The following manuscript was submitted to the April 2017 Arts in Medicine Themed Writing Contest.
Medical alert, paged — STAT to Bed 3,
The nurse comes a runnin’ — we need an MD!
An old man has fallen -– he’s bumped his head,
And thanks to blood thinners, he’s lost some Red.
Hello sir, I say, can you tell me why you’re here?
Did he lose his balance or was he drinking too much beer?
Oh good! He knows his name and he knows the year,
But most other details are rather unclear.
GCS 14, he’s just confused, I say with a grin.
And he’s old and he fell, so he’s probably comin’ in.
The cuts to his face, they’ll be simple to treat.
A few nylon sutures, he’ll be stitched up neat.
But that’s not my concern, because I’ve done my reading!
Inside his head, I ponder, there may be some bleeding.
So it’s off to CT for the STAT non-con scan.
I run to the next patient, all but forgetting that man.
I order tests, type notes, tell jokes with my staff,
Just a routine day among the ED riffraff.
Dr. Holland to the desk, radiology’s on the phone.
Hello? What did you find now? Appendicitis? A stone?
No, doc, this guy’s got a bleed! Did you not see his CT?
I guess I better go back and reassess the Old Man in Bed 3.
Well, now he’s not responding, his prognosis grim.
I didn’t check on him often, neither did his RN.
I intubate, push meds, trying to keep him alive.
Neurosurgery is paged and they promptly arrive.
This guy’s brain looks bad, we’ll take him to the OR,
But we should contact his family, might recommend a DNR.
Then he disappears, upstairs, right out of the ED.
He’s no longer my patient, just a bad memory.
A few days later, I see he’s passed.
He said a million words, but to me were his last.
I think about what I did wrong, what more I could have done.
I should have checked on him sooner, cared for him like I was his son.
I wonder to this day if I failed him. If I were better would he still be living?
But the hustle and bustle of a busy ED is unforgiving —
Too many patients to be seen, no matter your efficiency.
It’s what’s expected, demanded, when you’re in residency.
I wish I could change the day this man died,
Take back the tears that his family cried.
But this is medicine, and these are the facts.
Do some of our patients just fall through the cracks?
Is it just me? A system I can’t change? A little of both?
These are the things that terrify me the most.
Resident Physician Contributing Writer
Indiana University School of Medicine
Dustin is a PGY-3 emergency medicine resident at the Indiana University School of Medicine.