Moving on and saying goodbye…

She kept us on our toes for six weeks, clocking an impressive array of medical emergencies one after the other. Who knew that heart failure could be so stunning, and tragic, and poignant. I got front row seats to a thoracentesis procedure, where the fluid was sucked out of her lungs through a long needle. I got to sit with the MRI technician at 3 am as he isolated the network of carotid arteries on the screen, searching for the occlusion. I got a crash course in thyroid function and how it slowly but steadily weakened one system after another, the signs flashing by without me recognizing their urgency except in hindsight. She racked up to eleven specialists/teams coordinating her care by the end, with visits nearly every hour 'round the … [Read more...]

When you close an abdomen after a failed rescue, the OR is silent

I'm re-posting in its entirety here from KevinMD because it's just a beautiful, touching piece. From the doctor's perspective: I didn’t know her name until it was over, much too late. What I knew was she was thirteen and that on this winter day someone in her family had been pulling her behind their car, on a sled. No doubt laughing and looking in the rear-view mirror, the person driving had whipsawed around a corner, and the young girl — probably screaming (fear? delight?) — held onto the sled as it careened off the road and into the side of a concrete culvert. The girl took the blow in the middle of her right side. Reportedly, as they helped her up, crying, she fainted. The family member did what a family member who’d pull someone … [Read more...]