10. Rushing Doctor Costs A Life
When I was a medical student on my surgery rotation, I was in the OR with only the attending surgeon. The residents on service were otherwise busy, so the attending surgeon (somewhat impatiently) decides, “Fine, I’ll do it with just the med student.” It’s a relatively straightforward case, placing a gastric tube for a patient who couldn’t eat. The institution I now work at frequently does these under laparoscopic visualization, which is seen as overly cautious by some. Not me.
The attending puts a scope down the patient’s esophagus and I have a big needle to push toward the scope. His scope had bright light which he shines towards the skin when he’s entered the stomach and I press on the skin and see it dent in on the screen, showing we’re in the right place. I thought I took that exact same position and angle, and introduced the needle. Except it didn’t show up on screen. So I pulled back. Pressed again and tried again and didn’t see it. The attending grows frustrated and tells me to push the needle in deeper then. I had a twinge of concern, but eventually hubbed the needle, which was several inches long. Never see it on the screen. Eventually, the resident shows up and tries as well. He introduces the needle but never can visualize it. Eventually, he switched places with the attending, and after another try, got the needle into the stomach and we finished placing the tube.
I come back after my day off to find out that that patient died from internal bleeding. One of the multiple needle pokes – or possibly a cumulative effect – had injured arteries in the abdomen, leading to them bleeding out overnight.
Now, I know not to ignore that twinge, and I know that even “low-risk” procedures have a risk of catastrophe and always take care to mention that when consenting patients for surgery. “Low-risk” not “no risk”.
I harbored guilt over it throughout medical school and still had hesitation the first time I did that procedure as a resident.
