The coronary care unit (CCU) rotation is a unique place. Postoperative cardiothoracic surgery patients among many other pathologies from heart failure to heart transplant fill the unit, and it is the job of the cardiology fellow to directly participate in the management of the patients.
After spending two months taking care of patients in the CCU, I finally have time to reflect on the experience. I feel like I have grown so much as a physician in general. Numerous lessons are learned during that time, but one of the most important, and, unfortunately, sad, lessons is that you can’t save everyone despite your best efforts.
The CCU is one of the intensive care units, where we take care of the sickest of the sick. Thankfully, many survive to be transferred out to the general floor and are ultimately discharged out of the hospital to live their usual lives, but there are a few that end up passing away due to how sick they are. Most of them are expected, so even though it’s still sad, you’re prepared.
It’s the unexpected ones that can get to you, and I still remember one experience that affected everyone that involved a lady who was sick and joking with us 2 hours before she passed away suddenly in an unexpected deterioration. Despite resuscitation efforts, we weren’t able to bring her back, and the thing that topped it off was the soul-rending wail that the daughter cried when she found out about her mother. All of us were devastated, but imagine being the one who coordinated the resuscitative efforts, which I was. It definitely hit me hard, and the thing that helped tremendously was the support of my colleagues.
There was a viral photo that circled around recently of an ED physician crouched down against a concrete wall grieving the loss of a 19-year-old patient, and having gone through my CCU months, I get it. It’s the unexpected losses that can affect us as physicians; after all, we are still human beings at the end of the day. What makes it easier to deal with, though, is reminding ourselves that for every person we cannot save, there are many others that we can, and do, save with our best efforts on a daily basis.
It is a powerful reminder of the humbling nature of the medical profession if we are open to that humility. Thankfully, the passing of patients is not the norm, and in those difficult moments when it does happen, we can remind ourselves of the ones we have saved, giving us the confidence that we will continue to save the lives of others. No matter what may happen during the night with the darkness that comes, thankfully we can look forward to the sun rising again and bringing forth a new day, as it has done in the past.
“A thousand times we die in one life. We crumble, break and tear apart until the layers of illusion are burned away, and all that is left, is the truth of who and what we really are.”
Chiduzie Madubata is a cardiology fellow. This article originally appeared in Daily Dose MD.