A Matter of Life or Death

A Matter of Life or Death

On rare occasion I have had the unpleasant task to go to family members waiting in front of the operation theatre and inform them that a loved one has passed away on the operating table.

To witness the shock, pain, suffering and sorrow of the wife and children who have just heard that they have lost a beloved husband/father is indescribably sad.

Let me assure you it is not pleasant. The emotions that you have to deal with are immense.

The introspection that inevitably plaque you over the next few days, weeks, and sometimes years later is very hard on you. What if I did things differently. Should I have operated sooner or should I have delayed it longer? Should I have used different drugs? Should I have utilized the services of another anesthesiologist? Question after question!

A young man came into my rooms recently. He was referred by another doctor for the removal of impacted wisdom teeth.

Following my clinical examination, I admitted him to hospital, I got a series of blood tests and x-rays and placed him on high doses of antibiotics.

Inexplicably, his condition deteriorates overnight and he is transferred to the ICU the next morning. CT Scans are ordered. An Otolaryngologist and Neurosurgeon is consulted.

The patient developed an extremely rare condition: cavernous sinus thrombosis (blood clotting in the venous draining system surrounding the brain).

He suffered from an acute sinusitis and the infection spread via small veins through the skull base into the blood drainage system of the brain and the blood in this system started to clot.

The increase of pressure in the skull cavity pushes the eye forward and causes the membrane covering the eye to swell a lot.


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I tried more and higher doses of antibiotics, anticoagulant therapy (blood thinning medication) and cortisone to reduce brain swelling.

The patient had the benefit of the best clinicians, the best intensive care staff, and a variety of tests, monitors, as well as a tube in his trachea (main windpipe) ventilating him with Oxygen enriched air.


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For the next two days the patient improves, but then suddenly on the Thursday morning,  he deteriorates.

He is brain dead a few hours later – a vegetable only useful as an organ donor, for somebody who needs kidneys, a heart etc.

He was only eighteen. Eighteen years of nurturing and dedicated parenting ends in a disaster – a painful emotional disaster.

Somebody needs to tell his parents, and then to make things worse, that person must ask them for their son’s organs. Death for one person often means life for another.

Is this the type of thing that you will be able to handle?

Medicine is immensely rewarding – but be sure you can deal with the moments of exhilaration as well as the moments of sorrow.

Be prepared for it so it doesn’t catch you by surprise.

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    Comments : 1 thought on “A Matter of Life or Death”

    1. Hi

      The short answer is that it would be virtually impossible – as you are talking about a very popular and competitive residency – so all posts are given to USA students. Finish your Cardiac/cardiothoracic surgery on Pakistan – and then contact the following organizations that will be able to assist with specific advice on how to move to the USA:
      https://www.ecfmg.org/ and https://www.usmleworld.com/ as well as https://www.faimer.org/
      Also use the massive database of the SDN (Student Doctor Network) https://forums.studentdoctor.net/ may be of assistance.
      May we wish you the best with your future.

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