There is a patient on my team’s
service who tried to kill himself with alcohol and drugs. He is now sitting in the Intensive Care Unit
on sedation with a tube down his throat bringing oxygen to his lungs and brain.
I measure his reflexes day-by-day and his prognosis is looking more grim with each passing day. The longer he is here, the more problems
arise and there are infections and hematomas to add to the severity of
his situation.
At first it was hard for me to wrap
my mind around this case. If the man
wanted to die, why are we working so hard to keep him alive? It is apparent that he is a chore for all
involved with his care. It’s difficult
to take a person from the brink of death and find a way to bring them back to
life, and even if we are successful, will he even be able to live an
independent and meaningful life? I can't help but be sad for him, as the condition is self-inflicted, but my sympathy is hard-bought (more so than I care to admit).
Today on rounds I was bored; he was not my
patient. I was also hungry and we had
not been given the chance to sit since 7am and it was now around 1pm (I’m still
getting my legs trained for the long days on rounds. Some days they last 40 minutes, but most days
they last upwards to 5 hours! My greatest priority now is getting comfortable shoes...) I was
ready for it all to be over, and another comatose patient was not going to help
me pass my shelf exam.
While discussing this patient, the resident said it best: “Even if
he is a suicidal, alcohol-abusing patient with a multitude of problems,
we, as his doctors, owe him the best medical care we can give.” It might be cliché and pithy, but today it
was the message I needed to hear. At the
moment I don’t get to choose my patients.
The past years I’ve travelled the world to help impoverished Africans and Belizeans,
and spoiled myself looking at cute babies at the pediatric hospital. But not all the world is cute or
exotic. Sometimes the people that need
the most love are right in front of us in our own communities and are the least
cute, the least friendly, and the least interesting cases. I had forgotten that in my hunger and apathy
and boredom. I’m afraid I’ll only grow more bored and tired and apathetic about what is
going on around me as the year goes on. It is the inevitable fate of most medical students. My hope that even in the midst of unavoidable apathy and exhaustion, I will still keep my eyes peeled for the important lessons that camouflage themselves in the midst of hungry stomachs and tired feet.
