Photo by Nicholas Kampouris on Unsplash

I was doing on call the other day. Once I entered the ward to get updates of patients and pending jobs from my colleagues, I was informed by the nurse that there would be a patient coming to the ward from Emergency department having transferred from another district hospital. Great, what a start of a night shift.

Upon further questioning, the patient has actually collapsed while she was being sent to the ward. CPR was commenced immediately and she revived, however, with a poor prognosis. When she finally arrived the ward, the anaesthetists were preparing to intubate her since she was not very stable.

I was able to get history from her children while the anaesthetic team was attending the patient. Marie (not patient's real name) was actually fairly active at home, able to talk and take care of herself prior to her illness which started one week ago. She began to lose her appetite, coughing with greenish phlegm, fever and occasionally having shortness of breath.

She was then admitted to a private hospital yesterday when she began vomiting and feeling lethargic. The staff at the private hospital mentioned to the family members that Marie needed ventilation support due to her breathing issue so she was referred to general hospital as the ICU rooms at the private hospital were fully used.

Despite living alone at home, her house was actually surrounded by her 10+ children's houses which meant she has a very good family support. Her husband has passed away years ago and she was supported by her children since then. She neither smokes nor consumes any alcoholic beverages. Besides, she has been a housewife since her marriage.

After the anaesthetic team has done their job, I went to review Marie and did some documentations before attending other patients in the ward. One hour after that I had to draw some blood from Marie to check her oxygen level. When I approached her, she looked weak and I felt there was no palpable pulse!

Calmly (with mildly shaky hands), I asked the family members to wait outside and pulled the curtain while asking the nurses to bring in crash trolley and cardiac monitoring machine. Marie's GCS was already 3/15 so I cannot assess her consciousness level. I checked both the femoral and carotid arteries, no pulse detected. listened to the heart, not beating, Checking the eyes, both fixed, not a good sign. ECG showed flat line. CPR was commenced immediately.

In the meantime, the nurses called the Medical Officer and shortly she arrived and I explained the whole situation to her. After attempted several rounds of CPR for about 30 minutes with 2 shots of adrenaline injected through the cannula. Marie was then pronounced dead and CPR was stopped.

My medical officer then proceeded back to ED to see cases while I have to break the bad news to the family members. Truthfully speaking, it was one of the hardest things to do as a doctor as nobody wanted to hear bad news, let alone death. With a heavy heart, I met them and told them about Marie. They were really devastated upon hearing her passing away.

To us, it might be another death that happened in the ward, but for Marie's family members especially her children, their world was torn apart. Being such filial children with close-knit relationship with their mother to the point that they bought houses surrounding her so that they could take care of her all the time, their one and only mother who had been by their side all their lives was now dead.

It makes me ponder upon the meaning of life whenever I see patients die in the hospital. Life can be short and uncertain at times. One day you are alive, the next day you might fall sick or die for whatever reason. Hence, it is important to live a happy and meaningful life instead of the opposite simply because #YOLO.  Have a think about it. Cheers.