Indexing Title: OLEYSON’s Medical Anecdotal Report [06-02]

MAR Title: A brother’s death

Date of Medical Observation: November 11, 2005

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. I instructed my intern to immediately insert two large-bore intravenous fluids while I am doing the close-tube thoracostomy on the left. We continued the resuscitation even though the prognosis was dim. When 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. In spite the help of resuscitation, patient deteriorated quickly and pronounced dead-on-arrival. I began to approached the relatives who brought the patient in the emergency room and discovered that his family had no idea what had happened to their son.

Realizing  that I had a pending phone call, I rushed through it and picked it up but I was not the one whom on the other line wants to talk to. I only knew it was not a call but an information when one of the medical student pointed to the Internal Medicine emergency room “ Doon po Doc”. I turned to the green curtain and saw a young man intubated and undergoing CPR. I did not recognize the patient at first, but when I saw the humongous middle finger, I knew then that this was my brother in my college fraternity. He was diagnosed to have acromegaly of the index and middle finger. His index finger was removed by “ray” amputation before he took medicine.

Tired and exhausted,  my heart started pounding till  my mind was uncontrolled. He was a 26-year-old third year medical student, a father, and my brother in the fraternity who lie lifeless in our emergency room. Questions started clouding my mind on what vital things to do for him.  I told myself  to help and do everything  for my brother. I took the place of being a doctor giving the cardiac compression and asked another brother to do the ambubagging. Initial electrocardiograph showed a ventricular bradycardia. Another brother which was cardiologist came in and extend his help. We tried to defibrillate the heart to cardiovert, unfortunately, the defibrillator is not even working. We started dopamine and dobutamine to support the heart but there was no available medicine in the pharmacy. I shelled out money from my own pocket down to the last cent to provide the medicine needed.  We tried to resuscitate him for about two hours more but to no avail. My brother eventually died.  Hopelessly,  nothing much more I could do, he great lost to our brotherhood.

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

Reinforcements

Loosing someone close is not something new to me. I made an anecdotal report 2-year ago about my sister but still it is not my cup of tea.  Now I am faced again to reality of having  no working defibrillator and cardiac monitor in the emergency room to support our dying patients.

Stimulus

We should equip our emergency room with life saving drugs, defibrillator and monitor that would be available anytime the need arises. Although this case is a medical one, I have learned a lot from the cardiologist from Philippine General Hospital about advanced cardiac life support.  

Discovery

Refreshing our selves with basic training and advanced cardiac life support.

 Ethical 

Treat all patients equally as if we manage our own family.