“The Living are Getting Rarer”

Is it the dying season? I have never been on a rotation where quite so many people die. I am told that Internal Medicine “is just like that” – but it’s wasn’t like that last year.

It feels sometimes that we are playing at being doctors. Take some bloods, give oxygen, intubate if necessary. But it seems that those who were going to die will die in anyway. I have never been a fatalist, but these days I have my moments.

We had a patient with massive haemoptysis, diagnosed him with TB and got him on treatment and he was doing so well. The day before he would be discharged, he died of an MI.

A pneumonia patient was sure to survive, she was even HIV-negative. Only she was a meth user. I have never seen anyone crash that quickly.

A patient with cryptococcal meningitis was doing so well that I thought I would finally see cryptococcus survived. Twenty minutes after we had examined her (she was doing well, with no signs of impending herniation) I returned to draw bloods. She had died.

It seems the further I go into medicine, the more poorly I handle death. I suppose being a clinician is not merely about saving lives, but it would be nice to see more survivors.

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