What’s up, you guys? Hey, thanks for watching this video. Actually, I’m on vacation. And I’m just in my hotel room, so I thought I’d make a little video here because this hotel room is (bleep)ing badass.
One of the perks of studying a lot, going to school for a really long time is that you make…I don’t know. I guess you’re in the top 15% of people as far as income goes and the states, I guess, in the world. So sometimes if you want to treat yourself like I did for this weekend. I spent, maybe, a little bit much. A little more than I should have, but it’s my birthday. And I said, “Fuck it. I’m just gonna do it anyway.” So every once in a while, it’s fun to do. But save your money, mostly, okay? Don’t (bleep) it all up like an idiot.
This video, I wanted to talk about…Somebody asked me – I’m looking at YouTube comments – tell about the first patient I lost. So that’s an interesting thing to talk about because nobody wants to talk about those things because, obviously, we think that if we admit that, then it’s like, “Oh, I’m responsible for somebody dying.” Or something like that.
So there’s 100,000 medical errors in the United States estimated per year. It’s probably more than that. That cause death, okay? So there’s the whole, first, do no harm, which is crazy and stupid because we do a lot of things to people that – we’re trying not to harm them. Obviously, trying to help them. But a lot of the times, we actually do harm them whether it’s medication, side effects, or adverse reactions or whatever. I don’t know. It’s just a stupid, stupid saying. And I hate when people say that. Somebody said that not too long ago on Instagram or YouTube, and I’m just like, “Dude, if you believe…” If you’re a doctor and you believe that, you basically have not been a doctor very long yet.
But there’s a lot of books out there too where people talk about dying patients and medical errors and things like that, so we do it. We’re all human, and we make mistakes. And we have problems with all sorts of different disease processes and surgery and, just, complications happen.
One of the fellows that I was training under, he was a Vassar fellow, he was like, “If you play football, you’re gonna get tackled. So if you play surgery, bad shit’s gonna happen. People are gonna die. That’s just how it is.” Maybe not in – I don’t know. I was gonna say maybe not in plastic surgery or maybe not ENT, but still, surgery is very dangerous. Anything can happen. Anytime you go into surgery, as a surgeon, you have to know in the back of your mind that this patient could possibly die from everything.
Everytime I do appendicitis on an 18-year-old kid or a 25-year-old kid – they’re super healthy – anything can (bleep)ing happen. They could have a really bad reaction to the antibiotics that we give them, and they could have severe anaphylactic shock and get super sick and die from that. Or I could injure the bowel or anything and then not recognize it. They could be super sick afterwards, so anyway, you always know that.
And people always ask me how do you deal with it, and it’s incremental because it’s just like learning anything. At first, it’s really new and you’re like, “Holy shit, how do I deal with this?” And it happens one time. It’s really, really tough.
So I’ll tell the story of this lady.
I was in the cardiothoracic ICU, and she had an emergent CABG, so a coronary artery bypass grafting. She came in. She had a heart attack. She was about to die. The surgeon did a sternotomy and bypassed her coronary vessels. Gave her back her blood flow to the heart. I remember post-op day two – she was pretty big. She was obese and then short so BMI was really high. I was on at nights, and usually in the night, I try and do all the shit to get them to look really good for the morning rounds so that way, the surgeon’s like, “Hey, great job.” Whatever. So this one, I did all that stuff. Sit her up in the chair. Get her on this barometer. Do all this stuff, and he comes around. And he’s like, “She looks great. Send her out of the ICU.” I was like, “She’s not really quite ready yet.” He’s like, “Nah, just send her. She’s fine.” So I was like, “Okay.”
So I sent her out of the ICU, or they sent her out of the ICU that day – I was still on nights. I come back that night, and it was 7:00 p to 7:00 a. I came back in. I don’t think I rounded.
So what happens is when you’re on ICU, cardiothoracic ICU, you take care of most of the ICU patients. But the cardiac patients on the floor, after they go out of the ICU, you really don’t- You only tend to emergencies, and there’s a cardiac surgery resident that sees those patients in the daytime. But at night, you’re the person to take care of stuff if somebody crashes or something.
So the nurse called me, and it was a nurse that I didn’t really trust. And I didn’t really like her ’cause she would tell me stuff, and it would be wrong. So she calls me, and I’m going to get food, okay? I’m in the cafeteria. The cafeteria’s about to close because, whatever, it’s 7:00 or whatever time it closes. So it’s five minutes before the cafeteria closes, and I’m almost there. And she calls me and is like, “Hey, this patient is having a tough time breathing. Blah blah blah.” I was like, “Okay, give her, maybe some Nabs or something like that.” I can’t remember what happened.
