I have never cried because of a patient. And I made a promise that never will. That promise was shattered last night and it all began way too early.

SN: Doctor, patient is unresponsive!
Z: Which patient?
SN: Bed 10. The one with cryptococcal meningitis. Status unknown. Query IVDU.

I ran towards the patient. SpO2 monitor showed 50%.

Z: Record the blood pressure and pulse please. Take DXT together while you're at it. And someone else please put cardiac monitor on him. Thank you.

He was tachycardic. Sinus tachycardia.

I assessed the GCS was 3/15. Pupils were already fixed and dilated. During the afternoon rounds his GCS was 11/15. He was still able to move up his limbs.

Z: Ok. I want emergency trolley here. Prepare ETT size 7.5. I want the yonker to be here. The bag and the mask. The laryngoscope. Make sure everything is ready. I wanna intubate this patient.
SN: Doctor zafira, where is the houseman oncall??
Z: Kakak sayang, I'm the houseman oncall.
SN: I thought you're the MO?
Z: I have 2 lives Kakak. During the day I'm the MO. At night I'm the HO. And please someone call our MO oncall.
Another SN: Doctor! BP 30/40!
Z: Run 2 pint gelafundin fast. Make sure he has 2 lines! And someone please prepare dopamine 10mcg.

So I intubated the patient. SpO2 picked up to 90-92%. Blood pressure picked up to 120/80 mmHg. Suddenly I could see only 1 line on the cardiac monitor. Then I heard my MO's voice. A very calm voice.

MO: Start the CPR.

So we commenced CPR for 30 minutes. Atropine and adrenaline was given 3 times. The heartbeat just could not sustained on its own. His pulses were impalpable. Even the SpO2 on bagging dropped down to 2% the lowest but I still kept on bagging. Then my Mo went out to talk to the family members. I heard a woman's voice mumbling and crying simultaneously. I could not make out her words exactly. Then it became louder. It sounded much like this, "Doctor!!!!!!!!!! You better try harderrrrrrrrrrrrr!!!!!!!!! You did not try hard enough!!! You better try againnnnnnnnnnnn!!!!!!!!!!!!!!!!!!" "I should've never consented for the lumbar puncture!!"

My heart really was smashed into a million little pieces. And trust me. I did cry a little bit. It's too unfair to accuse us of not trying hard enough. I don't even know why this become so personal to me. Probably it begins with a glimpse of a passing thought. I just hope it won't end in obsession.

Footnote 1: If you are sick and you are on call, you better just say BRING IT ON BABY!

This may be a true story and maybe not.

Random: Guys who read books are just hot.

FIN