‘I don’t know.’
This was something I said quite a lot on Wednesday, because I had a year 12 student shadowing me for work experience. Having somebody who is entirely new to the ideas of medicine following you around for a day is an eye opener I would recommend.
Questions… so many questions.
‘So, the letter says he wanted to die at home?’
‘Why is he in resus?’
‘Is he just going to die now in a minute?’
‘Does he know?’ and I say: ‘That, I really don’t know.’
‘Didn’t his wife know that he wanted to die at home?’ And I say yes, but that watching the person you love dying can be a frightening thing when you’re by yourself, maybe she wasn’t sure what dying was supposed to look like, maybe she had difficulty coping. I tell her that the community palliative care team hadn’t gotten out to see them yet.
‘But why not? The letter said they would.’ And I say: ‘That, I really don’t know’.
‘If he’s going to die anyway, why was the other doctor trying to get a cannula in? Is that for drugs?’ And to that I think, where can I start?
‘So, that lady isn’t coming to intensive care either?’
‘Because you can’t make her better?’
‘Where will she go?’
‘Is she dying too?’ and to that I say we’re all dying to different degrees, she’s not dying today, this is more of a short to medium term dying situation. That man from this morning, he was dying today.
‘And what is she dying from?’ and I say it isn’t really one thing, there are lots of things that are wrong and today they got a bit more wrong, but there is still isn’t anything I can do in intensive care to make that better.
‘And you’re giving that man the drug to break down a blood clot?’ And I reply yes, because the clot is putting his heart under strain and that’s why he is struggling with such a high heart rate and low blood pressure. I tell her that his heart can’t maintain his cardiac output.
‘And he might bleed?’ and I reply that yes, it is a risk with thrombolysis for massive PE and that this patient is very unstable and needs treatment very quickly.
‘Does he know?’ and I reply that yes, I have told him there is a risk of bleeding.
‘And he said ok?’ and I reply that he asked what we would recommend and I told him that the intensive care and medical teams involved in his care believed that the potential benefits of thrombolysis outweigh the risk of bleeding.
‘So, he won’t have a bleed?’ and I reply that no, I can’t really know that, but that he didn’t have any other risk factors to suggest he would be in the group of people who are very likely to bleed.
‘But you don’t know that?’ and I reply that no, I don’t.
‘And does he know he might die?’, and I reply that I didn’t mention that word, specifically.
‘But you said the treatment for this sort of clot is life saving?’
And I reply that yes, I did, but I don’t think he will die, that’s why I’m giving him this treatment.
‘But you don’t know?’
And I reply. No.
Thank you for the questions.
By the Secret Doctor
Read the blog and follow @TheSecretDr on Twitter and on Facebook.
I literally would have told that work experience student to go do some reading.
Thank goodness most of my work shadowing students ask more interesting and sensible questions. [I usually say 'I'm not sure' rather than I don't know - it comes to the same thing really, but doesn't sound quite as stark.]
[full disclosure: I'm not a medical student] as a (hmmm) non healthcare professional, regular person-sometimes-a-patient who delves into end of life nuances and conundrums (bestendings.com) this is helpful, insightful, illuminating and serves to put into perspective in to the grey and greyer, the knowns and unknowns of the human condition. Thanks.
Hey guys, I'm so excited of getting my husband back after he left me and our 3 kids for another woman.
After 2 years of marriage, me and my husband has been into one quarrel or the other until he finally left me and moved to California to be with another woman. i felt my life was over and my kids thought they would never see their father again. i tried to be strong just for the kids but i could not control the pains that torments my heart, my heart was filled with sorrows and pains because i was really in love with my husband. Every day and night i think of him and always wish he would come back to me, I was really upset and i needed help, so i searched for help online and I came across a website that suggested that Dr Unity can help get ex back fast. So, I felt I should give him a try. I contacted him and he told me what to do and i did it then he did a (Love spell) for me. 28 hours later, my husband really called me and told me that he miss me and the kids so much, So Amazing!! So that was how he came back that same day,with lots of love and joy,and he apologized for his mistake,and for the pain he caused me and the kids. Then from that day,our Marriage was now stronger than how it were before,All thanks to Dr Unity. he is so powerful and i decided to share my story on the internet that Dr Unity real and powerful spell caster who i will always pray to live long to help his children in the time of trouble, if you are here and you need your Ex back or your husband moved to another woman, do not cry anymore, contact this powerful spell caster now. Here’s his contact: Email him at: [email protected]
you can also call him or add him on Whats-app: +2348071622464 ,
his website:unityspelltemple.yolasite.com ,
Jessica, 26 years, Texas, USA .
Thank you for this article. I'm glad the work experience student got the opportunity to talk to you. And I'm impressed that you took something from the experience too - we should all aim to learn from working with each other.
I often ask my medical students which phrase do I repeat most frequently- to the patients and to them- and it is exactly "I don't know ". I spend entire day's not knowing!
