Indexing Title: OLEYSON’s Medical Anecdotal Report [06-03]  

Date of Medical Observation: November 11, 2005 

Title: Who comes first   

Narration: 

            Another tiresome Sunday when I was a senior-on-duty manning the emergency room  while my co-residents at the same time, were doing a procedure in the operating room.  One moment, a 21-year-old male who sustained a single stab wound on the fourth intercostals space mid-clavicular line left caught my attention at around 11:00 pm.

He was unconscious, drenched with blood, stretcher-borne and his initial vital signs were palpatory 60 and tachycardic.  On auscultation, he had decreased breath sounds on the left so I decided to do close tube thoracostomy on the left.         

While I was doing the close-tube thoracostomy on the left, I instructed my intern to immediately insert two large-bore intravenous fluids. Patient continued to deteriorate, until no appreciable blood pressure was noted nor cardiac activity. Since my finger was already inserted on the chest of the patient I decided to open the chest through an antero-lateral  thoracotomy.  I started to do cardio-pulmonary massage. 

While I was doing the cadio-pulmonary resuscitation, the emergency nurse approached me and told me that there was a phone call from one of my brother in fraternity.  I told the nurse to wait for a second because I am in a crucial situation with a dying patient.  I did not know what happened to my brother but I have to prioritized my patient at hand.  Knowing the prognosis of the patient, I approached one of the man who brought him at the emergency room. I explained the condition of the patient and told him that death was inevitable. The man answered, “ hindi ko po kilala yan, nagmagandang loob lang po ako at dinala ko pa siya dito”. Nevertheless, I informed him of the patient condition and asked him if he could get in touch with the police officer to verify the identification of the patient.

Suddenly I remembered I had a phone call but when I proceed to Medicine emergency room where I found my brother in my college fraternity lifeless after a massive myocardial infarction.

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

            Being a physician, we are endowed with the privilege to heal and to save life to the best of our abilities. In our daily duties in the emergency room, we encountered many cases.  In  these scenario, I was in the middle of a resuscitation of a dying patient when my brother came. However, I prioritized my own patient because I cannot abandon him and attend to another.  I have a legal obligation to my patient and my conscience dictates me to attend on my patient.