Helplessness

First post with some substance in a while, and it's gonna be a heavy one about work. I'll try not to divulge too much in the interest of not being too specific about the patient's case but I'll try not to be vague-city either.

I'm working with the ICU team right now so I help deal with calls from other units when their patients are in trouble. There was a guy we were called about last week who wasn't really responding to anything. At first I think the nurses just thought he was having a deep sleep but over time it became clear he wasn't responding to anything. He was generally high functioning and independent before coming to hospital for a totally unrelated issue. A young grandfather and a husband. I met his family. For the better part of an hour or two we really had no idea what was going on. He had a huge work-up done yesterday for a similar issue and nothing came back remarkable. Labs so far showed nothing either. Besides him being essentially comatose (GCS ~4), he was otherwise stable. I actually had to leave in the middle of transferring him to ICU to go to clinic in the afternoon.

Later that evening I decided to look up the CT of his head because I had an inkling he had something neurological going on. He had a massive intracranial bleed with midline shift and herniation. I was floored. I don't think I've been shocked about a test result for a patient in a long time. He had imaging the day before which was pristine and overnight for no reason he bleeds.

It made me think that despite all the training we get, the hours we put in, as much as we label ourselves "experts", when something like this happens to somebody, we're completely helpless to do anything. There was nothing that was significant in his history that could have caused it, nor could it have been prevented. In a profession where we are constantly searching for answers or remedies to ailments, mother nature pulled a fast one on us where all we could do is look and not have an answer.