May 27, 2010

how to save a life

everyone wants to be a doctor after watching ER. House. Grey's anatomy (minus the explicit scenes). Chicago Hope. it's probably one of the most "noble" profession you'd ever come across. so when people ask you, and me, at interviews to enter medical school, why do you want to be a doctor? you hear different versions of answers that only mean one thing : because i want to do good, to help save someone's life. to make a difference in this world with all that i have. and of course, you have those that'll tell you because my parents made me do it i have no other choice maybe i really should burn in hell.

i say, we need to have that passion to do so. that love, dedication and sacrifice.

i walked into the A&E on Tuesday morning with so much of excitement and such enthusiasm i swear i myself would get the palpitations and soon the ventricular fibrillations and then to cardiac arrest even before a patient does.

anyways, i was really looking forward to this. at least i could make myself useful as a medical student, setting lines, taking blood, ecgs and oh so many things! :) i love it there. and today, was not a good day. today, i see  how cruel we doctors can be. so cold, and heartless.

a 28 year old malay soldier was brought in after more than an hour being unconscious. pulseless. asystole (flat lines on the cardiac monitor). CPR started. we all took turns to do it cos it was really tiring (my first time by the way). so full of energy from us, those adrenaline rushing through, wanting to save the patient so badly. 6mg adrenaline given. still asystole. half an hour passed, asystole. the MO came walking in, checked pulse. none. pupils fixed and dilated. cold peripheries. no spontaneous breathing. undetectable blood pressure. he declared death. and he said, as he checked the pupils "oooh, pupil dia macam full moon! macam itu twilight. tak pe lah. stop aje". WTF?!


this 71 year old indian uncle brought in by a taxi driver unconscious. pulseless. in cardiac arrest. CPR commenced. and they managed to revive the patient initially. and then after hours, he started deteriorating. and then he was in PEA (pulseless electrical activity). that same MO again came, and said to stop all efforts and let him just pass. and we're like WTF?! and we all stood, watching in dismay and disbelief, from 70 beats to 30 and then to 0. he told us that the patient was old, and that he had no family members. very poor family support which wouldn't at all be a good prognosis to his condition. so would it be worth it to save him?

i say we don't have the rights to judge who lives and who dies. it is not our prerogative to determine if that person deserves a chance to life. who are we to decide. who are we to tell. and isn't saving lives a doctor's main aim? i didn't understand. and i don't. because all i know is that we should still fight for the patient, when we still can. standing there and watching him go down should not at all be an option.

and so we were all upset. very. some say we'd probably get used to seeing this soon enough. getting to be a little more mechanical each day as we phase through our lives as doctors as we see more and more patients each day that we'd probably get so sick of it. i don't know about that. it would probably be a little too routined for me soon i might agree, but i definitely will not become that very person that even i myself would detest. and i won't want to place my family and friends' lives in the hands of a doctor like that. god gave us life for a reason. only He makes that decision :)

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