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From hope to heartbreak: a story of loss in the ICU

Ton La, Jr., MD, JD
Conditions
March 31, 2023
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Ms. Laura was a vibrant and feisty lady with a personality that filled the room. She had been my patient two months ago when she was admitted for an irregular heartbeat and COPD exacerbation. She was a smoker, and despite her heart issues, she had a strong will to live. I had advised her to quit smoking, but it was a habit that was hard to break.

When I saw her again in the ICU, she had to be intubated and connected to a ventilator. Her blood pressure was dropping, and I had to start her on various blood pressure drips, including Levophed, epinephrine, vasopressin, and neo-synephrine. I monitored her progress closely, and her blood pressure improved the next day. However, she started developing bilateral pneumonia, and I started her on empiric vancomycin and cefepime. She was a fighter, and I hoped she would make it through.

But the optimism was short-lived. On my day off, a code blue was called for Ms. Laura, and her heart stopped beating. Despite extensive conversations with her daughter on the day of her admission, she wanted her mother to be full code. Chest compressions in the event of her heart stopping, and medications would be given to try to restart her heart. Multiple rounds of CPR were done but to no avail. Finally, her daughter, standing outside her mother’s room, told the team to stop, and Ms. Laura passed away. I couldn’t help but feel a deep sense of sadness and grief, knowing that despite our efforts, we were unable to save her.

Days later, I received the news that Ms. Laura had grown Pseudomonas in her urine culture, We had treated her with the antibiotics we had started, but it was too little too late. I was wracked with guilt, wondering if we had missed something. But after speaking with my upper level, I realized there was nothing more we could have done. Ms. Laura was simply too sick; no matter what we did, we couldn’t save her.

The memory of Ms. Laura stayed with me long after she passed away. She was more than just a patient to me; she was a human being with a story. I remembered her voice, her smile, and her fiery spirit. She begged me to tell her daughter to stop smoking at home because it hurt her lungs. It was a plea that came from a place of deep concern and love. That was the last thing Ms. Laura told me.

In retrospect, I realized that Ms. Laura’s story wasn’t just about her; it was about the thousands of patients out there struggling about chronic illnesses, fighting for every breath, and holding onto life with all their might. It was about their families, who watched their loved ones suffer and fight for their lives. It was about the doctors and nurses who spent endless hours trying to save their patients, often without success.

Ms. Laura’s death made me realize how precious life is and how important it is to appreciate every moment we have with our loved ones. It also made me appreciate the value of empathy and understanding in the medical profession. As doctors, we often become so focused on the science and technology of medicine that we forget the human aspect of it. Patients are more than just a collection of symptoms and lab values; they are human beings with lives, stories, and dreams.

Ms. Laura’s story taught me to be more than just a doctor; it taught me to be a healer who sees beyond the illness to the person beneath it. It taught me to listen to my patients, to hear their stories, and to treat them with the compassion and empathy they deserve. Because in the end, that’s what it’s all about.

Ton La, Jr. is a physician and can be reached on LinkedIn.

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