Medicine Sucks

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On my OB rotation we had a man and wife who had their first child. The wife had neglected to tell the husband that she was HIV positive and requested that we not tell him either. After the birth, the father had a smile that went from ear to ear. He was the happiest man alive at the time. He kept hugging the mother and saying what a great person she is and how she is going to be a great mother. It was so hard not to "accidently" say something. I felt so bad for this guy. It was the greatest moment of his life and if he only knew the truth it probably would have crushed him. I just hope that somehow he finds out so that he can get treatment and can see the kid grow up.
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IntheDraft6 said:
On my OB rotation we had a man and wife who had their first child. The wife had neglected to tell the husband that she was HIV positive and requested that we not tell him either. After the birth, the father had a smile that went from ear to ear. He was the happiest man alive at the time. He kept hugging the mother and saying what a great person she is and how she is going to be a great mother. It was so hard not to "accidently" say something. I felt so bad for this guy. It was the greatest moment of his life and if he only knew the truth it probably would have crushed him. I just hope that somehow he finds out so that he can get treatment and can see the kid grow up.
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Assuming it was his kid and conceived naturally, isn't what she did against the law?
 
VA Hopeful Dr said:
Assuming it was his kid and conceived naturally, isn't what she did against the law?
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The kid was conceived naturally. As far as it being his, we can only go on what she said. I don't know leaglly what the right answer is. As a second year, off-service resident I was pretty much low man on the tottem pole so it was handled by those above me. I do know that she tested positive PRIOR to meeting him. This case happened in NYS, where previous partners are notified at the time of diagnosis. I remember being told that she has no legal responsibility to tell anyone after that, though I don't know how true that is. Legally, it may vary by state.
 
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Great stories, everybody. I just want to say that medicine does not suck. LIFE SUCKS! Medicine helps make it better.
 
The case I'll never forget... 3 year old hispanic male visiting from mexico with parents. Got nausea and vomiting- went to ED, diagosed with gastroenteritis. Got a little better, then symptoms returned, prompting return to ED, diagnosed with gastroenteritis. 3rd visit to ED, child stopped breathing on the way to the ED, and by the time that he got to hospital, was seriously hypoxic. Intubated, resuscitated... CT shows this weird cyst that communicated with the outside of his cranial cavity (parents mention some diagnosis of cyst on his head in the past). Apparently, the cyst had got infected, and had swollen and caused his brain to herniate down his spinal canal, causing brain death. The family wants to celebrate his birthday before he dies, so they bring all of the family in to sing him "Feliz cumpleanos" 4 days early. Half of the family, adults and children were cheering and clapping, and half of the people were sobbing. The last time I saw the child, I past his bed as they were waiting for the elevator to come and take him down to surgery to harvest his organs. Mom was holding him in her arms, sobbing and saying goodbye before the elevator doors opened. I still get choked up thinking about it. It sure made me appreciate my kids more.
 
Why medicine sucks:

1.) You have bacterial meningitis. Yes, the bacterial one is the bad one. We have to report you to the health department. You're not going home. Hopefully you're not going to die. I know you saw a doctor about it a week ago who diagnosed it as the flu. It was obviously a mistake. Here's a hospital gown. Happy Mother's day.



2.) Happy Mother's day. I know getting intubated wasn't what you wanted for Mother's day. It's the only thing we know to do to keep you alive until your kids get here...the kids who helped you pay for the tummy tuck and breast lift you had just a couple of days ago which, most likely, you're going to die from because of the complications you're experiencing.


3.) Happy Mother's day, here's your diagnosis of miscarriage.


4.) Happy Mother's day. I'll bet the brain bleed in your little boy isn't what you expected, or wanted. I know, it's strange. It just happened. He was fine one minute and dropped to the floor the next. Who knew that at only three years old, he had a ticking time bomb in there. Maybe, if you pray real hard and hope like hell, in fifteen years he may show signs of recognizing you again. That's if the surgery helps. Here's some off brand Kleenex courtesy of the ER. Hell, you can have the whole box. Happy Mother's Day.



Why do holidays bring on the sickness?
 
