When I had a little time to indulge in pob for a while, the word of the week caught my attention, do not hesitate to look for it to remember its definition, although I had heard it, it is not so common, I have tried for a long time to practice various aspects of the meaning of it.
I stopped to recall a conversation I had with a childhood friend who became my colleague, after years without communication he shared with me that he is doing the postgraduate degree in Neurosurgery.
Among the shared experiences I never forget, the words my brother always used to joke with us both (you are in a military career, there is always and there will always be a hierarchy).
What I still find unforgettable is the story told by my friend while in R3 (second-year graduate resident), where he is delegated more responsibility, such as preparing patients for the operating room and being present in surgical interventions, as well as being attentive to R2, R1, plus emergency and ward patients, one of those days on call, in which he was in the operating room, he told me that he carried out a routine intervention with success, after about 3 hours of work, then he went down to emergency to supervise your Residents and the emergency ...
It is achieved with the unique scene where her R1 is giving cardiopulmonary resuscitation to a young woman of approximately 21 years of age, who had fallen into post-arrest after multiple repetitions of clonic tonic seizures, product of a malignant end-stage brain tumor, which it manifested itself with the seizure clinic. The cardiopulmonary resuscitation being satisfactory, managing to connect the young woman to mechanical ventilation.
When my friend evaluates the Glasgow scale (it is a scale that quickly assesses eye opening, verbal and motor response), obtaining a score of approximately 3 in the patient (the normal value being 15 points) and then performing other maneuvers complementary, my dear friend realizes that the patient is brain dead (it was literally a corpse connected to an artificial respirator)
Upon realizing this, he called his residents to tell them that the behavior taken was not right. On the contrary to his point of view, it was to prolong the suffering of the patient and also of the relatives, although the fact had already occurred, he made his point of view clear.
To his surprise, the young woman's relatives were of very limited resources and her residence was also far from the capital, where we were, who had been referred so far due to the complexity of the pathology.
It is with sadness that I think and analyze the reality of this family, which they did not even have to eat, they fed on the solidarity of the relatives of other patients, they did not have anywhere to rest, and the agony lasted for 15 days, that was the time in which this patient was connected to the mechanical ventilator.
Observing both scenarios, how would you judge this reported fact with equanimity?
Observing the panorama from the point of view of the R1 who were alone, in the face of an imminent emergency that threatened to take the life of a young patient, and as the duty of a doctor to act "to save her life, for an instant"
Or do you prefer to see the perspective of a family which suffered in many ways and for a long time?, Without any resources that they risked even what they did not have to seek help and save the life of their young daughter