A Defining Moment as a Young Medic
My daughter these days has been wanting to hear ‘Your Doctoring stories’ in the evening, and yesterday I decided to share with her one of my most emotionally challenging and maturity-inducing one as a young surgical intern in 1998.
Another reason I have decided to publish this is to show my respect to present-day junior medical staff, who are finding themselves practicing in an unforgiving, authoritarian organizational landscape who if anything, are placing increasingly complex and onerous demands on their shoulders. However, always notice and remember the good when it happens, even as in this story, it occurs within an unfolding situation of passing and loss. Hold on to these memories, and begin constructing a bank of nourishing resources for your future selves.
The Story: It was a weekend on-call shift on a very busy orthopedics unit, and I was responsible for scut-monkey duties for FIFTY patients that day. I was already running around with only a quarter of a functional brain, dealing with post-op and other complications in these patients while the registrars were doing their thing in the OT.
I was then called to attend to a new patient, a lovely 96 year old lady who had suffered a fall and subsequently severely fractured her neck of femur. After engaging her in the necessary admission procedures, initiating some pain and fluid management and getting to know her a little, she was seen by the registrar and OK’d for corrective surgery. Sorted. Not. Two things subsequently happened: She started bleeding profusely from the fracture site, and a nurse made a very human error of administering incorrect medications (drug charts got confused during an overwhelmingly busy shift). Essentially, short story was that I was left as the medical presence trying to co-ordinate and stabilize the situation: Emergency Codes were called, fluids were delivered, and adrenaline was forced into her vessels all in order to halt the rapid reduction of her blood pressure. All to no avail. We all knew she was dying, including the patient herself. At the end, she exhibited the most prescient calm, and specifically looked at me. She then held out her hand toward me in a gentle reaching gesture, and said words I will never forget (amidst the turmoil of nurses and other medical personnel still actively trying to save her life in the background): “….I am leaving. I am leaving. ARE YOU…AN ANGEL?”
More from instinct rather than thought, and more from a sense of transient yet timeless and powerful connected-ness as the human being who had interacted most with her in her final hours, I held her hand as I think any of you would have done. And I answered her question with a “..Yes. And you will find peace now.”. She actually passed away with our hands still connected, and with a gentle sunbeam of a smile on her face. And my eyes were streaming with tears. I told my daughter that I shared this story with her in illustrating the importance of basic human kindness, regardless of technical prowess and the goal orientated drive to achieve etc. There is also a lesson here in the gentle acceptance of things we cannot control, but doing the best we can and showing basic kindness whenever we can and in whatever situation. The aftermath was in some ways even more challenging: the responsibility of informing her family was placed squarely on myself (as an intern, I didn’t feel emotionally ‘equipped’!), and the nurse who committed the error leaned on me for emotional support and even forgiveness over the subsequent weeks. She was later mercilessly de-registered from her profession, and I sadly lost contact with her. These are stories for another time. In many ways, it was the day I ‘grew up’ as a medical practitioner.
