haunted 1

Yesterday one of mine died.

People die on me all the time, but it's almost always expected, and usually they're ninety-four percent dead for quite a while before their last six percent gives in. This one wasn't. He was a grandfather with a great smile, a medium-bad pneumonia and heart trouble. He bragged nonstop about his grandkids, whom he'd raised since birth while their parents were in prison. He was getting better for the first two days, then looked suspiciously worse on day 3. That night while I lay sleeping, fluid leaked from his blood into his lungs and he began to gasp. His heart beat slow, then slower. My on-call partner went for broke trying to bring him back, and the cardiologist jumped in and did everything but donate his own heart to the man, but he died anyway -- leaving the grandchildren, who I suppose are now en route to foster care.

Today's moral: If you have kids, don't get yourself sent to prison.

I'm haunted. Did I miss a warning sign? From the beginning, I thought something was a little off. The patient looked okay but his numbers didn't quite add up. There was something funny about the low level of bicarbonate in his blood. I came up with lots of possible reasons for that -- he was in renal failure for one thing, and hyperventilating for another, and then I poured saline into him which drove up his chloride. But still. Would another doctor have seen what was coming and been able to avert it?

I've been a doctor for ten years. This is the third time in my work that I've wondered if someone's sudden death was my fault. The first two times, I was proven innocent beyond doubt. This time -- I don't know.

I wish I could ask a friend to look over the chart and tell me if I missed anything. On the other hand, I'm afraid to find out the answer.