Wow...things I didn't consider. I always thought about holidays like Christmas and New Years and Turkey Day...forgot about things like mother's day and how bad even a miscarriage would be worse than any other day of the year (not that a miscarriage is easy for anyone...just a bad memory for another holiday where people celebrate).
 
Good evening you very pleasant 50 year old woman. Never a sick day. No medical history. The reason you are having that abdominal distension for the past 5 days is you have widely metastatic ovarian CA. Horrible. She obviously had badness because she was incredibly nice. The strangest feeling is in the seconds before you tell someone their diagnosis...you know...after the next few sentences...their life will never be the same...:(
 
Wackie said:
Why medicine sucks:

1.) You have bacterial meningitis. Yes, the bacterial one is the bad one. We have to report you to the health department. You're not going home. Hopefully you're not going to die. I know you saw a doctor about it a week ago who diagnosed it as the flu. It was obviously a mistake. Here's a hospital gown. Happy Mother's day.



2.) Happy Mother's day. I know getting intubated wasn't what you wanted for Mother's day. It's the only thing we know to do to keep you alive until your kids get here...the kids who helped you pay for the tummy tuck and breast lift you had just a couple of days ago which, most likely, you're going to die from because of the complications you're experiencing.


3.) Happy Mother's day, here's your diagnosis of miscarriage.


4.) Happy Mother's day. I'll bet the brain bleed in your little boy isn't what you expected, or wanted. I know, it's strange. It just happened. He was fine one minute and dropped to the floor the next. Who knew that at only three years old, he had a ticking time bomb in there. Maybe, if you pray real hard and hope like hell, in fifteen years he may show signs of recognizing you again. That's if the surgery helps. Here's some off brand Kleenex courtesy of the ER. Hell, you can have the whole box. Happy Mother's Day.



Why do holidays bring on the sickness?
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F--- dude! Tough day. Sorry to hear it. I'll buy you a virtual beer.
 
Cric4U said:
Good evening you very pleasant 50 year old woman. Never a sick day. No medical history. The reason you are having that abdominal distension for the past 5 days is you have widely metastatic ovarian CA. Horrible. She obviously had badness because she was incredibly nice. The strangest feeling is in the seconds before you tell someone their diagnosis...you know...after the next few sentences...their life will never be the same...:(
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You are so right. Being nice is a poor prognostic indicator in the ED. I will never get used to that part of giving bad news, the fact that you know you're about to change their lives in a bad way forever and there's nothing you can do about it. All I can do is try not to think about it. When I think about it too much it just psyches me out.
 
This past week I had a 24 YO kid that was found down at a friends house with a GCS of 4. We brought him to the OR after finding an acute subdural and after we got the clot out, his brain continued to swell out of the craniectomy despite mannitol, steroids and lasix.

Leave the bone flap out and put in a ventric. Get him to the ICU on the vent and he does not regain consciousness. GCS of 3. Temp hits 105 and we're giving mannitol q4h, cooling him to 96 degrees, have the ventric wide open, breathing him down, still giving lasix. ICP in the 40's with CPP in the 50's no matter what we do.

Friday, I start talking to the family about his poor prognosis. Talk to his wife and grandmother, then talk to his mom on the phone and then his pastor. The wife wants their 4 YO child to get to see his dad and I tell her that I can't stop her, but tell her that is how he is going to remember his dad for the rest of his life and does she really want to do that.

Speak with them again on Saturday because they are concerned that he might be in the hospital for a few more days :( I again explain the poor prognosis and by now his pupils are fixed and dilated, bilaterally.

So, yesterday (Mothers day) we get an EEG which shows nada, get an angio that shows no perfusion and he fails an apnea test. I get to explain to the family that he is brain dead. What a Mothers day gift I have bestowed on three generations of Mothers.

Absolutely, the worst part of my job and we still never found out what happened to him, no visible signs of trauma. Nothing.

-Mike
 
HIANMI said:
Wow...things I didn't consider. I always thought about holidays like Christmas and New Years and Turkey Day...forgot about things like mother's day and how bad even a miscarriage would be worse than any other day of the year (not that a miscarriage is easy for anyone...just a bad memory for another holiday where people celebrate).
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Even better is during a shift where bad news is flowing to every exam room, you come across that patient who wants badly to be sick. I wish you could give them something that would make them really sick, just for an hour or so, to give them some perspective. Diagnosis-illness ideation?
 
