Losing a Patient
Losing a patient is never easy, even if you only talked to them or saw them once. As a medical student I usually don't get very close to my patients. So the ones who have died have been sad but have not impacted me all that much. However, this last March I was on an inpatient medicine rotation and I encountered a patient that left a mark on my heart.
This patient was in the process of being worked up for possible metastatic cancer when she was admitted to the hospital. The ultrasound and CT scan looked suspicious for cancer, but we could not be certain. We spent the next two weeks fluctuating between trying to get the specialists to make a diagnosis and trying to keep her out of the ICU. One day she would be doing okay, awake and able to converse. The next day she would be drowsy, confused and disoriented. She went into kidney failure numerous times. Finally she was transferred to another hospital and I was no longer able to see her everyday. I got to know the family quite well and cared deeply for them. Some family members even attended our church on a Sunday that Steve was preaching. In the end she became comatose and the family decided to withdraw life support. I found this out by calling the ICU at the other hospital, I had planned on going by to visit her later that day.
I really felt that this patient was under my care. I look back on those two weeks at the end of her life and wonder what we, as physicians, could have done to make her time more pleasant or even to extend her time with us. I don't think there really is anything more we could have done, the cancer, of which I still don't know what type, would most likely have taken her life in the end anyways. But I can't help but wonder, what if we had been able to get her home for a few days? Did we control her pain? Did she die in pain wondering why no one would help her? These questions will forever haunt me with no answer.
I will always remember this experience and hopefully it has in some way prepared me for what I will encounter in the future.
This patient was in the process of being worked up for possible metastatic cancer when she was admitted to the hospital. The ultrasound and CT scan looked suspicious for cancer, but we could not be certain. We spent the next two weeks fluctuating between trying to get the specialists to make a diagnosis and trying to keep her out of the ICU. One day she would be doing okay, awake and able to converse. The next day she would be drowsy, confused and disoriented. She went into kidney failure numerous times. Finally she was transferred to another hospital and I was no longer able to see her everyday. I got to know the family quite well and cared deeply for them. Some family members even attended our church on a Sunday that Steve was preaching. In the end she became comatose and the family decided to withdraw life support. I found this out by calling the ICU at the other hospital, I had planned on going by to visit her later that day.
I really felt that this patient was under my care. I look back on those two weeks at the end of her life and wonder what we, as physicians, could have done to make her time more pleasant or even to extend her time with us. I don't think there really is anything more we could have done, the cancer, of which I still don't know what type, would most likely have taken her life in the end anyways. But I can't help but wonder, what if we had been able to get her home for a few days? Did we control her pain? Did she die in pain wondering why no one would help her? These questions will forever haunt me with no answer.
I will always remember this experience and hopefully it has in some way prepared me for what I will encounter in the future.
posted by Rikki Suzanne @ 11:03 AM
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