Saturday night wasn’t busy as usual, and only one doctor was in the E.R. when bed 13 entered.
Bed 13 was a very heavy 32 years old women, like 160 kg heavy. I saw the panic in her eyes immediately; “I can’t feel or move my legs for 1.5 hours, and they are painful!”
Good reason to panic, I thought to my self.
The first thing that came to mind was – something wrong with her aorta, the body main pipe line. But I didn’t feel equipped to make the diagnosis.
She begged me “help me, can you help me? fix me”.
I waited no longer to bring the only doctor in the E.R. at the time, we will call her E.R. doctor number 1. I knew E.R. doctor number 1 wasn’t the best doctor at this shift, but she the only one I could find.
"its neurological!" said the E.R. doctor number 1 at once, and went to bring the neurologist.
"its orthopedic!" said the neurologist, "the spinal cord might be compressed"
"TO THE CT SCAN!" said the orthopedic surgeon.
*Due to her size it was a mystery how exactly they manage to fit bed 13 into the CT scan machine, but they did.
"its a spinal disc herniation level L4-L5!" said the radiologist.
"TO THE OPERATION ROOM!" said the orthopedic surgeon.
Bed 13 blood pressure was high, too high for surgery.
It was time to consult with E.R. doctor number 2, the best one in this shift, the one I couldn’t find at the beginning.
"Something is very wrong, TO THE CT ANGIO" said E.R. doctor number 2.
CT angiography is the best scan for diagnosis of blood vessels problems.
"its an aortic dissection, the spinal disc herniation was an artifact due to bed 13 weight" said the radiologist.
So we said the aorta is the body main pipe line, going straight from the heart to supply the body with blood, the aorta wall is made of layers;
an artoic dissection is when a tear in the inside of the aorta causes blood to flow between the layers of the wall of the aorta, forcing the layers apart.
It was 3 hours after bed 13 first arrived in the E.R., 4.5 hours after the she could move her legs, and things started to go south very quickly.
I wasn’t there when she passed.
I couldn’t keep on working, I heard her begging “help me” in my head, I kept wondering why I didn’t insist on E.R. doctor number 2, why I didn’t trust my instincts and kept on ready about aorta realted conditions, and how much of it was really preventable.