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ralegen said:
ROFL!
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You do realize that there wasn't actually anything even remotely funny about DocB's post, right?

Having to tell a family member that their grandfather just died is always a horrible thing. That we have to do it on special days makes it even worse.

Take care,
Jeff
 
I seem to work every f'ing holiday.


I imagine the woman looked at her sister while in the ICU waiting room and said, "Happy 4th of July" before hearing the overhead page regarding her husband, "Code Blue, room 1103, Code Blue, room 1103".
After 45 minutes-
We're very sorry ma'am. He came in with chest pain, we got him to cath lab in remarkable time and he was doing better. In fact, he was getting ready to move down a level. Then he developed that peritoneal bleed which the CT results had just come back, the nurse had just hung blood, and it was more than your husband's body could handle.
Happy Independence Day. From now on, fireworks will have an entirely new meaning for her.
 
Bless you all, I don't know how you cope with the kids. Just reading these I had to go check my four year old who is asleep, safely, in his little bed, with his Power Rangers bedspread, probably dreaming of tomorrows football practice.

My love and trust is forever with the doctor that saved him when he was born, APGAR of 1, then 0. The quiet work in the corner, the terror of not hearing a first cry, Dr Collinson saying "he's not the worse baby we've delivered", she might as well have said "it's ok, we'll fix him". The absolute trust we bestowed on her that she would, and she paid us back in spades. Look, there he is, four and a half years later.

Nursery2.jpg


Sometimes you can't fix it, but more often you can. Thank you for trying anyway, we as the parents give you everything we have and we know you do everything you can. We know you can't save everyone, but remember that many more of us will always remember you for the good you did.


Sending love to those of you having a bad night, bad week or sad memory.
 
BeetleMama said:
Bless you all, I don't know how you cope with the kids. Just reading these I had to go check my four year old who is asleep, safely, in his little bed, with his Power Rangers bedspread, probably dreaming of tomorrows football practice.

My love and trust is forever with the doctor that saved him when he was born, APGAR of 1, then 0. The quiet work in the corner, the terror of not hearing a first cry, Dr Collinson saying "he's not the worse baby we've delivered", she might as well have said "it's ok, we'll fix him". The absolute trust we bestowed on her that she would, and she paid us back in spades. Look, there he is, four and a half years later.

Nursery2.jpg


Sometimes you can't fix it, but more often you can. Thank you for trying anyway, we as the parents give you everything we have and we know you do everything you can. We know you can't save everyone, but remember that many more of us will always remember you for the good you did.


Sending love to those of you having a bad night, bad week or sad memory.
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Thank you.

Those sorts of things mean a lot.

-Mike
 
BeetleMama said:
Sending love to those of you having a bad night, bad week or sad memory.
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Wow. Thank you, indeed. It is very easy to get pretty cynical in medicine, espeically in emergency medicine. A message like yours helps remind us of why we do what we do.

Again, thanks for posting that. Great picture, BTW.

Take care,
Jeff
 
The story of one of my first codes as an EMT: We AOS to find ~55yo M sitting in his car in obvious distress in a supermarket parking lot with his wife.

Q: "How you doin, buddy?"

A: "Not so good..."

Then he collapses. ALS is on scene too; light him up once in the parking lot and all the way to the hospital; several rounds of drugs. Meanwhile his poor wife is in the front seat of the Ambo the whole time. Once in the resus room the techs and nurses take over working him. More drugs and electricity. The medic is showing the doc the ECG etc. Doc called it about 15m (I don't exactly remember) later. He said we did everything right, but the guy just had the Big One.

That was the day I learned that you do everything right and people still die. :(

And I'll second a previous poster's comment that those who act all incredulous about the "things I've learned from my pts" thread should be directed here.

Keep up the good work and stay safe.

Best,
jb
 
It sucks when you have a 14 month male come to the ED because the family just returned from a 5 month mission in a Central American country and were told their child has cancer. They drove directly from the airport and arrived at the ED at 6am. A CT scan was done and showed an abdomen full of tumor.
 
