How does it feel to lose a patient?
I remember their vitals as being within normal, they were the first patient that I checked first thing in the morning in my very first oncall during my internship. Their friend has explained to me how his condition has progressed, I remember that I wrote everything down in their file, I was very slow and it took me two hours to finish four patients in a round that had one person, that’s me the intern. What an exhausting day! I remember that I was talking to a consultant at the nurse’s station, “am I doing well?” I said, and they replied with “This is very good, you should always take your time with your patients”. I finished the whole ward by myself! What a relieve! I should tell the ROD about everything I did, and if I did it correctly… “Good job” he said, “Go and pray for Alduhor and then you can come back to help me finish the other ward that we haven’t started yet”.
It seemed like it’s going to be a long day either way. I was blaming myself for how slow I was.“The morning rounds are way faster than this, how did they do it?!” I whispered to myself, My phone rang, It was the ROD’s, “Hello, Sultan… Have you seen the patient in room number 201?”, “Yes… Yes I did, doc” I replied, “How were their vitals?” he stopped me mid-sentence, “It was normal, nothing seems out of the ordinary” I replied and was stopped again by another question asking if I wrote everything down in their file, of which I answered with “Yes”, “They have passed away, can you come down, I need to go to finish some papers”.
I can’t describe how shocked I was. May they rest in peace. It was a traumatizing first oncall in Medicine, “It’s ok, this is medicine,” I whispered to myself again that night before I went to sleep.
While this seems like a suitable end of this blog post, I still have an even “better” story…
I remember being a part of the pulmonology team at the same rotation, I won’t lie, I truly enjoyed Internal Medicine, and I will forever have appreciation for those people who choose it as a career path. That day, the consultant, whom I truly admire to this day, called me early morning, asking me to excuse myself from the morning round and come to check on his patient, and so I did.
“Keep an eye on this patient, I want you to monitor their vitals and keep updating me every half an hour, this patient has been just out of the ICU of which they have been staying there for a couple of months, they’re old and they have multiple morbidities” the doctor said, of which I reached my hand into my backpack and took my notebook out of it. I started monitoring their vitals every half an hour, I remember this lasted for almost five hours. I called one of the residents in the team and after they checked their condition they mentioned that “this patient might ‘expire’”, I hated this word with all my guts, how insensitive! (later on, I learned that this word is being used all around the hospital). I remember that we did everything we could do to stabilize them, I also remember how their children were surrounding them, and I also remember that person who is a caretaker of the other patient in the same room, coming to talk to the family members and telling them how to do ‘Shahada’ and how to close their eyes when they pass away. It seemed like everyone accepted to the situation, everyone but me…
That patient passed away…
“You failed your mission, Dr. Sultan” the consultant said, I can’t describe how miserable I was that moment, I didn’t want to meet the family members, not after I reassured them that everything will be ok. I remember being phased out at the nurses’ station. “Why would he say that I failed my mission? Did I do anything wrong? …” and many many other questions that crossed my mind. I don’t remember that I slept well that night, I remember coming the next day to the morning meeting with some coffee (I don’t drink coffee and I despise how it tastes), and after we finished, I heard someone calling my name, it was the same consultant, the consultant whose words made me feel so bad, the consultant who is responsible of making me drink coffee that morning. He said: “I’m sorry that I was harsh on you yesterday, I wanted you to see how it feels to lose a patient, I was actually testing you”, “I hope I didn’t do anything wrong doctor, it was a huge responsibility I know and I did whatever it took to manage that case” I replied, “We all did everything to save them, not everything is sunshine and rainbows in Medicine…” he said back to me…
The feeling of losing a patient was depressing to say the least. I hope you never do lose one, and if you do, please learn and continue to learn so you can save many others. Thank you Internal Medicine.