Working in an emergency department is never boring. It is a fast paced and demanding job. Emergency departments deal with almost anything, from mild ailments to life threatening illness. Here are their stories.
(Details have been changed to protect patient identity)
Alfred is a 45 year old man who is in reasonable health. He is happily married with a child. He has a stable job, a modest house and is overall enjoying life. Alfred also likes to lift weights; he is a stocky man of average height. He likes to keep his hair short and is always clean shaven. Alfred comes to the emergency department in the evening.
He is unconscious, he has no pulse, and he is not breathing. He is rushed to the ressus bay and his clothes are removed. He has a tube down his throat and someone is pushing on his chest in a rhythmic fashion. He has two lines in either arm running fluids. We don’t know why Alfred is unconscious; we don’t know why his heart has stopped beating.
His family arrives. They are ushered into the family room. Alfred is still not breathing, and he still has no pulse. He is young so we go as far as we can to bring him back. He is given adrenalin through his IV. We place pads on his chest and send a surging current into his heart, still nothing. We repeat this over and over. Forty-five minutes after Alfred arrives he is pronounced dead. A blood curdling scream fills the emergency department as his wife drops to her knees. Alfred’s lifeless body is taken to an empty room to allow his family to say goodbye. We leave the tube in his throat and the pads on his chest. He has gone a grey color, life has left his body.
Within the next few hours more family members arrive, their faces drowning in tears. They spend some time with Alfred before leaving. Once his family leaves, his body is cleaned and bagged. He is placed in a special bed that will hide his body under a normal empty looking bed to be transported to the morgue. After spending some time in the morgue, he will be transported to a funeral home and be buried or cremated. Alfred was so young, what went wrong?
Alfred woke up that morning like any other. It was a weekend and he was coaching his sons soccer team. He went home after the game to his family, but was feeling a little ‘off.’ He went to have a drink and sit on the couch to watch some television and he collapsed. Why did Alfred die? The theory was a heart attack (or myocardial infarction) based on his blood tests perhaps triggered by recreational steroid use. But the real truth is we don’t know. He needs an autopsy. Even then, we may never have an answer.
It is a doctor’s job to save lives, but sometimes, no matter how hard we try we just can’t. These cases weigh heavy on our soul and they are cases we will never forget. Minutes after Alfred’s death we must move on to our next patient with an ear ache or a stubbed toe and try to push him from our thoughts. I don’t know why Alfred died, but I do know that we did everything we could to save him.