stemi

My Ecology

You died. You bloody died! You weren’t supposed to die. You were supposed to be the part of the story where I learn the true magic of modern medicine, the Saving Lives dream come true. But you died.

My history of you begins with the bat phone. It’s really called that. Loud important noises go off, the two way radio gets picked up, the story begins. An electronically transmitted ECG appears on the screen. It’s bad. It’s real bad. My registrar tells me to go to the resus bay and I busy myself setting up stuff to put a line in and get blood. Needles, tubes, alcohol wipes. And then you’re there on a stretcher, eyes wide open, scared. You’re barely moving. You’re talking two words at a time. People are everywhere, fussing with breathing gear, setting up for an ECG, attaching you to monitors. The boss is shouting orders. I shout back that I’ll get a line in. My reg leans in and says “are you sure can do it fast?”. I nod yes. It’s automatic. Immediately I doubt myself, I’ve only tried one line this large before and it was such a horrible painful failure that I never tried again. But this time it’s different. The line goes in immediately.

We push in fluids, the cardiology team arrives, time for you to go upstairs. Upstairs. The magic life saving place that is the cath lab, where truly broken hearts get fixed and where you’re supposed to live. You’re only young. Your wife and daughter appear as you’re being wheeled away. The boss stops the bed moving for a minute so they can have a moment. An eternal moment. I watch from a distance as your wife sinks into a chair and your teenage daughter stands there blankly. And then you’re wheeled away. Wow, I think. Wow. To be a cardiologist must be so amazing, because they’re going to fix that.

We go back to our other patients. Five minutes later the sound of emergency pagers ring out, reaching a collective crescendo. The team leader nurse is already halfway out the door with the portable defibrillator. She shouts at the medical student, the only one free to push the cart. He’s only just started on clinical rotations None of us doctors can help, we’re too busy with the other patients. I watch him obediently follow her up stairs.

We go back to work. Later the team leader appears. “He arrested. He’s tubed now. They’re pushing on with the angio”. Everyone agrees to find out what happened in the morning, it’s time to go home, now past midnight.

I’m at work today. I have a few patients I’m sorting out, mainly elderly people with elderly person problems. I see the cardiology registrar. I ask him. The registrar shrugs and says “oh that guy died”, and walks off.

You weren’t supposed to die.

I go back to work. The wind is out of my sails. For a minute a small voice tells me I want to cry. Another tells me it’s not my journey. Another tells me to get back to work which sounds sensible so I do. Another says nothing and just observes.

“You’ve got to learn to be more lazy”. I look up, and an intern is standing there, handing me a coffee. It’s late. It’s nearly time to go home. “you’ve seen so many patients” she says, “way too many!”

She’s right in a way. I’m not getting out on time. There’s a lot of paperwork left to do but I don’t really mind. I used to mind. I stay back and finish it. I lament my lack of thoroughness for seeing so many. I call consultants to get the patients admitted and give half baked stories but it’s late and they just want to sleep so they accept them.

I get my handbag and walk back to my car. Driving home I notice the other cars on the highway, some big, some small. Lights passing through the night.

You weren’t supposed to die.

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