Indexing Title: NALUDINOs Medical Anecdotal Report [06-07]

MAR Title: What Limits a Physician

Date of Medical Observation: July 2006

Narration:

This was one patient whom I would find hard to forget. A young man in his early 20s was wheeled in to the emergency room. He was apparently stabbed a few minutes prior to consult. He had only one abdominal stab wound. This patient was stable, and was actually laughing with his friends. After a through examination we decided to operate on the patient. He had a penetrating stab wound. He took the news lightly.

When we opened up the patient, we were quite surprised with the amount of bleeding. We tried valiantly to control the bleeding. The stab wound penetrated his abdominal aorta and the inferior vena cava. We put proximal and distal control on the bleeding vessel. After a putting up a fight, the patient succumbed to his injuries.

During the operation, blood replacement was not commensurate to the blood loss of the patient. We did not have enough blood available. We were able to repair the vessel injuries but we were not able to replace the life giving blood.

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

This patient was an eye-opener for me, a wake up call for some. The physical status of this patient did not reflect the true extent of his injuries. If we did not examine the patient thoroughly, we might have mistaken his stab wound to be non-penetrating. If we took the patient lightly we might have committed a grave mistake.

A physician certainly has limitations. His skill limits what he can do. The environment he works in limits him even more. But these limitations are not without solutions. The doctor can hone his skills and his working environment can be improved.

If we continually hone our skills we will be better prepared for the challenges these patients throw at us. If we are given the right instruments, the right materials, enough resources we will be able to give the best care to our patients.

Recognizing the fact that we will not always have enough of these resources; we are forced to make the best of what we have.