Miracles and Tragedies

I witnessed a miracle last week.  At about 1030 AM, a 64-year-old female patient had the abrupt onset of slurred speech and left sided weakness and sagged to the floor.  Her husband immediately called the ambulance and the patient was transported to the Emergency Department. The field diagnosis was a stroke in evolution. Our ED team quickly confirmed the ominous signs of a stroke and started the protocols within minutes of arrival: Head CT, neurology consult and then, thrombolysis emergently.  After the infusion of the medicine, the patient’s headache improved, her speech was clear and coherent, her facial droop gone and she could move her left arm and leg almost normally.  The patient sustained this clinical return to her normal state and a few days later walked out of the hospital.  The family was overjoyed and grateful and all of the staff justifiably was pleased and gratified.  Medical care worked:  Smiles and high fives all around.

Last week, I witnessed a tragedy.  A 40-year-old female was brought into the Emergency Department, unable to walk.  An admitted, long-term IV drug abuser, she had developed a severe left leg infection for several months.  She never saw her physician and by the time she was treated in the ED, she had a huge left leg wound that had literally destroyed the soft tissue and eroded into the underlying tibia. The patient got immediate IV antibiotics, an ED orthopedic consult.  She was admitted and will have a probable amputation of the lower leg.  She will never be normal again and will not walk out of the hospital.  Medical care worked again and the patient’s life was saved.  The family was grateful but appalled at the outcome.

Every day, we as physicians are the unique witnesses and participants in the most important part of people’s lives:  their health care.  No one else can do what we do. We see real life miracles and tragedies in our patients.  Most of the time we can remedy their injury and illnesses.  Almost all of the time we can comfort them. Sometimes they are angry and yell at us; many times they are frustrated with their lives.  But, they always need us.

Susan Evans Mc Cloud wrote:

I would be my brother’s keeper

I would learn the healer’s art

To the wounded and the weary,

I would show a gentle heart

Recently, I met with a recently retired fellow physician, who is now doing the medical directorship of a large government health program.  A superb clinician and individual, he for decades had treated his patients with compassion and care.  Now, he was embarking on a new career:  administering to thousands of patients needs but in a new and different role.  He also remarked how as he stepped away from his practice how impressed he was with the wonderful, unique opportunity he had been given to treat patients and be part of their lives.  He gave me some wise advice: to savor and cherish the moments we have now and everyday, in our various medical practices.