Medicine is Hard & I Chose It

My first patient this morning was dying of gastric cancer.  The surgeon didn’t feel removing his stomach would extend his life.  Chemotherapy is limited in this country anyway but especially for the poor since everything must be paid for either by the patient or the hospital.  There was nothing to be done except have him see the social worker. 

Then just as my day was ending two young men came in from a motorcycle accident. Riding a motorcycle is very dangerous here; no one wears full clothing let alone helmet, leathers or closed toed shoes.  It is more dangerous with a passenger, in the rain, and it is worse if the driver his holding an umbrella in front of his face to avoid being pelted with rain (this came out later). 

The 16-year-old had a broken femur it was open but otherwise was okay.  He came through surgery fine after a few touch and go moments.  The driver was not okay.  He came in unresponsive pale and flailing.  Large abrasions to the trunk and legs, his oxygen was low, his blood pressure was low – initially normal heart rate then it got fast.  He had a flail chest.  The ultrasound show showed blood in the abdomen.  We rushed him to surgery and he died on the way.

We had no blood to give him – because blood has to be given on scene by a family member or staff and this takes time to match and draw.  Everything needed to be faster.  Only One knows if he could have been saved.  But I heard his wife crying.