Wednesday, June 13, 2007

Some people say there is no such thing as luck, or fate. This story has made me a believer.
Here, as in most US medical centers, all health workers (doctors, nurses, PCAs, respiratory techs, PT) have to be trained in basic and advanced cardiac life support (BLS and ACLS). We're required to recertify every few years to stay up to date. One of the spokesperson for this program at my hospital is a consultant of mine in endo, Dr. A.L.
Why would an endocrinologist be a spokesperson for ACLS, you ask?
Here's his story, told to me recently.

He was a youngish Scotsman, perhaps in his mid-30's then. Lean, active, keen on research. One of those M.D/Ph.D types. Had just attended our division's annual BBQ/picnic on a Saturday, where he stuffed himself silly like most of us do. Which soon followed with dyspepsia.
Despite it being a weekend, he had experiments going on in the lab. Probably tissue cultures or something similar, I imagine. And so he decided to drive back to work. Now, here, the employee carpark is at one corner of the medical center, connected by a network of long, lonely tunnels. His lab, on the 5th floor of the hospital, far away from the patient-care areas, and certainly vacated on weekends, except for the cages and cages of mice.
And so he parks his car on that late afternoon, and starts walking to the lab. Huffing and puffing from the now-worsening dyspepsia/heartburn. And it so happens that the emergency department was just midway between the carpark and the lab. In the tunnel, not too far from the ED, he falls to the ground. Unconscious. In cardiac arrest, from an acute myocardial infarction ('heart attack'). And it was serendipitious, that at that very moment, an off-duty ED nurse walking out sees him on the ground, and promptly begins CPR and activates the code team.
The code team arrives and immediately begins 'coding' him. However, despite the CPR, medications and shocks, he remained pulseless. And 20 minutes into the code, they are ready to cease efforts and to 'call' the code (ie terminate resuscitation). Not knowing who this young man was. And at that time, someone moves him, and out of his jacket falls his employee nametag.
Dr. A.L.
Seeing it was one of them, the code team hesitates, and resumes resuscitation. Not wanting to give up yet despite knowing it was likely going to be fruitless. And after what seemed an eternity, his pulse returns. And against all odds, he suffered no hypoxic brain injury.
He take his endocrinology board exams a few months later, passing with flying colours and proceeds to become one of the foremost world experts in thyroid cancer.

A series of events led to that fateful outcome. Had he passed out 3 mins earlier (in the carpark) or later (in the lab) , or had the nurse not seen him in the lonely tunnel, he would have been dead.
Sheer dumb luck? Fate? Do you believe?
And are you ACLS-certified?


Anonymous Caprice said...

Great story.

However I am totally disgusted that these people should deem that some lives are worth more than others.

Surely every life, regardless of whether or not you are in the medical profession, is just as precious?

Guess I am too naive and innocent.

6:42 AM  
Blogger vagus said...

of course all life is just as precious.
this wasn't to say that that doc's life was worth more, just that the team came to a point when they thought resuscitation was futile (ie not revivable, or revive with permanent damages), doctor or not. but because there was that little bit of bias seeing that that was a doctor, that they wanted to keep going. if nothing else, just sustain the body long enough for the family to bid him goodbye.
but truth be told, i think we're all human, and do harbor some biases, though not intentional, and certainly not malicious.
a few examples of where the code team may try a bit longer: kids, young adults, one of their own, when family hasn't had the chance to say goodbye.
we're only human.

7:45 AM  
Anonymous Anonymous said...

I remember him telling us that story during orientation. Wow. Are you working with him now?

The Lin

12:27 PM  
Anonymous dhssraj said...

not having a pulse for 20 minutes is pretty long. i dont know what the odds are for someone like that to come back from asystole but i think i raed somewhere its less than 1% if im not mistaken (dont quote me). and if you watch how CPR is done, its not exactly as prim and proper as they show it on tv. its actually extremely rough and traumati. i dont know how much id wanna subject myself or someone i love to that for a long time honestly, i really dont.

sometimes ppl take their collegues as members of this large extended family, with a certain level of camaridarie, love and respect for each other. doesnt mean they hate everyone else outside the workplace, just means theres a somewhat closer bond.

the weird thing is with family sometimes you do become a tad 'irrational' and keep going on hoping for a miracle. very rarely miracles actually happen happen (depending on belief systems i guess). this really sounds like one of those.

another very noticable example is with cops i guess. ike how when a police officer is killed, the whole force really gets riled up.

i dont know if its justified, but i know its only human.

9:43 PM  
Anonymous dhssraj said...


9:45 PM  
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9:44 AM  

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