For the past five years, each New Year’s Eve I am sadly reminded of a call.
During that holiday season we had a series of busy nights. It seemed like call after call was for a nasty patient who combined his or her stupidity with alcohol and violence. Around 4 AM on December 31 we went to a well-kept suburban home, similar to one I grew up in, for difficulty breathing. We were greeted by an anxious woman in her bathrobe who led us into their bedroom. They were about my parents’ age, and their living room was filled with pictures of grown children.
Her husband did not look well. He had been taking several courses of antibiotics for cold-like symptoms that would not go away. His skin was gray and ice cold, and he had no blood pressure. We gave him oxygen, started two lines, and gave him as much IV fluid as we could. For the last five minutes of the transport there was nothing left for us to do. I kept my fingers on his wrist and hoped I would feel a radial pulse.
They were about to intubate him at the hospital when I droped my paperwork off. Nothing about the patient’s anatomy indicated this would be difficult. I stood outside the room to watch, and to my left I saw his wife sitting alone in the waiting room. A nurse pushed Etomidate and Succs, and a new attending put the laryngoscope blade in his mouth. One attempt went in his stomach. The bougie didn’t work. The patient’s heart rate dropped. The doctor started barking orders, and everyone in the room panicked.
I looked to my left and made eye contact with his wife. Her expression changed after she saw mine. I looked back at her husband The doctor had done a surgical crich, but it was too late. My gaze shifted back and forth from the patient and his wife. Now she looked even more worried. She stood up and marched to the reception area. They started pumping on his chest when the receptionist asked if his wife could come back. The doctor was sweating now. He yelled no and to tell her to wait a minute. I felt sick and walked away.
I passed the waiting room on my way to the truck. I saw his wife sitting alone again, and I wished her luck. She asked if I knew anything about her husband. I said they were still working on him and that someone would be out soon. She knew I wasn’t telling her everything, and I was glad she didn’t press it.
It doesn’t bother me that he died. I expected him to. I hope that the doctor can apply lessons from this airway disaster to another patient. What bothers me most, and what I still think about, was his wife sitting alone in the waiting room while I watched her husband die.
The next night was New Years Eve. I thought about the call while watching the festivities on television at home with my wife. I wondered what she was doing then. I wondered if they had plans to go out, and I wondered if she was alone again.