Friday, May 7, 2010

She should be dying now.

I haven't written much in this blog about the fact that I am a nurse, and I don't know why this particular experience is on my mind today. It happened over 40 years ago.
I was a nursing student at a hospital in a major metropolitan area and nearing the end of the 3 years of "training," which is what nursing school was called in those ancient times. The education was inexpensive, because the students were slaves of the hospital. We really did earn our keep. There is no denying, however, that by the time the three grueling years were over, we were very well prepared.
I was assigned to take care of a women about 30 years old who had ulcerative colitis. She was married and the mother of two young children. I had watched her condition deteriorate over the several days since her admission. Her doctor who was a general practice physician had eventually called in an internist to consult, but it was not the internist on the staff who had the most experience in gastrointestinal disease. She continued to become more ill.
On a Sunday, a surgeon came in and saw her having also been asked to consult on her case. At this point the woman was desperately ill. I was convinced that her intestine had perforated, and that the only way to save her life was immediate surgery. The surgeon examined her. I made sure he was aware of her symptoms, but he was clearly not planning to take her to surgery. I wanted to jump up and down and scream at him, but it was a major faux pas to tell a physician his business. So, I played like I was just a curious student and tentatively inquired, "Dr. H, do you think there is any chance she is perforated?"
Dr. H who was a very prominent surgeon flippantly replied, "No...but go ahead and satisfy yourself. Order a flat plate of the abdomen."
Then to my horror, Dr. H. left and went out to play his Sunday round of golf.
I ordered the X-ray to be done in the room with portable equipment. It came back clearly showing a perforation of the intestine which would result in massive infection in the abdomen.
We couldn't get through to Dr. H on the links.
The patient died.
A husband was left without his wife.
Two little children were left without a mother.
I was left wondering why patients came from hundreds of miles around to have Dr. H operate on them.
She should not have died 40-some years ago. Today she would be in her 70s....a better time to die. She should have seen her children grow up. She should have been a grandmother.
Sometimes being a nurse is heart-breaking.

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