How about this one:

A 12 year old kid from Iraq, accidentally shot by an American soldier in the back. Going to be stuck in a wheelchair for the rest of his life. His father, apart from having to take care of his invalid son has to look for a job. Which is going to be difficult since he also lost his right arm in the bombings which killed his wife and daughters.
 
Had a very nice gentleman in his 40's come in to the office for neck pain and very slight radiculopathy. High school teacher, really gives a damn about the students, nice, reasonable. You know the type.

We get a cervical MRI and an astute radiologist picks up a mass at the lower end of the brainstem, which is just barely in the last one or two cuts. So we send him for an MRI and he has a large tumor with mass effect on the brainstem, wraps around the carotids, extends into one orbit, flares out along both sides of the sphenoid and he has absolutely zero symptoms.

WTF can you say to this guy. You know you're about to send his world crashing down. He handles it calmly and the only thing I could see was his lip quivering.

This is the part of the job I just f****** hate.

-Mike
 
I haven't lost a patient yet but I think medicine is cool. That's all I can say..........

hehehe


:)
 
docB said:
So you knew it would be bad right off. Scumbags live forever.
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That is so true.

The idiots who do outrageous crap (like driving drunk and killing a 2 YO), break their necks in three different places and then refuse to wear their c-collars (because it itches). Have absolutely no deficit.

On the other hand, it seems like, those who actually give a damn and contribute to this world get the shaft as far as this stuff goes.

-Mike
 
had a nice lady with a nice family tonight. I thought i felt a mass in her belly, but I also thought i was incapable of such physical diagnosis. Regardless, I was sure she had the big C.

My attending kindly reminded me that all of her symptoms could be explained by GERD.

How reassuring. Don't I feel silly. Oh what, the radiologist is calling? Oh, her U/S is full of tumor? Oh damn.
 
God bless each and every one of you.

I thank you for being there when needed and for the terrible price you pay sometimes.

My wife and unborn son were murdered by a drunk driver March8,1990, (I was dozing in the passenger seat).

EMS, Lifeflight, and ER staff worked for nearly 2 hours to save the baby, Kathy never had a chance. John lived for 58 minutes.

I'm here to tell you that the ER doctor did save one live that night, Mine!
Dr. Spence sat with me nearly 2 hours, while I cursed God for letting me walk away from the wreck with not even a scratch, then taking my family.
He kept Security from intervening while I threw furniture, nd then sat me down and explained that he'd seen this many times, and most people in my position never got the chance to hold thier child or hear him cry.

He asked me to take what comfort there was, that Kathy never knew what hit her, That I'd got to experience my son, if only for a few moments before he died.

He shared with me that he'd lost his wife and daughter the previous year to a house fire, he'd only been back at work four days.
He cried with me, and prayed with me. When I buried John in Kathys arms a few day later, he was there.

God Bless you all.

Kathryn Lorraine Applewood-Reilly
Sept. 1, 1970-March 8,1990

John Patrick Reilly Jr.
Marh 8,1990-March 9,1990

Dr. Clark William Spence
Aug. 17, 1956-Oct. 9,2000

Rest in peace
 
wait about the baby born with HIV-isn't there a mandated reporter law or something? Just wondering, not rousing feathers
 
:(

I'm caring for a pt right now who's situation is just killing me on the inside. 20yo male brought to the ED after suddently developing a left sided hemiparesis. Fell down while at Wal-Mart and hasn't been able to move that side of his body since. On top of that his mental status has been declining. When he first came in his was responsive, but not making much sense. Within 12 hours he become completely comatose. CT and MRI of his head showed several large lesions, a couple of which had started to bleed resulting in a huge midline shift.

Labs showed a WBC of 207k, platelets of 10k and severe anemia. Diagnosis is acute promyelocytic leukemia (AML: M3 t15:17). No symptoms at all until the collapse at WalMart. Actually just finished up basic training for the Army 2 weeks ago.

Yesterday he blew his pupils. We talked to the family and he's now a DNR. Probably not going to make it through the weekend.

