Wednesday, April 15, 2015

OMG, you're alive!

     As a  physician, it's great to revisit the medical miracles you've played a hand in. In the monotony of the common every day events, a visit from that one patient who you brought back from the brink, can really lift the spirit. These moments are rare, especially if they happen while you're a medical student or resident that is destined for a short stay in the community, never to see that one incredible patient again. Even if you stay in one place for a few years, many patients get lost to follow up (for a variety of reasons) and the curiosities for whatever happened to Mr. or Mrs. X  can fade over time.
     As a 3rd year surgical med student, I remember attending trauma clinic and following around a weary 5th year senior resident (Dr. HC) as he lurched from room to room in his scrubs and clogs doing post op checks and removing stitches with little enthusiasm but great urgency. Clinic was a chore, an obstruction from the operating room or his call room bed. One day he picked up a chart of a gentlemen Mr. D (name changed) who presented with stitches that were surfacing from his abdomen from a trauma surgery a few years prior. He knocked on the door while reading the chart, entered the room head down while still reading and introduced himself... while still reading. When he finally looked up, he stopped suddenly, grabbed his mouth and mumbled "Oh my God!"
     3 to 4 years prior, when Dr. HC was a lowly surgical intern on trauma call, he assisted on a lengthy operation on a young Rastafarian gentlemen that suffered multiple knife wounds to his abdomen. I don't recall the details of the surgery but Dr. HC made it clear to me, that he didn't expect this patient to survive once he was patched up and shifted to the intensive care unit. The patient had a lengthy stay in the hospital and despite the visceral experience of doing surgery on him, Dr. HC's gypsy, sleep deprived surgical life turned Mr. D into simply another case to log and a patient unwillingly forgotten.
    After a few more seconds of disbelief, Dr. HC was finally able to drop his hands from his mouth and give Mr. D a  handshake. Mr. D's chief complaint  were put on hold while I was told about the circumstances of how they 1st met. Mr. D actually didn't even know who his doctors were on that terrible day but was pleasantly surprised to hear that this random resident sent to remove some stitches today, helped save his life. But Mr. D's enthusiasm was tempered, probably due to the discomfort he was feeling that day,the difficult post op course, rehabilitation and numerous nutritional issues he'd been battling ever since his abdominal trauma. But nothing could temper Dr. HC's smile as he grinned from ear to ear, repeating several times " Man, I can't believe it's you. "
    Dr. HC was a battle weary 5th year surgical resident, in a bleak inner city hospital. During my 12 weeks as a surgical med student, he was generally pleasant but had always had a morose aura. His chance encounter with Mr. D was the first time, he looked genuinely happy. In one of those very important "teachable moments" that med students crave, Dr. HC emphasized that it's cases like Mr. D that keep you going. It was a valuable lesson and although I didn't become surgeon, I did become a much better doctor that day.

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