Date of Medical Observation
April 2007

Narration

“My God , My God!”

 These were the words I uttered while driving fast homeward.

My sister just phoned in and informed me that my father and younger brother were rushed in a hospital.

They were stabbed.

Like  film clips rolled in front of my eyes. I recalled those patients we had at the ER-Trauma     complex.

Those with gunshot wounds. Those with head injuries. Those with stab wounds.

I was still in a state of denial until I got in the hospital. It was the nearest  secondary hospital in our place.

I rushed to the ER where I found my father lying on a stretcher. His left arm was wrapped with blood soaked gauze while a lady doctor sutured the wound over his left  chest.

“How is the patient?” I asked. 

“Ok naman po, mukha superficial lang un stab wound.” the lady doctor said.

Then came my brother from the x-ray room. His face was bathe with blood, which came  from a laceration on his forehead.  He cried when he saw me. “Kuya , may saksak ako sa dibdib!” 

I auscultated his chest. His breath sound was clear.

I assured him that everything will be alright.

A surgeon came in and  assessed the patients.

After introducing myself,  I told him that I just want to make sure that the patients are stable and x-ray results are negative.

And that I am going to transfer them to the hospital where I work to manage them personally.

While we were waiting for the x-ray result,  my other relative came. He told me that one of my cousins and my uncle were badly injured.  They were in another hospital a few meters  away. 

Assured that my father and brother were safe, and a surgeon was there to take  good care of them, I hurriedly left  to look for my cousin and uncle.

A similar scenery  was waiting for me when I reached the other hospital.

I found my uncle on a stretcher literally bathe with his blood and sweat. He has a laceration on his left cheek. He held  a blood soaked towel  tamponading a bleeding stab wound over his left chest.

His lips were pale so as his feet. He was breathing heavily.

To my surprise, he was unattended!

As if something stroked my nerves, my reflex went on its own.  I myself, grabbed an IV solution and inserted an  IV line. A nurse then came in to help me.

 “ Double line! Double line!” I shouted.

I secured the wounds with gauze, and auscultated his chest. The breath sound on his left chest was decreased.

I told  the nurse that I will be needing to insert a chest tube, but she refused. 

So I just waited until he was stable.

After a couple of minutes, my uncle’s vital signs improved.

A doctor who attended to my cousin came from the OR. He is a general practitioner.

He told me that my cousin has hemothorax. He inserted a chest tube and was able to drain 1 liter of blood. My cousin’s hemoglobin dropped to 5mg/dl.

He also told me that we have to transfer the patient into a bigger hospital. There was no surgeon around to attend to my cousin.

I called my co-residents on duty and informed them that I would be transferring four patients with stab wound on the chest.

One was a candidate for open thoracotomy.

I’ve decided to transfer four patients using two ambulance.  But to my dismay when we returned back to the other hospital to fetch my father and brother,

the surgeon whom I entrusted them with  already left.

I sent my sister to accompany the first ambulance all the way to OMMC.

Then I attended to my brother.

He was on labored breathing  and looked very exhausted.

I heard crackles over his left chest and the x-ray plates showed massive hemothorax.

I asked for a chest tube and  commanded the lady doctor to assist me.

I was trembling. I can hardly extend my finger to poke my brother’s chest.

“ Kuya di ako makahinga”, he cried.

Tears ran down my cheeks as I inserted the chest tube.  Five  hundred milliliters of blood was drained.

Thanks God!

I was able to transfer him together with my father safe and good.

After which I felt relieved.

INSIGHT

Physical, Ethical, Psycho-social

Discovery, Stimulus, Re-inforcement

How are we going to conduct ourselves in situations like these?

A patient needing an immediate surgical intervention,  but  unfortunately left in the hands of inexperienced, incapable physician.

I know it is neither  proper nor ethical for us to meddle with the management of our colleagues.

It is clearly stated in our oath as             physicians.

Yes, I know.

I am not even licensed, neither do I have the right to do surgical procedures outside our training institution.

I may even be charged with administrative suits and my license be revoked for what I did.

Yet, I whole heartedly believe, what I did was right.

Sometimes protocols must be deviated, rules must be broken and professional ethics be set aside. Especially when the lives of your loved ones are at stake.

END