Tuesday, April 27, 2004
Deja vu
Whilst referring a 59 year old woman with vagueness and a 2 day hx of headache to the pretty blonde, we realise that we have Tuesday, March 02 in common (scroll down or search for) when she accepts the patient and laughs about being paranoid after the last person she admitted who collapsed on the ward, and that she'll run this by her reg for immediate CT scan. And it's the same reg on call, and the same admitting team too!
Then, unbidden, she remembers - oh. And it was you who referred, wasn't it?
Click. Yes.
I remember my own guilt at the time. Why hadn't I moved for urgent CT? Maybe if I had, he wouldn't have collapsed in the toilet and died 2 hours later on the ward.
Rational retrospective hindsight revealed this to be false to me. There was no indication for an immediate CT since he appeared stable, and an urgent transfer to a london hospital for coiling would probably have resulted in him dying during the transfer, or on the table. 2 hours is too short a timeframe to organise neurological intervention in the middle of the night.
Looking into her eyes, I couldn't help but see the same sadness and guilt that I had felt then. Magnified a hundred fold.
How much worse it must have been for her. Her patient. Her accepted referral - her responsibility. Her ward. Her (sensible!) decision to save the CT for the morning.
Silent pause.
Me : "It was unfortunate".
She : "Yes, it was".
Whilst referring a 59 year old woman with vagueness and a 2 day hx of headache to the pretty blonde, we realise that we have Tuesday, March 02 in common (scroll down or search for) when she accepts the patient and laughs about being paranoid after the last person she admitted who collapsed on the ward, and that she'll run this by her reg for immediate CT scan. And it's the same reg on call, and the same admitting team too!
Then, unbidden, she remembers - oh. And it was you who referred, wasn't it?
Click. Yes.
I remember my own guilt at the time. Why hadn't I moved for urgent CT? Maybe if I had, he wouldn't have collapsed in the toilet and died 2 hours later on the ward.
Rational retrospective hindsight revealed this to be false to me. There was no indication for an immediate CT since he appeared stable, and an urgent transfer to a london hospital for coiling would probably have resulted in him dying during the transfer, or on the table. 2 hours is too short a timeframe to organise neurological intervention in the middle of the night.
Looking into her eyes, I couldn't help but see the same sadness and guilt that I had felt then. Magnified a hundred fold.
How much worse it must have been for her. Her patient. Her accepted referral - her responsibility. Her ward. Her (sensible!) decision to save the CT for the morning.
Silent pause.
Me : "It was unfortunate".
She : "Yes, it was".
