When a Patient Dies, a Part of Us Dies With Them
From a doctor’s diary
I still remember back to when it was 2015 and I passed my final exam and completed my Bachelor in Medicine and Bachelor in Surgery (MBBS) degree. Now, the next task was a House job, a one-year internship program. My friends and I were all happy. We were young, about 24 years old. The feeling that now I can wear a white coat, and I can have a stethoscope across my neck. I am officially a doctor.
Now comes the practical life. The first ward allocated to me was Internal Medicine.
The hectic roster:
The first challenge I faced after becoming a doctor was my duties. I knew it would be difficult. I had seen it in Grey’s Anatomy and television shows, but I hadn’t experienced it. The roster was three consecutive nights and then two consecutive days. This means we go to the ward at 8 pm and come home at 2 pm the next morning and for three consecutive nights. Then, after a break of one day, we would do two consecutive days from 8 am to 8 pm.
It was exhausting, especially the nights. I am a sleep lover. I used to sleep for at least seven hours, otherwise, I experience mood swings. I didn’t know this until I started an internship. It was difficult to see patients the next day when you had the night shift in an emergency and hadn’t slept properly — or not at all.
Back then, I understood, but I couldn’t quite embrace the idea that countless other possibilities could and would unfold.
It happened one day
In the medicine ward, we were assigned 10 patients — or beds. I still remember the old man in bed number two.
He was there for about five days. He was about 75 years old. He suffered from a stroke a few years back, was diabetic and was diagnosed with high blood pressure along with sepsis due to bedsores. He was not fully oriented in time and space. We were giving him medication and regularly checking his vitals because of his critical condition, mainly due to sepsis.
One morning, his blood pressure (BP) suddenly dropped and I could barely find the pulse. It was very feeble. We immediately started support to maintain the BP as it was just 50/30. Despite all our efforts, the BP didn’t rise, and he started gasping. We started CPR, but it was all in vain. He didn’t respond.
After a few minutes, the senior doctor declared him dead.
The guilt:
That patient was under my supervision for almost five days. I never thought — or maybe didn’t want to think — that the patients we take care of could die.
Yes, death is inevitable. It will come and it will come uninvited. But I couldn’t easily come out of that emotional trauma. The patient — especially his face — was continuously on my mind; my thoughts were that I didn’t do enough.
His wife said he was in so much pain for many years that at least his misery had ended. But still, I couldn’t get out of that guilt feeling, that sadness. About 15 days passed and I was still stuck in that moment.
Acceptance.
Life and time never stop; the clock continues ticking. Slowly, after seeing more and more critical patients, I realised that death is a reality and it’s going to happen. We can do our best to keep patients alive but it may still happen regardless.
I still clearly remember his face even after so many years; he still comes to my mind on and off with a wave of sadness. But that is life. We all have our grief, our own story.
Like the feeling of happiness when we save a patient’s life, the death of every single patient lingers in our hearts. We remember them. We also learn from them; about our approach from what went well to what we could have done better.
There has never been a doctor who served many patients who, despite their best efforts, didn’t lose some of them to death. But they understood that was part of life itself (by Zig Ziglar)
