My First Life

We got a call from the paramedics that they were bringing in a gentleman with some difficulty breathing. He was awake and alert but his blood pressure was very low and he appeared dehydrated. I was caught up so I figured I should pick up this guy. An hour later, after we initiated his work up, as I was talking to him and his fiance, she casually mentioned, “oh by the way, sometimes he seizes” just as my patient started seizing. I’ve seen enough seizures by now that they don’t fluster me as much as the first time, but still, they will always be kind of scary. As I was giving instructions to the nurses to get medicine, my patient went pulseless and stopped breathing. Completely flatlined on the monitor. The next few hours were a whirlwind of activities trying to stabilize this person. Tubes, lines, fluids, you name it, we probably did it. We paralyzed him and sedated him and initiated the hypothermic protocol, literally cooling his core body temperature to preserve organ function. It was crazy. We had no idea what caused all this! Everyone was sure he was actively trying to die as his blood pressure kept on dropping back down to the 70s/40s (normal is around 120s/80s with variation). Somehow, we managed to keep him alive long enough for him to go upstairs to the intensive care unit.

The next day, I learned that not only did he wake up and was responsive; he was extubated and was breathing on his own. The team upstairs did not figure out the cause either, and from what I know, was waiting for the patient to wake up to ask him if he had taken anything.

Though we see these patients more often than not in the ED, as interns, we are usually not assigned these patients. They are medically complicated and require a lot of time and knowledge, which interns have neither. However, somehow, he became my patient and I was 100% involved in his care with my senior resident. It was a crazy adrenaline rush and when it was all over, this wave of exhaustion kicked in and I realized how tired I was. It was just like the movies and tv shows (for once.)

I’m totally counting this as my first life saving experience. These are the moments that remind me how much I love medicine. It’s simply amazing.