26th June 2022

 The First Death!

I wasn't able to write much in these past few weeks of June probably because of the stress in OG dept. I won't say I didn't have time because I actually did but then I wasn't feeling like it.

So yeah, I wanted to record this one day's happenings properly. Megala! (Name changed). The moment I came to OG ward, I was practically pushed into the middle of the ocean along with Sid. Only Sid had a life jacket (ward work-experience) and I didn't. And the one patient that we had to write multiple opinions for, on a daily basis, was Megala. Now I had never written an opinion before so I didn't know much to begin with, but I did try my best. The harder part was talking to Megala. She used to have a new complaint every single day and most of the time, the PGs and the DMOs who came there said that she was just psychologically affected having been 26 yrs old, unmarried, and living with Stage 4 ovarian cancer. Every single complaint required a new opinion for which we had to run around writing memos. 

On my third day of ward, I said "Ma'am please don't discharge Megala in the next 2 weeks... I cannot write her discharge summary alone" and all of us were having a good laugh about it because her case sheet was almost as big as a Mother Robbins. Maybe even bigger! But I never imagined I would regret what I said 3 days later. Sunday morning! I come to the ward at 8 and almost immediately after I entered, I got a call from my PG. "Come immediately to SICU" she said. I knew that Megala had been shifted to the SICU the previous night and was given 1 round of CPR by Sid. I was told she was stable after shifting her to the SICU. But when I got there, I saw my friends giving CPR to her. There was a flatline in the ECG monitor and a few mins after I got there, the Anaesthetist who was trying to revive her asked my friend to stop CPR. I saw a few broken bottles of Adrenaline and other drugs there. So i asked my other friend what happened the previous night.

Megala was given 5 rounds of CPR and was revived 4 times, with each successive time being harder than the previous one. Multiple shots of Adrenaline were given and still nothing worked. Megala was declared dead after the ECG technician confirmed her flatline at 8:45 am. The Megala who used to complain to us on a daily basis about her headache and her tiredness and palpitations and stomach ache and vomiting and so on.... Was no more!

Now to be fair, I wouldn't say I was very attached with this patient. It was the exact opposite. I thought of her as someone that was increasing my intern stress. I used to get soooo tired running to and fro from the ICU DMO at night just to get an opinion for her cough. I was terrified of writing her discharge summary because that would've taken me atleast 2 days to finish. Maybe more? But seeing her cold eyes without any movement becoming yellow, all I could think about was that I would gladly write her discharge summary now instead of seeing her like this! I didn't like this feel... But the worst part came after. It was apparently the intern's duty to remove all tubes and venflons and everything from the patient's body. Me and my frnd were asked to do this. I had to remove the venflons and Central line from her neck. And i couldn't do it. I said I never connected with her. But I had tears in my eyes. I never thought i would become emotional over some random nobody that I met 5-6 days back. I was slowly taking the plasters out from the venflons and the nurse near me said "Doctor she is not going to feel pain anymore she's already dead. Just quickly remove everything and be done with it." I didn't know how she was saying this and also was soooo comfortable working near a cold dead body who was breathing an hour back. Maybe I'm just not used to this yet but i realized i did create a bond while talking to her everyday. It was something that was unknowingly created when I was doing her dressing... When I was listening to her complaints... When I started reading about Ovarian Cancer, Interval Cytoreduction + HIPEC... All of these were stuff that made me think about her more and the fact that she is no more was hard for me because she was indeed one of my patients... Whether i did her surgery or not. 

Megala did teach me one life lesson. It's that in this field, there is no space for personal relationships with patients. My friend Sid was bonding with Megala on a daily basis, talking to her about getting her Prawn Biriyani when her Ryle's tube is removed and I know for a fact that he was the most disturbed by Megala's death. He wasn't even on duty that day but when I called and told him about her death, he immediately came to the SICU despite having an off day after 4 weeks. It was not sadness... It was more like a numb feel. What he did to her on a daily basis... Were they all in vain?... Maybe... But he did give his all to make sure she was comfortable. I just hope I did the same for her as well!

Goodbye Megala! Bon Voyage...