I have been called at times by neighbors in desperate situations. While many years ago, i used to be jittery of making a wrong diagnosis or administering a wrong management, now I understand the limitations of the situations well and know that I am not required to do miracles, just make a difference if I can!
This couple, nearing their 80s are very close and dependent on us for their medical and emotional support. they don't take any kind of help from their son and his family, who live on the first floor. Today morning I got a call from uncle and I could sense the doom in his voice when he said, 'pata nahin sudesh ko kya hua hai'. In 10 seconds flat I was there and saw aunty sitting lifeless on the sofa with inhaler in her hand. I pulled her down on the floor, assessed her heart beat that was not there and started cardiac massage. Told uncle to summon a CATS ambulance, his son and whosoever can drive. He couldn't connect to the ambulance, was reluctant to call his son and confused to do anything else. I, while doing cardiac massage, asked him to call Rita and other neighbors. By now, aunty had gasped twice and my optimism was increasing. Neighbors came and announced 'deepak ko bulayo', then realized that I was already there but seeing me doing cardiac massage, asked me 'do we need to go to the hospital??? or is it over???'. My frustration was mounting and I ordered, call the son, my wife and ambulance from whereever. Rita has great managerial skills in panic situations and I knew she would do something. Fortunately, son came down, mobilized a car. Me, the son and daughter-in-law tried to lift the bulky body into the car and did it with great difficulty. Reached the nearest hospital wthin 5 minutes. Asked the lone casualty wardboy to get a stretcher, he replied, wahan se le lo'. By now I was totally exhausted doing cardiac massage and lifting her and had sprained my back badly, was unable to bend, my hands started trembling with weakness. I approached the CMO, introduced myself and requested for her to be shifted in. He obliged, I also pleaded for help to whomever i saw. 4 people shifted her in. The SR or somebody came and started taking history. I told him, let's start resus simultaneously. By now everybody was getting the feel that I am some doctor and from my age they could gauge that am not very junior. The SR took over the cardiac massage as he found me totally exhausted, I started doing AMBU, the JR put in the line, sister pushed in ADR and ATR,. We intubated her and suctioned lot of secretions. Everything was in place, ECG technician pulled out a straight line, the pupils were fixed dilated, it was all over many minutes ago.
I wished we had a better ambulance response, better manpower and training to shift unconcious pateints, better physique, longer time for brain to become dead or .......................simply better luck.
Though I knew, I didn't succeed but I had not failed in my duty. That was the only positive in the grim situation!!
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