Hiatus

I am taking a writing hiatus for a bit and just writing in my personal journal. Not much is professionally changing for me and residency continues to be tough every day. I'm going to reflect and come up with some useful things to say and then I'll be back.

Miracles do happen

It seems impossible for me to write this. To explain what happened to me last week, what transpired in the life of my patient, his family, my team and all those who heard his story. I'm just finishing up a week of vacation - a week away to gain some perspective - and I want to share this story.

I never got to meet him prior to his surgery. He was coming in for a liver transplant. One of the few people who was still pretty healthy before his transplant, he was just at the cut-off of even being sick enough to qualify for a transplant. I would later learn that in addition to working, he also still played soccer with his kids on a regular basis. As the second year resident on the team it was my job to go out and procure the liver. I left before he arrived at the hospital. We drove out in a limo to a random hospital in a part of the state that I'd never seen. We were there with a heart team, a lung team and an eye team to follow us. The liver looked smooth and healthy, aside from a slight tinge of yellow. We arrived back at my hospital mid day and since I figured the surgery would be over in a few hours I initially stuck around after getting some work done. Five hours later with lots of surgery left to go, I headed home to shower and spend some time with my husband before going back to help manage the patient post operatively. Eventually I got the page that they were rolling out of the OR soon. I headed back, worried that I might have a difficult night on my hands given the length of the surgery but having no idea what I was really in for.

I never sat down that first night. My patient's blood pressure would not hold, his lungs showed signs of failure. He required twice his entire blood volume in blood transfusions every two hours. He was bleeding uncontrollably - from everywhere. Later that night he had to be essentially re-operated on at bedside as other organs showed signs of failing. The following day he was re-operated on again. The following evening we removed his liver.

His new liver had essentially died inside his body and was killing him. He was on suprahuman doses of life supporting medication. His lungs were starting to work against the ventilator and he would not stop bleeding. So the liver came out. For those who don't know - the liver is not an organ you can live without. The second the liver came out - the clock started ticking. He had probably one day, three at best. He needed a new liver. The amazing thing was, once the sick liver was removed he started to do better - he started to wake up! This is when I sent out my plea for prayers. We worried that his brain no longer functioned after all he had been through. His neurologic exam prior to removing his liver had shown many signs consistent with brain death. Then he woke up.

He fought for three days. Most didn't expect him to survive more than 24 hours without a liver. He survived three days. I spend countless hours beside his bed, staying there in shifts alternating with my chief resident - my attending was also always present (he probably slept less than anyone). And on the third day he got a liver. 3 offers on the third day - we took the closest. As he headed into surgery again, I touched his arm and told him, I couldn't wait to meet him.

The hospital around me changed during this experience. People I don't know asked how he was doing. Said they were praying for him. Many nurses commented that his story has reminded them that miracles still do happen in the hospital. We all work so hard in a broken system with few clear rewards. His story has touched many and renewed faith in healing.

As I headed out of the ICU and out of the hospital to begin my vacation last weekend, my attending called me over and asked me to follow him. He took me to our patients room who sat their with an oxygen mask over his face. He looked over at us and said "hello." I told him I was so happy to meet him.

Before all this happened, I again questioned my choice in career. Feeling stiffled in my personal life because of the time I've dedicated to career I wondered if I made the right choice. I wanted to quit. This experience demonstrated to me on a grand scale the good in what we do. We all play our parts. My attending has been a phenomenal role model in all of this. He always believed when others made it clear they thought his efforts were futile. He didn't sleep or rest and his operative skill helped save this patients life. The nurses who took care of our patient fought tirelessly for him. They fed us and kept him alive while we slept. His family did not give up on him. His wife was there for him in every way. Even now I sometimes can't believe that he made it through. That it really was so bad. Miracles do happen.

and guess what...

IT HAPPENED! Thanks for those who prayed. This is the craziest most amazing week of my residency. More later...

a simple request..

To all who follow my blog... I could be in the middle of witnessing a miracle. Please pray for my patient.