So I go get my food, and I go up to see her. So she had, basically, died. And she was maybe, I don’t know, in her 60s or 70s. I can’t really remember. I think it’s 60s, so I was like, “Oh, that looks bad. Holy fuck.”
So I go, and I check her pulse. And the nurse was standing there, and I was like, “Does she have a pulse?” And the nurse was like, “I don’t really know.” So I was like, “Oh my God.”
Some nurses are awesome. Other nurses are not quite there yet. Let’s put it that way.
So I went there. No (bleep)ing pulse. I was like, “Oh my God.” She’s blue in the face, so I call code. We start doing compressions. Got her intubated. During the intubation, she aspirates.
Oh, I forgot to tell the crucial part of the story. So the patient was asking for a hamburger that day. She was like, “I want regular food. I want a hamburger and french fries and this and that.” I was like, “Oh man. Take it easy.” And she scarfs down all those hamburgers. It’s whatever. Just all that stuff comes up. She barfs all this green stuff. Goes in her lungs. Ground hamburger. All this. It was bad.
And she essentially died from a really bad pneumonitis almost overnight. Yeah, pretty much overnight.
So the middle of the night sometime, I had to call the family in to tell them that they needed to get to the hospital really fast. She was doing really poorly, and by the time they got there, the patient had died. So the last time the family saw her, she was up and awake and eating regular food and, obviously, hurting from her sternectomy but talking no problem. So the family gets there, then I had to tell them that she had died. And they just, obviously, a surprise like that, they were crushed and actually fell on the floor screaming and stuff. It was horrible.
But I really felt bad because that nurse called me and said, “Hey, this patient’s not doing well.” Honestly, I can’t remember what she said, but I just got this feeling after that I was like, “Man, if I would’ve just turned around and not went to go get my food right there. Turn around and go up to see that patient, maybe I could’ve saved her.”
That was my first really bad one that I really felt it was my fault. I could’ve done something before to intervene. It’s really hard. I was devastated. It hurts for weeks, maybe months, after that. And I couldn’t sleep well. I just had this terrible, terrible feeling in the pit of your stomach. You’re like, “God.” That kind of thing.
There’s a lot of things that go into some event like that. There’s usually multiple stops where you can help somebody, and so surgeons really usually blame themselves for everything. We do a mortality conference. We always…We never blame the patient. The patient, obviously, participates in healthcare. But we always blame ourselves because we’re the one taking care of them. We feel that we’re responsible, and somebody has to take responsibility, right? So we always do it, and so that’s how I feel.
When things like that happen, they happen because I’ve had plenty more of things like that. I always feel like it’s my fault, and it’s like, “Oh, I could have intervened in these places.” I mean, obviously, other people could’ve intervened as well in all of these scenarios. But I always take it upon myself.
The first one, it hurt for months. And the second one hurt for a little less than that, and the third one hurt for a little less than that. And then you have to realize that these things are gonna happen. You learn from all of them, but it’s a big deal. It’s not really great when this stuff happens. Happened not too long ago where I felt like I did something wrong, or I don’t know if I did something wrong. But I felt like I did. Looking at the scenario, I was like, “Wow, this probably was my fault here, which led to a domino effect of things.” And then the patient died a few weeks later, so it’s really hard to do that all the time. But that is general surgery.
That’s cardiac surgery. That’s transplant surgery. I’m not sure that you get any better at it or it gets better, but you have to deal with it. That’s our job.
I’m not sure what to say because I think people wanted me to say something that’s how do you deal with it, but I…You just have to. There’s not really an algorithm for it, I don’t think. Maybe there is. I don’t know. There probably is, actually, somewhere. Some psychologist is probably watching this going, “What the fuck is this guy doing?”
I don’t know. You guys wanted to know that story, so there you go. That’s the story. I guess this is not as fun of a video. Maybe. I don’t know. Maybe for some people.
Anyway, I hope you guys like this channel. I hope you like this piece of wood right here. This is amazing. This place is crazy cool.
Thank you guys for watching. Subscribe, like, share, all that stuff. And if you guys have those kind of experiences, let me know in the comments.
Anyway, hey, thanks you guys so much for watching all these videos. This is so awesome. I love all your comments as well. Trying to get to all of them. I can’t always get to all of them, but I do read them. So keep putting them down, so I will see you in the next one.
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