gods

On Saturday night, a Russian-speaking elderly man came into the emergency room for high blood sugar (hyperglycemia).  That wasn't his problem; his problem was that he was having a heart attack.  He was sweaty, nauseated, and experiencing chest pain.  The ER sent him up to cardiac catherization.  We got up there at 4 am.  I was sent to carry the cell phone so that we could communicate by translator.  I accidentally hung up.  We couldn't get the translator back, so his catheterization was delayed because we needed to get consent for the procedure.

Finally, the attending physician swept in and took over from the fellow fumbling the consent.  "We have to go," he said.  "No time for this."  The Russian translator finally came on the line, and the senior physician told the patient, "We're going to save your life.  Got that?  Sign here," and the man signed.  He was sweating profusely, breathing shallowly and quickly.

They swept him into the cath lab while his wife waited anxiously outside.  I watched through the window as the cardiac fellow and attending draped him, inserted a wire through the blood vessel near his groin.  Lacking the ability to explain, the attending exclaimed, "Ouchie-mama!" as they inserted the catheter to give the man some warning.

They were imaging as they went, squirting contrast and taking imaging studies.  Even I could see two distinct narrowed areas in the right coronary artery, which feeds blood to the heart.  If the blood flow to the heart is interrupted, the muscle will eventually die from lack of oxygen.  This causes the chest pain and pressure in a classic heart attack.  If enough muscle dies, the heart will no longer be able to push blood.

Forty minutes later, they completed the procedure and reopened the arteries to his heart.  On screen, the images showed the right coronary artery, open and clear.  The man's blood pressure began to rise.  They just saved his life.

As I walked away that night, I thought, Those surgeons are gods.  I just witnessed them save this man's life.

* * *

What I did not mention above was that the man had metastatic melanoma, a skin cancer that had spread throughout his body.  He was already dying.  We had saved his life, but only temporarily.

* * *

I ran into the cardiac fellow today in the ER.  He told me the man died yesterday, after all.