The Doctor Will See You Now [Non-Fiction]

Chapter 72: General Medicine

When I admitted Gerald, a 78-year-old man from a nursing home, under my care, I was annoyed with the admission notes from A+E. It states clearly on the A+E documents that Gerald had three days' of abdominal pain, a complaint that should have been under surgical care (usually anything from the diaphragm upwards is medical and any bleeding from the gut or abdominal pain is surgical). Gerald also has COPD. So A+E wrote "Epigastric pain. Exacerbation of COPD." Even though Gerald wasn't wheezy or short of breath and he was given only 2L of oxygen (the bare minimum) on arrival to the ward, which I promptly took off because he didn't need it.

So the COPD complaint was complete BS.

The plan was to take some investigation bloods and do some X-rays and then observe for 24 hours. If all the results were normal and Gerald remained OK, he could go home. He was found sitting on the ground at 3am the subsequent morning. Nobody saw him -- he could have gotten out of bed and sat down or he could have tumbled. Subsequent examination found no bruises or broken bones. X-rays were normal and his CT brain didn't show any bleeds or strokes. But the daytime doctor who rounded him decided to keep him for one more day and see, simply because he had that unwitnessed fall / sitdown.

That night, Gerald had a cardiac arrest.

Ten rounds of adrenaline and 40 minutes of CPR later, we couldn't restart his heart for a sufficient amount of time (he did resume a heartbeat twice, which lasted all of ten minutes max each time) so I certified him dead. His son was distraught. It was 11pm at night and Gerald had, for all intents and purposes, been stable and fit for home. I had no idea what happened.

The case was referred to coroner's court. Cause of death uncertain.