That's tough enough - I can't imagine having to deal with such a rapid sequence of terrible news. But what's worse, the M3 subtype he has is very treatable if caught early enough. It has like a 90% remission rate with Retinoic Acid treatment. But it doesn't matter for him, the damage is done.

:(
 
So you have a bit of a pleuritic right chest pain. Probably nothing but my job is to think worst case scenario, so let's check a few things. Hmmm, your X-ray shows something hazy in the RUL that wasn't there 2 yrs before. Let me get a CT. Oh, your CT shows a 3 1/2 cm nodule. Oh look - there's another one, and another -- and oh my, look at all those big hilar lymph nodes. What, you just watched your husband slowly and painfully die of colon cancer with all kinds of complications this past year? Figures. You're a nice upstanding member of society. Well, at least you know what to expect!

Yes, sometimes I hate this job. :(
 
Spry older lady who recently "beat" NH lymphoma, got remarried 3 mos ago. Loses use of her right arm over a week. CT head shows a decent size met, my first time telling someone something like this. The last time I saw her, she and her husband were sharing the same bed in the ED, just holding each other. :(
 
11 y.o. M collapsed at a friend's house, presents in cardiac arrest. Coded for over an hour and never got a rhythm.

His little sister (3 or 4 y.o.) runs up to him, grabs his hand and tugs on it, "Wake up. It's time to wake up now."

Not a dry eye in the room.
 
Hard24Get said:
Spry older lady who recently "beat" NH lymphoma, got remarried 3 mos ago. Loses use of her right arm over a week. CT head shows a decent size met, my first time telling someone something like this. The last time I saw her, she and her husband were sharing the same bed in the ED, just holding each other. :(
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We just operated on a guy who also "beat" NH lymphoma who had a large 3-4cm lymphoma in his brain. That kind of stuff sucks, man. :thumbdown:
 
Had a 45 y/o liver bomb start to circle the drain the other day in the ICU (coagulopathic, GIB, oozing everywhere)- wife and 13 y/o daughter at bedside. VTach, code him, get back a sinus rhythm, convince wife to make him DNR for any further events. She says she just needed to see us try once for her daughter's sake, so she'd know we tried everything.

Pt hypotensive on max pressors, becomes bradycardic, I tell family he has minutes left at most. RN and I watch as his daughter gets out her iPod, puts on Skynrd's Freebird, puts the earphones in his ears and just starts saying over and over again "I love you Daddy, I love you so much, I'm playing your song for you," as she watches him die. Asystole soon after, I call it, daughter screams "no, there's still something on the screen!" Sorry honey, that's just the vent, that's not him. She goes ballistic when I shut it off.

RN and I both were choking back tears at the end. Medicine truly sucks.
 
BeetleMama said:
Bless you all, I don't know how you cope with the kids. Just reading these I had to go check my four year old who is asleep, safely, in his little bed, with his Power Rangers bedspread, probably dreaming of tomorrows football practice.

My love and trust is forever with the doctor that saved him when he was born, APGAR of 1, then 0. The quiet work in the corner, the terror of not hearing a first cry, Dr Collinson saying "he's not the worse baby we've delivered", she might as well have said "it's ok, we'll fix him". The absolute trust we bestowed on her that she would, and she paid us back in spades. Look, there he is, four and a half years later.

Nursery2.jpg


Sometimes you can't fix it, but more often you can. Thank you for trying anyway, we as the parents give you everything we have and we know you do everything you can. We know you can't save everyone, but remember that many more of us will always remember you for the good you did.


Sending love to those of you having a bad night, bad week or sad memory.
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you may want to post this over in the peds forum. i doubt it was an EM doc resuscitating on the radiant warmer . . :D :p we need all the positive reinforcmeent we can get considering the crap we put up with from parents :)

hazl0004 said:
It sucks when you have a 14 month male come to the ED because the family just returned from a 5 month mission in a Central American country and were told their child has cancer. They drove directly from the airport and arrived at the ED at 6am. A CT scan was done and showed an abdomen full of tumor.
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depending on what it was this kid probably had a decent chance. you miss most of these in the ED since they aren't usually true "emergencies". most are scheduled admission/workups for imaging/line placement/treatment. luckily the most common childhood cancers also have the best cure rates.

my personal worst was admitting a 12mo w/ glioblastoma to the picu. she presented only with intermittent "arm twitching". poor prognosis from the outset, and she died 6 months later after multiple surgeries and rounds of chemo.

anyway, back to your regularly scheduled ED thread. . .

