The Doctor Will See You Now [Non-Fiction]

Chapter 109: General Medicine

Because Hong Kong hasn't had a new nCoV case for 3 days in a row (woop!), my COVID Series will probably become more sporadic in terms of updates. So, meanwhile, let's continue my other medical stories, both old and new.

When I was an intern, I got called to see Lisa, an 87-year-old woman who came in for general weakness. Most of the work-up is unremarkable. But suddenly Lisa started coughing up blood.

I go and see her. She shows me the tissues. Yep, fresh blood. Not much of it, but enough to cause alarm. I listen to her chest and pop in a cannula. Her chest is clear. I send bloods off. Her husband is by her side, equally anxious. I explain I don't know why she's coughing up blood but the main thing is that she can still breathe OK (because coughing up blood so bad that it blocks off the airway is an actual, major risk) and her vitals are stable. So we'll wait for the blood results, get a chest X-ray, and just keep an eye on things.

"Will she be OK?" he asks.

"She's OK for now, but let's wait for the bloods and x-ray," I say.

"Will I get to go home tomorrow?" Lisa says.

"I'm not your case doctor, so save that question for him tomorrow," I say.

Two hours later, I get called to a cardiac arrest. I sprint onto the ward. The name above the arrested patient's bed looks familiar. My stomach drops.

It's Lisa.

She's lying in a pool of blood, soaking through the bed linen. Her face is ashen. The nurses are jumping up and down on her skinny chest -- I can hear her ribs crack -- and the phlebotomist is hunting for a vein on her skinny arms. The one I popped in earlier had fallen off already.

The resus goes on for forty minutes, during which all I can think of is my reassurance to Lisa and her husband a few hours earlier that it wasn't much to be concerned about (at that point) and her question about discharge. We fail to get a pulse back. The resident stop the CPR and confirm death.

Ultimately, I hadn't done anything wrong. Unless she was actively hosing blood out of her mouth and her airway was compromised, it wasn't like we would rush her down for urgent bronchoscopy to stop the bleeding, but it just sucked how suddenly she deteriorated out of the blue and it was so awful for her husband.