As a Doctor, Reflecting on the Loss of a Patient in Healthcare

The experience of losing a patient is deeply personal, even when they are not formally under our care. Recently, I found myself deeply affected by the sudden loss of a woman I cared for in a skilled unit within a nursing home. Known for making delicious cookies for the floors workers, her spirits and positive attitude stood out to me. I admired her vitality and optimism, looking forward to seeing her daily. On the day when I unexpectedly found her room empty, that cherished hope turned to despair. She had died from a blood clot due to inadequate assessment after falling at night. While there was anger and frustration involved, the acceptance that it was her time to go brought a bittersweet sense of peace.

Medical Undersights and Patient Mortality

My residency testimonies underscore the precarious and often understaffed environment of medical wards. In one such ward, we cared for moribund patients, many of whom had severe conditions such as brain aneurysms, comas post-accidents, or spinal injuries. With limited resources, like ventilators, an intensive care unit was out of reach for most. Life support, such as ambu bags, which provide manual ventilation, were critical but insufficient to reverse the devastating conditions.

One particular case involved a young man who had fallen from a tree and sustained a cervical spinal injury. Despite advanced healthcare facilities, his prognosis was grave. His employer and companions were desperate, unwilling to accept the inevitability of his passing. Yet, they played a heroic role in performing ambu bag ventilation, a task that most could barely manage, let alone sustain for a prolonged period. The stark contrast between their original claims and their subsequent actions highlighted the depth of their father's love, regardless of his frailty and exhaustion.

Morality in Healthcare: The Role of Ambu Ventilation

Ambu bags, a crucial tool in emergency situations, require continuous and coordinated effort. The act of performing ambu bag ventilation involves attaching an inflatable balloon to a tube inserted into the trachea (endotracheal tube) and manually pumping it at a specific rate to provide respiratory support. Despite the limitations, patients rely on this method in the absence of mechanical ventilators. For the family of the young man, taking on this task was a testament to their love and determination. However, it also highlighted the systemic issue of understaffing in healthcare facilities where medical personnel, often overwhelmed, struggle to provide even the most basic care.

The tragic story of the young man, suddenly gone at the hands of a critical injury, resonates with the broader issues of medical ethics and the limitations of available resources. His death was a poignant reminder of the importance of prioritizing patient care, even with the constraints of limited resources. The support he received, despite the overwhelming odds, was a heartwarming display of the power of human solidarity.

These experiences in the ambu bag case and the loss of the woman in the nursing home serve as stark reminders of the moral and ethical challenges in healthcare. We face tough decisions daily, and the importance of empathy and compassion cannot be overstated. These cases underscore the need for better resources, training, and support systems to mitigate the risks and limitations in our healthcare systems.

Conclusion

Loss and mortality in healthcare, whether through personal experiences or clinical observations, leave a profound impact. It is a call to action for healthcare professionals to advocate for better resources, support systems, and ethical considerations. Honoring the humanity of our patients, their families, and their caregivers is critical in navigating the complex and often challenging landscape of patient care.