Indexing Title: CLEYSONs Medical Anecdotal Report [05-04]
MAR Title:  Vessel of the soul
Date of Medical Observation:  April 23, 2005

 Narration:

            I have been in this institution as a surgical resident for five years now and trauma patients undergoing 0emergency operations are not new to me.  This is a story of a 24-year-old male who sustained two stab wounds, one on the right upper quadrant and the other on the left flank area. He was directed to the operating room to undergo exploratory laparotomy.  The procedure went on smoothly. I expected him to recover immediately. To my dismay, on the   third post-operative day, he developed high grade fever, tachycardia, he complained of difficulty breathing and there was slight yellowish discoloration of his skin. I could hear crackles on both lung fields so I requested for a chest x-ray which revealed pneumonia.  The impression then was sepsis secondary to hospital acquired pneumonia. I talked to his mother and explained his condition. For four days, the patient’s fever was persistently high, he was dyspneic and there’s deepening of the yellowish discoloration of the skin and sclera. His mother was there all the time continuously attending to her son’s needs, staying awake for 24 hours doing the TSB until his fever was alleviated.

 Eight days after the operation, the patient have shown some signs of improvement as evidenced by alleviation of fever, normalizing cardiac rate and though respiratory rate remained at 30’s then, he was more comfortable.  He was even able to deliver jokes. I can’t help but notice the smile formed on his mother’s haggard face as if she has seen the sun shines for the first time.  She tends to his sons needs with more enthusiasm.  I felt so uplifted.  Progress on patient’s recovery continued on the following days.

 He was apparently stable until… sudden episodes of vomiting occurred and complaints of burning pain on the epigastric area were made.  I immediately ordered for the proper medications and he responded very well.  On the following day, a repeat chest x-ray was ordered.  After the procedure, while heading back to his room, he vomited coffee ground material and passed out black tarry stool.  I was informed of the said incident and upon evaluation patient was noted to be pale. Hemoglobin level was low warranting blood transfusion.

 Massive episodes of hematemesis and melena persisted.  Patient’s condition continuously depreciated with signs and symptoms impending septic and hypovolemic shock. Despite the entire regimen given to the patient, with mechanical respiratory support, broad spectrum antibiotics, and other supportive medications he eventually left to embrace the glory of God’s kingdom. 

  Insights (Physical, Psychosocial, Ethical)  (Discovery, Stimulus, Reinforcements)

                       The life of a training surgical resident is akin to a mystery tale that is full of twists and turns.  As our training goes, these experiences will shift the plot of our life to a different way, hopefully to the right way.  This case made me realize that no matter how long you have been accustomed to a certain tradition or procedure; you can never tell that nothing would go wrong. These experiences strengthen my belief that in every patient, every experience there is always a lesson is learned.

 It also reminded me of the saying, “our body is the vessel of our soul, of our life and life was only lent to us by the Almighty Father. No matter how we hold on to this life on earth, if it He decided that your life will only be this long, no one can stop or change that.  It made me realize that, as a doctor, I am an instrument to fulfill what was already written and had decided upon. The life of a person is in Lords hand and not in mine. Death is truly in the hands of God, the ultimate author of life.