Wednesday, April 29, 2009


Among the first few questions that my preceptor asked me in the beginning of male medical was "Can you handle death?"
I said it depends.
One of the patients whose case that I was actively clerking passed away today. Intracranial bleed. My last few memories was him breathing raggedly, even as I stood observing his cardiac monitor during the grand round. His BP was crashing, and I was the one who struck off all his antihypertensives from the meds chart, under the specialist's order. Menial task. But I remember being on high alert, scared that I would miss out on anything. The MO's and the ward sister and the preceptor was concerned with the fact that the wife seemed more concerned about his mouth ulcers when the crux of the matter is that the patient was dying and she should be prepared for his demise. I think she was in denial and I don't blame her.
20 minutes later, when I was at the other side of the ward, still in the middle of a round, the nurses started calling the MO. The patient was bradycardic before going completely asystolic, which means his heart slowed down until suddenly, it stopped beating. The patient's wife was asking why isn't anyone doing anything. The ward sister looked distressed and asked the MO to please could someone counsel the wife again about the patient being not for active resuscitation. I looked askance at my preceptor. I don't understand the business of not for active resuscitation. I mean, I do understand it, but I find it morally difficult to grasp. Even if it's technically not wrong to not try and bring back to life. At least that's what I remember from bioethics and flipping through the Catechism of the Catholic Church, but I may be wrong so do correct me.
The heartbreaking thing was when the daughter and son tried to perform CPR. The family refused to let him go. When he was finally pronounced dead, I saw the wife started falling apart. Heaving, gasping for breath sobs. As I walked out of the ward, I had to bite my lips. They are taking out the biohazard bag, already starting to do clean up. I had to pinch my fingers. Do not get emotional. Do not cry. But then I saw the daughter outside, silently crying, sitting dejectedly in a corner. I cannot help myself but walk over to her, put my hand on her shoulder and told her I was sorry about her dad. I walked away to go for the mortality meeting. Thank God for the meeting. I wouldn't want to stay in the ward to watch the aftermath.
Death can be so painful. I saw one last week, but that was so peaceful, I was quite happy to see him go, finally free from his emancipated body. Today was a bit hard to witness though. I said the Divine Mercy prayers as he died, so that was the most I can do. I love doing clinical, not for the deaths of course, but the intensity of it. It's different being in the ward compared to being behind the pharmacy counter where everything is clean and sterile and happy. It's difficult but immensely rewarding when the patients do get better.


Sheena said...

My mother asked me that same question before I started my elective at Miri General Hospital. She describes the medical ward as the "land of death." No kidding. Her exact words.

Just want to affirm you, goose, for feeling for the family & praying for them. It means a lot more than you realise. Take care of yourself & God bless!

"The LORD is my shepherd, I shall not be in want.
He makes me lie down in green pastures,
he leads me beside quiet waters,
he restores my soul.

He guides me in paths of righteousness for his name's sake.

Even though I walk through the valley of the shadow of death,
I will fear no evil, for you are with me; your rod and your staff, they comfort me.

You prepare a table before me in the presence of my enemies.
You anoint my head with oil; my cup overflows.

Surely goodness and love will follow me all the days of my life,
and I will dwell in the house of the LORD forever."

Daphne Maie said...

Thank you, goose! I like your O&G stories.;) Missing you. Take care and God bless too.