My first patient who died on me

Prisoner with congestive heart failure and an cardiac ejection fraction of 10% (most people eject greater than 57% of the blood in their heart per beat). He was in his hospital bed with leg shackles on and a guard from prison watching him 24/7. He had seemed to be doing well considering his heart failure as many people live a long time with it by taking meds and diurectics. I came in to check on him in the morning and he said he was feeling fine and wanted to go "home". I tried to take his blood pressure and couldn't get anything. I went and got the nurse and said hey I can't get his blood pressure. She says oh we haven't been able to get it all night using a blood pressure cuff. We have been using a doppler to get the systolic. The last one we took his systolic was 88 at 3am. It was about 8 am. I said 88!!?? I called the resident she says she has been talking with the nurse and knew all about it. She said she had stopped all his meds that night. We go to round on him at 9 am with the attending physician the resident and two other med students. A new guard comes in to change shifts and comes running down the hall saying he isn't breathing! He was declared dead. I think maybe he had become hypovolemic from too much diuretics trying to get rid of some of the fluid overload on the heart. ALso a beta blocker was stopped and I think that may have induced a tachycardia causing more strain together with the hypovolemia. As a third year I didn't have much say in his treatment plan but I did question the attending when she said she was putting him on a beta blocker as I thought if he had some asthma or something it could cause constriction of his bronchioles. I know you arent supposed to stop a beta blocker once started. Anyway, what a way to die shackled in a hospital room with no visiters or family coming to see you the whole time and a guard next to your bed when your heart is failing on you.

 

In your 4th year of residency they will let you in a little unspoken hospital rule -

"we don't waste tax dollars keeping felons alive."


Barry

 

That's funny, I didn't think the US government spent tax money keeping anyone alive. If you can afford it, great, otherwise you're dead. Isn't that the case?

 

Pretty much man... I think the goverment gets kickbacks from the insurance hacks

 

I'm thankful that I have insurance... for now at least anyway. Every year, my coverage gets worse.

It's it nice to know that we have Doogie, I mean Doug... er Dan around, huh?

 

ohh... and someone who can't post a picture:

 

did you ever wonder if doogie used to molest his patients when they were anstitized?

 

Yeah, he'd take pictures of "boobs" "butts" and "pee pees" and give them to his sidekick.

 

No but there is no doubt Dan does.

 

Makes me think of Kill Bill

 

I bet your dentists makes you take your pants off before he gets started, dosen't he?

 

Yes, he does ....

 

I thought this was normal procedure?

 

Isn't Rat a dentist or something? I never knew dentistry was so kinky. What a dirty hussy Rat is!

 

Not at the hospital I am at. I have one patient 38 year old alcholic prostitute that gave her self Type 1 diabetes by drinking her pancreas to death. In addition she has severe anoxic brain injury due to smoking crack cocaine that makes her have the mind of a 5 year old which means she can't remember to take her insulin or pancreatic lipase so she keeps ending up in the hospital for diabetic coma or whatever months at a time where the nurses adminster her meds. Becasue she can't make any pancreatic lipase she can't digest fats and has to take a synthetic pancreatic lipase which costs a but load so to speak as if she doesn't have it she gets diarrhea and starts losing all her Magnesium causing her to get contractures of her skeletal musles and when we replace the magnesium she gets diarrhea. She continually scratches herself so she has develped is continually developing nasty skin infections that threaten to make her septicemic. So I have to go in and see this woman who is all shriveled up and brain damaged who is farting and crapping all over the place as I try not to gag and get out of the room as soon as possible. She has been in the hospital 16 times this year with her latest stint being for 2 months at a cost to taxpayers of 100s and 100s of thousands of dollars.

 

man, thats really sad, and infuriating at the same time. Isn't there some kind of invalid care she could goto? or family care?

 

Sad my ass you bleeding heart pussy, She did it to her own fucking self now she is living off our tit.

Forget a family care center put a slug in her fucking head and move on. She is of no use to anyone or the world.

Its like I always talk about, People like that should be done away with.

 

Man I can't wait until the one day you need some kind of help. I bet you voted for Bush didn't you?

 

No I did not vote for Bush nor would I ever, I have no heroic in my med records and a card in my wallet if I'm really bad off.

Because unlike most people I do not want to be any trouble for my wife or family.

 

Maybe you could do us all a favor and slip an overdose in her IV.

Barry