Date of Medical Observation
April 2007
Narration
It was Sunday evening, another busy night at the emergency room. Patients come and go
like ants. I just came from a 2 hours long operation upstairs of a below knee amputation, my very first on my own. Just before
I was able to reach the trauma complex . two young girls were rushed by their grand mother bathe with their own blood. They
sustained gunshot wound from a stray bullet. Miyuki a 10-year old girl can’t hardly extend her thighs as she sustained
injury on her abdomen. The bullet entered on the left lower quadrant making its way out on the left paravertebral
area at the level of 2nd and 3rd lumbar vertebrae. She mourn every time we try to touch or move her
. Her cousin, Rendal a 12-year old girl sustained head injury. The bullet entered on the occipital
area tangentially went through and fractured the skull before leaving outward about 10 cm from its entry point. She was literally
soaked with her own blood and vomitus. She looked sleepy but can still open her eyes and respond
to questions. She vomited a lot. The vomitus was her previously ingested food, semi solid, partially
ground pasta, meat and rice. These two young girls were allegedly walking home from a birthday party when the assault happened.
Obviously these two patients sustained serious injury. Both needed immediate attention. Both needed to be operated immediately.
This scenario hooked me into a dillemma. I asked my self, What shall we’re going to do? Are’nt we calling a code? My seniors were a lot more relax than I was. They seem to know the right
move. Then my most senior co-resident decided. “ Direct na to!” He pointed his hands
on the patient who sustained abdominal injury. As he said, everybody moved and transferred the patient upstairs. A little
confused, I tried to rationalized the situation. I looked at both patients as Miyuki was being strolled away going to the
operating room while Rendal was left at the ER. As the stretcher gone, I turned back to Rendal,
My eyeballs stopped straight toward her face. “This patient is going to die if we do nothing.”
I told to myself. Our best option for her survival was to transfer her to any satellite hospital capable of doing an emergency
neurosurgery operation. Lucky enough we were able to coordinate her at Jose R. Reyes Memorial medical Center where a neurosurgery
resident warm heartedly accepted her. Whew! Going back, Miyuki tolerated the operation well, she sustained injury to the ascending
colon which was repaired primarily.
<!--[if !supportLists]-->n<!--[endif]-->Insight, Discovery, Stimulus
<!--[if !supportLists]-->n<!--[endif]-->Physical, Emotional, Psycho-social
ER-Trauma complex is a very busy place. We treat approximately a thousand patients per
month. Not once or twice that we encounter seriously injured patients requiring immediate attention. With regards to this
particular case that I presented, Sometimes we get hooked into a dilemma where our most sound and just decision would change
everything.
I bothered to ask my senior co-resident after the incident. He told me that decision making is not an easy
task. One should consider everything. In this kind of profession, we don’t have the luxury to commit mistakes, because
what is at stake, is the life of thepatient.
“ Choose first the one with the highest possibility of survival” He said.
We made the right call, very fortunately I guessed. We were able to save two lives, at least partly.
