I can still hear her screaming, I can still hear her vomiting, I can still hear her crying.

Different people react differently to bad news, and no situation is alike the other. One family cancer is different from another, even if it’s the same type at the same stage.

 

The family in room number 14 was quiet when I entered the room to do the last ECG to the dead patient, the one that is needed to verify death for legal reasons, the one with the straight line.

They sat there patiently, not saying a word. They knew already, they were the ones to call the nurse to tell her the patient finally stopped breathing.

You see, the patient in room 14 was an old lady who suffered from a long illness, everybody knew the death is near, they accepted it quietly, welcomed it.

The ECG was flat, ‘I am sorry’ I said, the family nodded, they didn’t cry, they didn’t say anything.

Later I came with the doctor in charge, they shook his hand and said ‘thank you’.

Quiet families are quite common, as most of those patients meet their last moment in the hospitals.

 

On the other side, room 9 patient’s family was surprised when the patient took his last breath. Room 9 was a 70 years old man with stage IV cancer, DNR, with a morphine drip, which he got with his family’s consent after understanding what it means.

I guess it was not a surprise as much as a shock, and who am I to judge?

They waited for an answer about their dear father’s condition after it was clear he was not breathing anymore, the poor intern was very confused, didn’t know he had to explain the family what not breathing means.

They cried and hugged and mourned. It didn’t matter that they knew what is coming for the last year, it was still sad.

 

The next story is about a motorbike accident that happened a few weeks ago.

Shortly after the ambulance arrived to the emergency department with a barely-living-very-wounded 28 years old man, his friend came to the hospital, recognized his bike, and the location of the accident. The patient was severely wounded and couldn’t be identified by his facial features along.

The friend was logical, a bit shaken, but OK. The doctors explained the situation; they had to transfer the biker to another hospital, a bigger one, due to his severe head trauma.

I was in the room when the friend called the biker’s mother.

“Hey, it’s *the friend*”

“Yes! I remember you, how are you?”

“Listen, I am in the hospital, *the biker* had an accident. They want to transfer him now to another hospital”

“How is he?” she asked calmly.

“I don’t know”

“How is the bike?”

“Pretty bad”

She was calm the entire conversation, I couldn’t hear any sign of distress, and I was so surprised she cared about the bike. Later the nurse told me its most people’s reaction, and it’s due to shock and not being able to process the situation.

 

And now back to the screaming lady.

The patient in bed number 8 was not there originally, she was checked in the clinic outside the emergency department for a first time partial seizure. Bed 8 was a 23 years old female, with the only history of 6 months treatment for a psychiatric disorder.

The results of the head CT came back.

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The neurologist explained the mother alone about the findings, a large brain tumor.

How would you react? How would I? How can you explain to your daughter she got this horrible thing inside her head?

And I can still hear her screaming.

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