The patients we treat, and the lives we can and can’t save

Disclaimer: Any names or places I use in this entry have been changed in accordance with the laws outlined by the Health Insurance Portability and Accountability Act (HIPAA) to protect my former patients’ anonymity.

I would be lying if I said I remembered every patient that I’ve seen. I’m pretty good in that when a patient sees me afterward and smiles silently at me, I’ll remember what I did for them; otherwise, my mind is a large mush of cuts, bruises, fainting, backboarding, intoxication, and sprained limbs. There are several people that always stick in my mind, and that I find myself thinking of sometimes.

Just like in real life, I remember all my firsts. Most of these were in controlled, practice settings, so the memories are not as strong, but they still keep a special place in my brain. The first person I set an intravenous needle into was my buddy in my platoon in medic school. The first person I took a real patient history on was a recruit who was reporting sick for a fever. Notice how I said “most of these”.

I still remember the first time I had to run a code for a heat stroke patient that came in. The three minutes that I was left in charge of the 4-man emergency drill while someone else ran to get the medical officer were some of the longest minutes of my life. I do not remember his name, but I remember his face and the relief I felt when I heard we saved him.

There was also the time I administered albuterol to an asthma patient for the first time. I was not on call that night, but I happened to be much closer than the crew, and so I grabbed the closest drug bag and I ran down. The patient turned out to be Mary, someone who I had treated before for a different condition. Mary was turning blue in the face. Literally. I had never seen that before, but I knew it was bad. Mary is fine, and when people ask how we know each other, she is more than happy to share this story.

Not everyone I remember was a serious case, of course. There is the male patient who informed me that he was a good Southern boy and that he only drank whisky, and that “your gloves are too rubber”. His words, not mine. He grinned at me sheepishly whenever I saw him around campus after the fact. Then, I remember the face of the first (and hopefully last) patient to puke on me because I got too close and it was a rookie mistake. She does not remember me at all.

And then, there are those we can’t save. A man, Peter, came in during my clinical rotations came in for a checkup. Peter had schizophrenia, was in an institution, and was also HIV positive. He had no one left for him, except for his caregiver from the institution, who had to come with him to the hospital. Near the end of my shift, I followed the doctor I had been assigned to to Peter’s room, where Dr. Doe informed Peter that he had stage 4 lung cancer, and that the 8-10 years he was supposed to have left just got cut down to around 6 months or less.

What is the point in me telling you all this? Some people view healthcare as a way to earn money, while others are in it to save lives. Whichever category you fall into, remember that we are in a rare situation where mistakes actually cause lives. For those not involved in healthcare, I hope you gain a little bit of insight into our psyches; despite what you may think of that rude EMT or that patient nurse you had last week, we care about you and we remember you in one way or another.

Our successes are remembered by the people we treat, and we remember those we could not save, even if they have no one left in this world, like Peter, may he rest in peace. I feel privileged to have had the opportunity to, and that you let me (in most cases), treat you (all 400+ of you) in your time of need.

Photo courtesy of: The New York Times Blog

Postscript:

Other patients I still think of – Girl who I did my first nasal-pharyngeal airway on who was worried about leukemia coming back, I hope you’re still cancer-free; Rachel, who was date-raped, I hope you have recovered and are able to live a normal life again.

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