The other day, I was on the train when there was a commotion at one end of the car. I couldn’t see clearly from where I stood, but someone kept saying, “Mom? Mom?” and someone else gave up their seat. Then a third lady called for a doctor. No one moved. After a minute or two, a fourth-year and I went up to the end of the car to see what we could do. As we pushed our way through, all I could think was, “I don’t have my stethoscope, what can I do?”
The patient was an older woman, sweating profusely but conscious and speaking in full sentences. No apparent distress, as they say. She denied chest pain or shortness of breath, mumbling instead something about how she hadn’t had enough water and that she had a kidney problem. She had a water bottle in her hand. So we walked back to our seats, reassured.
But I can’t get it out of my head — what if it had been something serious? What if she were still down when we found her? She had a pulse and was breathing, so CPR would have been foolish. I could rattle off a long list of the causes of loss of consciousness, but I can’t tell you what to do about any of them in the field. Stroke? Get ’em to a hospital so they can get IA tPA. Seizure? Get ’em to a hospital so they can get diazepam. Massive pulmonary embolus? Get ’em to a hospital so they can get IV tPA and a drug-eluting stent.
I’m almost done with my medical education, and I know how to do a million-dollar workup, but I don’t know how to save a person’s life.
These existentialist thoughts have been made possible by Procrastinia, Muse of Students Everywhere, and by contributions to your PBS station by Viewers Like You. Thank you.