--your friendly neighborhood "no, i don't have a way to guarantee your baby will sleep from 2 to 4 every day" caveman
 
Not exactly in the ER, but this this doesnt fit anywhere else...

I'm on my peds rotation and last week we admitted a kiddo with new onset ALL, Ok, not that uncommon, he's 3 and has a pretty good shot. I met the family, nice folks from a rural farming town nearby.
So today I'm in the heme/onc clinic and find the family sitting in a exam room with the 4 year old brother. WTF, right? I talk to my attending before we go into the exam room to see what the deal is. He says the older brother had signs of strep throat yesterday, PCP ordered a CBC, and guess what... anemia, neutropenia, and thrombocytopenia. The Trifecta. So on PE, we find matted nodes all over, and hepatosplenomegy. BM comes back. Congratulations...you now have 2 children in 5 days diagnosed with ALL.
I mean, come on.
:mad::mad::mad:
 
Homunculus said:
you may want to post this over in the peds forum. i doubt it was an EM doc resuscitating on the radiant warmer . . :D :p we need all the positive reinforcmeent we can get considering the crap we put up with from parents :)
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Oh I expect so, but it was these guys that my heart went out to, I wanted them to know they are appreciated in all they do for us.

Here and during my emergency c/s, they still have one thing in common. They are all doctors, and good doctors at that, otherwise they wouldn't be here with such heavy hearts for their patients.
 
I had my first experience with with medicine sucking. I was the first update this family about their 21y/o daughter with a GCS of 3 and herniation on CT. The worst part was that I gave them some hope because I said that neurosurgeon would most like put in a ventriculostomy. I felt like throwing-up when the NS said that there was nothing he could do for this girl.

I don't think I will ever tell the family a consultant will do a procedure without talking to the consultant first.
 
This is a cat story, not a human story.

In 2005, our cat Kensington threw a blood clot to his left front leg right after Thanksgiving. We rushed him to the emergency vet, where he was diagnosed with Feline HCM. He was referred to a veterinary cardiologist, who put him on a bunch of different pills. Despite a poor prognosis, he gradually regained full use of his front paw. We continued to monitor his condition and took him back to the cardiologist for routine echocardiograms.

In February 2006, he had another routine echo in which it was determined that his heart was shrinking. Against all odds, he was actually getting better. The treatment was working!

That weekend, he had trouble breathing. We rushed him to the vet and he was admitted, put on oxygen, and observed overnight. We weren't too worried, because he was getting better. Right?

They discharged him the next morning. While Kittendaddy was at the front desk checking out, Kensington threw a blood clot to either his lungs or his brain and died right there in my arms.

It's not fair. He was getting better, dammit. He was getting better. :(
 
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To continue the nice guy=certain doom theme-

Busy evening complete with a feces throwing crack ***** and an irate virus-suffering antibiotic demander.
I draw a super pleasant 45yom showing up with his "kidney stone" c/o. Had a distant history of stone and had been seeing a family friend homeopath. His explanation was he feared debt from his lack of insurance. He proudly explained, "I've got two boys. Their college fund is more important than my having a regular doctor. This guy sees me for free." He works two jobs. Neither one has coverage.
His naturalist wizard had been prescribing corn silk and marshmallows (no $hit!!) to fix his painless hematuria for a year. The back pain he had been suffering from for a month brings him to the ED.

His gravel filled prostate gives me a dx. Spiral CT shows lytic lesions from sacrum to t-spine.

Me, the intern, drops the bomb. He calmly changed position on the cot. Turning to his tear-faced wife he asks, "you got that life insurance paid up right?"
 
Hayduke said:
Me, the intern, drops the bomb. He calmly changed position on the cot. Turning to his tear-faced wife he asks, "you got that life insurance paid up right?"
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My sympathies for all involved:(. Drag this one out over on the topics forum when people tout the greatness of the homeonaturochiropaths.
 
