Medical instinct

I’m not normally a superstitious guy. I don’t read horoscopes, I don’t believe in ghosts, and I’m suspicious of all things spiritual. It’s true that I never admit to having a good day when I’m on call, but that’s more because I’m afraid of how my team might react than any potential consequences. (Good days are highly jinxable, or so I’m told.) This past year, though, when a patient informed me on a particular night that he was going to die before morning, I’ll admit that I was unnerved.

This was the kind of guy who was frail enough to go at any time, but there was no real reason that I could see why he should pass on that particular night. His blood pressure was fine, his labs were reasonable, and in eyeballing him, he just didn’t appear toxic. Why he thought he was going to die was a mystery to me, but he had a look in his eye like he knew something. To make the situation worse, he waited until just before I was heading home to let me know.

I’ve had many patients die, but this was the first time a patient had ever told me before it was going to happen. Usually it’s the other way around; I’m the bringer of bad news. Perhaps if he’d have given me a warning shot, as we’re taught to do (“Doc, I’m afraid I’ve got some bad news for you. . . “), I’d have handled it better. But he didn’t, and the news stunned me. The problem was, since I couldn’t identify anything immediately life threatening to him, I didn’t know what to do about it. I ended up signing out for the cross cover to check in on him that night, and went home for a restless night of sleep myself.

The first thing the next morning I went to see my patient, who was doing fine, precisely as I had left him. Silly me. Apparently, my medical instincts had proven more reliable than his spiritual ones. It was a victory for medicine and science, and I was cleared from incompetence. Either that or the Grim Reaper simply hit the wrong room. I can’t claim to know exactly what transpired that night, but at least the next time somebody announces his or her impending doom, my reassurances to the contrary will carry the weight of a little bit more experience.

posted by Wyatt @ 10:35 PM Comments: 5