I work at orthopaedics. People don’t die here. Some have nasty fractures, I work mostly with joint replacements, some simple, some complex, but they don’t die. Most go home to a happy satisfying life, some need further long rehab elsewhere, but they don’t die. This pt had a surgery on his femur a year or so ago and it got infected. Pt was immunocompromised, so susceptible to infections. The infection was more or less under control, then less and less under control. Further surgeries, washout, what not. Some antibiotics could not be used. Part of bone removed. I worked with this pt for about 2 months, twice a day. Pt was walking with difficulties. Then I would just transfer the pt to a chair. Then just bed exercises, active assisted. Then passive range of motion. Sometimes we just talked. Pt was getting weaker and was sleeping more, kept eyes closed while I did some mobility in the bed, as much or as little as the pt could tolerate. Then the pt told me that the doctor said there is nothing else they can do, we have maybe a week or so. So there I was with tears in my eyes. I got to know the pt’s family, too. Last night the pt passed away. I feel kind of empty and flat. There was nothing the doctors could have done, the infection was too much and the pt was elderly. But I still feel somehow off. I can’t get attached to the patients as they don’t stay on our ward for long and certainly don’t die here. I’ll get over it, but at the moment it sucks.
I’m sorry. It’s awful for him and for you. Try and take some comfort in that this means you’re human and feel this loss - you should be worried if you don’! It doesn’t make it any easier I know but you and everyone else did all they could.
something to take solace in is you gave the patient the balm of touch – even if occasionally uncomfortable – in their last months on earth. It’s so personal, and i’m sure it helped immensely.
I’m thankful to be alive, suffered similar last year.had sepsis (need metal from shoulder surgery removed, it was infected) Wasn’t immunocompromised before though
I don’t think I could do it. Especially if you have patients die because they won’t take good advice. I am certainly thankful there are people who can.
Thank you for sharing.
I am medical as well (Anaesthesia, or Anesthesiology for some). Our patients don’t die either, although sometimes some give it a bloody good go and occasionally we do lose somebody because of something catastrophic.
You highlight the traits that I think are sadly missing all too commonly in healthcare staff these days. Compassion, empathy and caring. You say you can’t get attached to patients because of how long they stay with you normally, I know the feeling as most of my patients end up asleep with me. But behind each patient is a life story, trials and tribulations, fears and anxieties and vulnerability. Even in the briefest episodes of care, we can still connect with patients on a human level, we can still bond with patients and we can have a very big impact on their outcomes.
That this has hit you hard shows those lovely qualities. Whilst some in healthcare say you should try and be emotionally detached etc, I don’t always agree as in many areas of medicine, we do better for our patients by forming those connections with them, allowing them to be vulnerable in our presence, letting them know they will be well cared for and respected.
Thank you for highlighting these qualities and for allowing yourself to feel off. They are good lessons for all of us.
Excellent posts by you and Amnesia, my late father was a trauma surgeon and of course had his fair share of encounters with death. He really kept to himself and never shared much, but every now and then my sister and I could see a bit of emotion (sadness, maybe fear, disappointment?) behind his usual stoic self.
I too have had the unfortunate event of losing a patient in ortho. This is why i’m constantly annoying my mom to do balance exercises etc. it’s amazing how much a few simple exercises a day can prolong your life.
There are various personalities that allow people to gravitate into what they do. And how they cope (to include trying to protect their family) . I would say the person that had the most profound effect on a young me was a Trauma Surgeon. They aren’t all like this, but he was one of the most sensitive and empathetic people at the bedside I have encountered. A great human.
Good write-up from your perspective. Death is always difficult, I think even more so if you know there’s nothing you can do to help. I’m reading this as they call a code down the hall here in the ER.
We each have our own coping mechanisms, but they are rarely truly comforting. From my end, I have to make sure not to get emotionally involved in the situation, or risk burnout.
In my field (ophthalmology), we also do not see much death. Before ophthalmology, I worked in general surgery/trauma, and it was a more common occurrence.
Unfortunately, a death happened under my care this summer. It was not one of my patients but a fellow cyclist. At a local event, he went over the double yellow line, on a downhill curve, and struck an oncoming truck at about 35+mph (56km/hr). As I caught up with the group, I heard one of the other cyclist asking “is anyone here a doctor?” It then fell on me to assess the poor guy and try to do what I could to help him. Me and another physician performed CPR on him for a long time, before the paramedics and Life Flight helicopter arrived at our rural location. Then he was intubated and resuscitation was continued. We even tried on the scene chest tubes (modified) but the blood loss was too much. Once he arrived at the ER, they pronounced him.
Normally, death does not bother me so much. This one did bother me. Before the start of the ride, I’d seen this guy walking around and talking with his friends. Now he was laying there, on the ground, dying in front of me. From the time we wake up, none of us really know what to expect from our day. I felt so bad for this poor guy’s family.
I’m not meaning to kidnap your thread about death. I’m sorry it happened to you, or any of us. Like you said, it just feels better to say it out loud sometimes.
That does suck. I have got quite attached to people having had the same group for 30 years. One guy died a month ago. He presented with a cough for a few weeks. I told him it was likely viral has he had no physical findings and no red flags. Two weeks later we did a chest xray and big lung cancer. The family has been accusing me of killing him It is taking some time to get over that one. I once had a patient in his thirties die of of pulmonary embolism after an ankle fracture. He lied on his life insurance application about a pre existing condition so his wife go no life insurance payment. I think I have about a death a month in the nursing home. In the last few years starting to get to me. My advice is it still is okay to get attached to people. You probably spent more time with the patient than the doctors did so understandable it hurts