Wednesday, February 12, 2014

the haunting of the emergency room

I've seen my share of dead bodies over the years.  Its part of working in the ER. Some are expected and some aren't. Some are dead when they get here, some arrive living, then die.

Those that arrive living, but are expected to die, are usually people at the end of a long battle with cancer or something like that.. Some have a sudden event outside the hospital, make it to the hospital, but the decision is  made by the family to stop treatment.  Sometimes we just can't save them, its just their time to go. They are very elderly and the doc decides to stop treatment after a while.

Then there are the unexpected deaths. The people who had something catastrophic happen, be it trauma or some medical event.  Yesterday they were fine, today they are dead. Sometimes they are young.  It feels unfair they are dead.  One thing you learn in ER, life is certainly unfair. The family is stunned. These are the people you will hear crying loudly, it breaks your heart how they are suffering.  It makes you want to cry too.

These deaths are tragic, but you can point to a reason for them.  Something bad happened and death resulted. Its sad, but your mind tells you that is what happens sometimes.

Then there are the deaths that happen unexpectedly in the ER.  They don't happen often. They are the people who walk up to the triage window.  They are walking and talking.  Here's the thing: this is the last time they will be walking.  They will die shortly after they arrive.  These are the people that just kill the ER staff.

Sometimes they have very specific complaints like chest pain,, shortness of breath.  They go right back. Sometimes they have vague complaints. They have stable vital signs. They look OK. I had one like that recently.  I put them on a cart in the back of triage. There were no beds. They only were back there about 5 minutes before they went back to a room.  Within a half an hour they were dead. Boom just like that.

In this situation, someone went to the room, they are unresponsive. They have no pulse.  They are rushed to a stab room.  Everything is tried.  It usually goes on for a long time until we realize it is futile. They aren't coming back. They are declared dead.

We are left saying to ourselves: What just happened? They were OK when they got here.  We start second guessing ourselves. Could I have done something different? Did I miss something? It takes you a while to realize that there is nothing you could have done.  It wouldn't have made a difference. OK, you tell yourself, but they still will haunt us for days.

Now its time to try and find the family.



Dovelove1097 said...

Excellent post, but that picture creeped me right the fuck out. ((shivers))

Alessandro said...

one can get used to anything if necessary. lucky those who do not see it