Trying to make sense of the senseless

December 24, 2012 by MassDevice

By Westby G. Fisher, MD, FACC

Westby Fisher

I believe that every human soul is teaching something to someone nearly every minute here in mortality. 

- M. Russell Ballard

 Aside from being a bit warmer than usual, it was a typical Friday afternoon. A patient with syncope, a paucity of heart beats, the need for pacemaker. The lab techs rolled their eyes as the room was prepped. An early as exit was not going to happen after all.

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But the later hour promised efficiency for the only way out was through. We each did our thing and like so many times before, sighed in relief that things went smoothly. Home at a reasonable hour was to happen after all.

Until the ER called while I was closing.

"Another patient, 97, heart rate 21, needs a pacer, too," they said.

"What does the family want? He is 97 after all…" I asked as I placed the final layer of sutures.

"The patient wants it. Takes care of his wife…," they said.

"I'll finish here and you guys get the room ready. I'll see the ER patient. Has the family of this patient been called?"

Once again, the staff excelled. Patient transported from the table, family contacted, then the room cleaned and readied for the next potential patient.. For me, the note would wait. A brief discussion, orders entered, then ER visit, wondering all the while if the next pacemaker needed to be done.

It was easy to find the ER bay as every nurse and technician pointed the way to a small-framed man who was alert and conversant, but clearly not feeling himself. His symptoms started earlier in the morning and just didn't get better- his medications hadn't changed.

"Do we have a potassium?" I asked. 

"'lytes are fine," someone said, "K's 4.5."