My day:

97 year old pleasantly demented female with hx colon ca presents with GI bleed. The family wants only for her comfort.

Young 85 year old woman who is very active in her community presents with N/V and abdo pain. Ovarian ca. I think she is suicidal.

Nice 54 year old man who runs his own business, came in with cough, SOB, pneumonia, a 40# unintentional weight loss, and iron deficiency anemia. He asked me if he would be going home soon because he had to get back to his business.
 
Annette said:
My day:

Nice 54 year old man who runs his own business, came in with cough, SOB
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I don't want to tell you how long it took me to figure out that "SOB" = shortness of breath.

I'm sorry you had such a bad day.:(
 
sharmei17 said:
I haven't lost a patient yet but I think medicine is cool. That's all I can say..........

hehehe


:)
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Umm...did you actually read this thread?? Good lord.

************
A demented old man came into the ED. He was agitated, and his nursing home couldn't take care of him, so they sent him to the hospital. In the ED, his agitation and confusion gets worse. He eventually attacked a nurse, getting a chokehold on her neck. He broke two of her vertebrae, and she has been unable to work since. His wife insists that he used to be the gentlest man alive, and he probably was. Poor man has no idea what he did, and that poor nurse unfortunately was in the wrong place at the wrong time.

And not an ED case, but...

On geri psych, had a patient who had advanced Alzheimer's dementia and zero esophageal motility. Even swallowing water was a problem because he couldn't get it down and aspirated everything. His daughter (who refuses to believe that her father is demented) keeps saying to him, "Dad, remember my wedding day? Remember my high school graduation?" and insists that his random gurgles are "answers." Then, she pulls out his favorite food - strawberries and whipped cream - and starts trying to force feed him. Even when strawberry juice starts coming out of his nose, she still insists that he is capable of eating, and wants to know why we are "starving" her father.

Everyone - thanks for sharing your stories. I hope everyone who's working has a good weekend, free of any gut-wrenching moments like those on this thread.
 
I linked over here from the Ebonics thread. There's one of those periodic troll related arguments going on and people point to this thread as a vindication of our compassion. And it is. Reading through the old posts I still get choked up. Some of the faces are really vivid in my mind.

Since this thread is about catharsis and soul searching though I am a bit worried. The last time I posted a case was in March, six months ago. I've seen other sad cases since then but I guess they haven't made much of an impact on me. Not enough to post them anyway. Am I losing my compassion? I like to think not but this profession will grind you down. How many of us think awful thoughts like "If it's a code I hope it stays asystole so I can get back to the rack full of charts." or "If it's a bleed I don't have to worry about TPA and I've got an iron clad dispo." That's bad. Tears, occasionally, keep it real.

How do we get back to where we were before they ground it out of us?
 
I share your concern, DocB. The picture of the kid makes me cry, so I figure I'm not too far gone. It reminds me of a card a woman gave one of my attendings- "Because of you, my children have a mother."

I can't find the words to express what I want to say about this, so please excuse my clumsiness. Most times it seems it won't make a difference no matter what I do, so it may as well be easier on my day. But there are times when, despite the odds and all previous experince to the contrary, I make a difference. I think it is these rare times that keep me human.
 
docB said:
I've seen other sad cases since then but I guess they haven't made much of an impact on me. Not enough to post them anyway. Am I losing my compassion? I like to think not but this profession will grind you down.
Click to expand...
Sometimes I worry about that as well, although I'm not speaking from the point of view of an EP.

Awhile ago I responded to a call for an unconscious female diabetic, and I was holding back tears when I saw her screaming and fighting in terror as a bunch of firefighters were holding her down, and my partner was starting an IV in her. It was just your standard hypoglycemic call, but I felt horrible for this girl who was very altered and probably very confused and afraid about what we were doing to her while she was in that state of mind.

On the flip side, not long ago we were called out for a suicidal patient who was giving her life story to me which was admittedly pretty sad, and yet all I could do was hope we could hand her off quickly to psych so I could go grab lunch.
 
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