I am Fatima Melim, i will like to let every know that there is a true and real spell caster out there and he has helped me in so many way just a few days since i came in contact with him through the help of my good friend who introduced me to him. he did a love spell for me and assured me that after 2days, my ex husband will return to me and to my greatest surprise the 2day my ex came knocking at my door begging for forgiveness. I am so happy that my love is back again. Once again thank you Dr, Adodo, You are truly a great man wow this man has brought back the joy in my life that was stolen and now i live a better and sound life. he bring back my divorce husband home with his love spell, when i lost my husband.he is true to his word and he is here in the world to help mankind. he is the realest of all spell caster online. he is Dr Adodo. you can get him via email: [email protected]
i want to say a very big thanks and appreciation to Dr. Keke Odin the chief priest of all spell casters worldwide for bringing back my husband who left i and the kids for almost three months within the space of two days after following all instruction given to me. i am very much grateful for restoring peace in my marital home, and i pray God almighty give you the strength and wisdom to continue helping more people having similar relationship and marital problem like mine. for help you can contact him now through his email and mobile number below
Email: [email protected]
Mobile Number: +1 386-336-9876
i couldn't believe that i would ever re-unite with my ex-lover, i was so traumatize staying all alone with no body to stay by me and to be with me, but i was so lucky one certain day to meet this powerful spell caster and a powerful witch called ANA SARAH,after telling her about my situation she did everything possible to see that my lover came back to me,indeed after casting the spell my ex-lover came back to me 48 hours later thats two days,my ex-lover came back begging me that he will never leave me again,1 month 2 weeks later we got engaged and got married,if you are having this same situation just contact ANA SARAH on her anasarahspiritualhome.yolasite.com thank you very much ma for restoring my for bringing back what i lost back to me
Thank you Dr Uduga for helping me, i keep thinking if this was real or a dream, because i can still believe my husband who drove me out of the house about 3 years and 4 months ago because of the little quarrel we had, but now i came back looking for me, asking any of my friends he saw to give him my contact but no one did, so as time goes, one day i was coming out of a shop were i went to buy some stuff i saw a car stopping in front of me pointing light and i was angry because i hate that, so i had to leave and drop my things in my car, few minutes later i saw someone coming towards me in a hurry mood so i roll down my glass guess who i saw friends, i saw Philip my husband calling my name, begging for to forgive him that it has been long now he have searching for me but no one could tell my where about, so i was so so surprised to see a man who drove me out of the house and told me not came back again now he is begging me. Though i was very happy and overwhelm cause it was a promise from Dr Uduga that he is going to bring back my lover within 48 hours when i contacted him, which he really did, i am really really happy now with him and he promise not to do without me again, i want to give a big thank to great dr Uduga for the great things he has just rendered to me. i really appreciate if the contact is needed, do not hesitate to contact him for help his is capable and powerful, try dr Uduga and see what he can do for you too. here is the contact, you can call his cell number +27849633679 or email him through, [email protected]
i'm Carolina Bryan from Geogia, United States.
How I Got My Ex Husband Back........... I am elizabeth by name. Greetings to every one that is reading this testimony. I have been rejected by my husband after three(3) years of marriage just because another woman had a spell on him and he left me and the kid to suffer. one day when i was reading through the web, i saw a post on how this spell caster on this address [email protected][email protected]salvationspellforallnation.webs.com/
I want to let the world know about Doctor paul the Great spell caster that brought back my husband to me when i thought all hope was lost. Doctor paul used his powerful spell to put a smile on my face by bringing back my man with his spell, at first i thought i was dreaming when my husband came back to me on his knees begging me to forgive him and accept him back and even since then he loves me more than i ever expected so i made a vow to my self the i will let the World know about Doctor paul because he is a God on earth. Do you have problems in your relationship ? have your partner broke up with you and you still love and want him back ? Do you have problem with your finance ? or do you need help of any kind then contact Doctor paul today for i give you 100% guarantee that he will help you just as he helped me. Doctor paul email is: [email protected]salvationspellforallnation.webs.com/
i want to say a very big thanks and appreciation to Dr.uwota the chief priest of all spell casters worldwide for bringing back my husband who left and the kids for almost three months within the space of two days after following all instruction given to me. i am very much grateful for restoring peace in my marital home, and i pray God almighty give you the strength and wisdom to continue helping more people having similar relationship and marital problem like mine. for help you can contact him now through his email and mobile number below [email protected]
!!!!!!!This is the most wonderful thing i have ever experienced, And i need to share this great testimony, I just want to say thanks to Dr.Mack for taking time to help me cast the spell that brought back my ex husband, last year my husband left me for because things were not working out between us, so he had to call it a quit, my Husband abandoned me, everything was so hard for me, i love him so much, i could not take the heart break, i had to find a solution then i came across Dr Mack On how he has been helping ladies in getting there husband back so i contacted him and he help me to cast a return spell for my husband and the next day my husband left his side chick and he came back to me pleading for forgiveness with so much love and caring. i will never forget this help that DR Mack gave to me. if you are here you need help to get you lover back you can contact him via [email protected]
I gave Dr. Alli a call regarding sudden change of my wife and he made it clear to me that my wife will love me till the end of the world,that she will never leave my sight. Now me and my wife is back together again and has started doing pleasant things she hasn’t done before, he makes me happy and do what she is suppose to do as a woman without nagging. Email him for any kind of help you may need Email: [email protected]