I knew I was hurting him. I could see it in his eyes. His expression of helplessness will forever be in my mind. His leg was heavy even though it was small and thin, reduced greatly from what it probably had once been only a few days before. I was happy when she finished because my shoulders were on fire. I took off the gown, threw away the gloves, and wiped off the sweat that had just accumulated on my brow. When I inquired about the other patient, I was informed that he wasn't doing so well and had recently been put on a ventilator. This was hard to believe because he had been in good shape the last time I saw him.
Today I returned to the unit after a two week absence. As normal, I asked about the patients that I had seen previously. One of the nurses was resting her head on the desk.
I asked about a patient whose nose had been removed.
Apparently she returned home. Noseless.
Then I asked about the patients that were relatives. I provided all of the details to make her remember.
She said one had died. The one that had once been doing well. I assumed she might have been confused and walked over to the other side where they had been.
I looked in each room since sometimes they move patients to different ones within the unit. Finally I found one of them. He was off the ventilator and sitting up being attended too. It was the one whose leg I had held.
The photographs were off the wall. The little girl lost her Dad. The wife lost her husband. The unit lost a patient.
I soon found out that he had developed two DVT's (deep vein thrombosis blood clots), one in each leg.
I remembered a case on "Dr. G Medical Examiner" where a patient had suddenly died while on vacation and no one had knew why. It was due to deep vein thrombosis. He had been sitting on an airplane and developed the clots, which later traveled to his heart and killed him. They are hard to detect because patients often show no sign of symptoms.
Because the patient had been sitting in a bed on the respirator, he wasn't able to move around as much. Since his legs had been burned and he too had received a skin graft, blood flow had probably been reduced due to minimal activity and possible vein injury during surgery.
The patient whose life I watched be saved, who I most certainly thought would be okay and be able to make more family photos like the ones on the wall, didn't make it.
He's gone.
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