I feel like a stranger in the white coat. A little fresh, a little raw, a less confident version of myself. A little unprepared for the routine of the Emergency Department. A month of posting in ED is mandatory for residents from other departments to ease the workload of the regulars and I walk in to do my share.
I start documenting the cases alloted to me.
26 year old unmarried male, driver by occupation, with a history of accidental fall from a height of 15 feet presents with complaints of severe back pain. Power 0/5 in both limbs. Sensation absent below the umbilicus. No external injuries. Adv: Xray DL and LS spine. Provisional: Traumatic paraplegia.
My age! Damn it, he’s my age.. And he may never walk again, let alone drive..
3 year old girl brought by parents with history of drowsiness and headache since morning. Known case of pinealoblastoma with hydrocephalus; VP shunt in place. Adv: Non contrast CT Brain. Provisional: ?Shunt Block.
Neurosurgery is full. They will never be able to take up the case for surgery at such short notice. Yes, I understand you don’t have the money to go anywhere else.. Yes, Bangalore is far and you don’t speak the language, but the institute there is the best option for her.. Please don’t cry, we are as helpless as you are.. There is only so much we can do right now..
64 year old lady with end stage renal disease brought with high blood sugar. Pulse not palpable. Cardiopulmonary resuscitation initiated. Injection atropine and adrenaline stat.
She’s back from the dead! Can’t say I expected that..
35 year old male, known case of Rheumatic Heart Disease/Double valve replacement done admitted with sudden onset breathlessness. History of chronic alcoholism present. On examination, patient comatose, pulse not palpable, pupils dilated, not reacting to light. Stuck valve suspected. ECG gives flat line. Death declared to parents.
Hesitation cuts all over his left forearm.. linear scars that once bled frustration and pain. Maybe he was already tired of this tormented life? Bouts of chest pain, dyspnoea, medications and surgeries. Maybe he willed his heart to stop just like he willed the blade to cut into his wrist??
Hope and helplessness intertwine as the minutes inch forward. And at the end of 7 hours, as I walk away a mess of nerves and relief, I remember how lucky I am to not be in pain, to not be connected to half a dozen machines, to not be just alive, but healthy too. Not just surviving.
It’s funny how often we forget that.