Narration

It was Team 1 elective day and I was on duty. Upon assuming my post at the emergency room that morning, I was told that 2 of the from duty residents were doing an “Emergency” herniorrhaphy for a strangulated hernia. At around 9 am, I went to the operating room for a scheduled Modified Radical Mastectomy. As I entered the hallway of the OR, there was a foul smelling odor and I learned that it was coming from the OR suite where the strangulated hernia was undergoing.

We did our MRM and while doing so, the procedure from the other room was finished and the patient was stable. The rest of the elective operation went on and all the scheduled patients were operated on.

After the elective operation, I manned the ER. And while I was attending to a patient, I received a call from the Recovery Room that one of the patients was having an arrest. So I endorsed my patient and I ran to the RR. I tried to recall who amongst our patients was arresting. As I entered the OR, the nurse at the RR told me it was the patient who underwent “E” herniorrhaphy.

When I saw the patient, he has no cardiac activity and was on ambubagging. As I examined further, his pupils were dilated and the ECG was a flat line. I called the nurse and asked her to look for the relatives. As we were waiting for the relative we were trying to resuscitate the patient. I ran through the chart of the patient and studied the case for it was the first time I literally saw the patient.

He was 86 years old and looking at the history of the patient, he started suffering from his present condition from more than a week. His physical status was IV. I read the operative technique so as to get an idea how extensive the operation was.

A relative came, I took a deep breath and told myself that this is it. I learned through my limited experience as a doctor that one of my hardest job was pronouncing a dead patient. More so, pronouncing someone else patient. I braced myself from the challenge ahead of me.

The relative was a grandson and a “baranggay kagawad.” I explained to him the condition of his grandfather prior to the operation, the patient’s age, the condition he was suffering for more than a week, the relevant past medical history and the personal social history. I told him of the Physical status was IV, that with or without the operation the patient was at risk, the extent of the operation and the impact of the situation to the patient.

I tried to answer all the questions he asked. It was hard since I had limited knowledge of the patient’s history and the operation done. I can’t answer him with an “I don’t know” for he was expecting answers to all his questions. It was really hard to say “Patay na po ang Lolo!” but I had too.

INSIGHT (Physical, Psychosocial, Ethical)(Discovery, Stimulus, Reinforcement)

One of the hardest parts of being a doctor is pronouncing a patient die. You have to have answers to all the questions the relatives will ask. You’ll have to depend on your knowledge of the case, an idea of all the procedures done to the patient. You can never answer the relatives with “I don’t know” or it’s hard to say, “Ask your attending physician.”

As a doctor, medical recording is very vital. As exemplified by my experience, I used the chart as the basis of what will I tell the relatives. This recordings will answer all the legal issue of the situation and you will have to base your answers on the chart.

And as a doctor, you should have a heart! Be compassionate! Empathize. Answer questions truthfully, and understand the pain they are going through.