#27 / # 28: Another tale of two patients

Compare this essay to a previous post comparing two patients.

The trauma experience continues at the private hospital. I've seen and taken care of several patients lately who have been involved in some serious traumas. My last call day started out at 7:15 AM when a patient came in from a high speed collision and they overhead paged saying that a patient had just arrived in the ER. She was in an accident and being transported to the hospital when suddenly she lost consciousness and the ambulance crew couldn't find any pulse and in the ensuing chaos the ambulance never notified the hospital that they were bringing in the patient. She was intubated and stabilized in the emergency room and transferred to the operating room where we explored her abdomen for a source of bleeding (none was found) and her chest was opened because her heart rate dropped precipitously but her heart stopped and she never made it out of the operating room (we were going to send her to interventional radiology to see if she was bleeding into her broken pelvis.)

It was a strange feeling to see a patient lose her life without having any personal connection to the patient. I never even knew her real name - she was just "Trauma Female" on her charts. I wasn't scrubbed on the case so I didn't have a personal connection - just a peripheral involvement as I got paged from 10 minutes into the trauma saying that I should go to conference even though there was a trauma because there weren't enough people in conference. After conference, I went to the operating room where we were losing the patient and I made a few calls trying to get the patient to interventional radiology but she crashed during my calls. It was a frightening chaotic experience but in the end my level of involvement in the case made it feel for the patient just about as much as if I had seen the whole experience in a movie.

On the other hand, I have a really strong connection to another patient who I met in clinic for treatment for a diabetic foot ulcer. The patient was in his mid-twenties and has type 1 diabetes for more than 10 years (poorly controlled) and as soon as I walked into the clinic room I knew he was going to lose his foot based on the smell alone. We admitted him, took him to surgery the next day for a toe amputation, and he's been recovering and working with physical therapy the past few days. I keep going by and trying to give him pep talks on how to better control his diabetes. He seems extremely motivated to do so after this recent complication and we've managed to get his sugars under control in the hospital so we'll see. He's broken down and cried twice this hospitalization: once when we were talking to him about the possibility of an amputation and the other time when I was first changing his dressings and he started thinking about his cousin who recently died in the hospital.

Last call nights Sunday October 15th and Thursday October 19.
Amount of sleep last call night: 1 hour and 2 hours.
Currently reading: Greenfield's Chapters on Trauma.
Currently watching: Arrested Development. Not as good as Six Feet Under.
Next call night: Sunday October 21st.