3 glasses of Rose Lambrusco and one emotional episode of ‘House M.D.’ made me start writing.
It wasn’t the first MI patient I’ve seen, but it was MY first MI patient.
MI = Myocardial infarction, a.k.a Heart attack. When one or more of the heart vessels is blocked, and the heart doesn’t get enough oxygen. Living tissue kinda need oxygen to stay alive, and you kinda need the heart to do the same.
Bed 6 came to the E.R. (emergency room) around 21:00 today, I saw her first around 21:40, vomiting and intense right upper abdomen pain, so intense she cried.
I held her while she was vomiting. Bed 6 is 57, she is living alone and has no one to comfort her in this time of need. She has an uncured breast cancer and 2 relatives that died from the same cancer type. I felt sorry for Bed 6.
I inserted an I.V. line for her to get some pain relief and anti-nausea drugs.
I took some blood tests – everything I could think of that is related to this area in the abdomen – liver, pancreas, gallbladder. and the heart, just in case.
I presented the case to one of the on-call doctors, as I am fresh out of med school. He came to see Bed 6 and asked for the same blood tests I already took, both of us thinking about the digestive tract, planning ahead the X-rays.
I asked the ECG-guy to test her 30 min after I first saw her, realizing I couldn’t find her ECG test in her file case.
The ECG guy was about to leave for home and said he is going ask the next shift. She finally got her ECG at 22:45, when I asked the new ECG-guy to get it. It was an hour after I first saw Bed 6, and a few hours after she started vomiting.
The ECG was full of snails (or ST-elevations)
I assume most of you don’t know what it means, to me, to all of the ER staff it meant one thing – a myocardial infarction.
That is why I am drinking today.
I am drinking today because a woman almost died, just because I insisted on the ECG an hour too late. And I feel guilty.
And I am drinking today because I am glad that I did insist and in time, before her heart explode.
What I learned today is, next time that someone is coming into the E.R. with clear abdominal symptoms, ECG is the one of the first things to do. I am glad no one had to die for me to learn that.
The blood tests I took for the heart never came through, the lab never processed it. It would’ve told us about the heart attack, I would’ve seen the problem earlier.
Was this woman lucky I was there to insist on the ECG? Was she unlucky for having me as her doctor, and for delayed ECG and unprocessed blood test?
In another time, in another universe, would she still be alive? Would she be better?
Cheers (4th glass now), for Bed 6.
* Update -Bed 6 underwent cardiac catheterization that night and another one a week later. She is alive and recovering