Being a medical professional is not an easy job, especially when you're faced with tragedy every single day. The following doctors, nurses, other medical professionals took the time to share what some of their most difficult moments were with patients.
(Content has been edited for clarity.)
Pediatric Nonaccidental Trauma
“A case of pediatric nonaccidental trauma (aka child abuse) where I had to see a 4-year-old child who partial and full thickness (second and third degree) burns all over about 50-percent of his body. This was the child’s punishment for having diarrhea. The kid had been suffering from horrible pain for four to five days before police/CPS found out and brought him in. He was a lovely kid during the whole time that I was caring for him. It’s shocking how horrible people can be to others, especially to children.”
Severe Schizophrenia
“I’m a psychiatrist. I once had a patient with such severe schizophrenia, and there was nothing I could do to help her. I mean I could medicate her, but the medication I had to use were so powerful that they would’ve essentially left her mute and incapable of clear communication. All she could do was sit and stare. It broke my heart and left me feeling quite helpless and powerless because there was just nothing I could do.
There were only two extremes in which she could live, and they were either so powerfully deluded and paranoid that she was a danger to herself/others or so medicated that she was a shell of a person. For her safety and the safety of others, I had to medicate her.”
Circumferential Burns
“I was a medic in the army. When I was in Iraq, I worked in a small Level-2 facility that used to be an Iraqi prison (It was a clinic now with a forward surgical team, one dentist, one hygienist, and a small lab with limited capability and a portable X-ray machine). The medics routinely got called to pick up local nationals from the entry control point of the FOB (forward operating base).
One of the injuries I picked up from the gate was a 3-month-old baby girl with partial thickness circumferential burns on her torso and legs. She was crying uncontrollably at home and was dunked in a pot of hot oil. The father told my interpreter that the oil fell on her, but when the terp told me what the father had said, he also informed me that the father was lying. I had already deduced that much since you wouldn’t get circumferential burns from a spill. Once I brought her back to the cash, the doctors immediately confirmed my opinion that the father had dunked the baby. The doctors did everything they could for the baby, but she didn’t survive.
Two weeks later (It could have been longer, this was in 2008), I got another call to the gate for a burned local national. I responded to the call only to see the same father with his 6-year-old son. The boy had bilateral circumferential burns on his legs from the knees down. This loser had burned the boy the same way that he had burned his baby, but of course, we weren’t allowed to judge and could only treat. We treated and stabilized the boy and then evacuated him to a medical city for further treatment.
I was so furious that we couldn’t do anything about this father for abusing his children.”
Time Equals Tissue
“I’m a registered nurse. During code blues, we work as a close team with the doctors. We had a cardiac arrest, which I managed to catch on the monitor right away as it happened. This guy went into ventricular fibrillation. I saw it on the monitor and thought: ‘That’s not an artifact.’ I told the clerk to call the code and ran to the room to start CPR. I got on his chest right away, so he was without perfusion for 15 seconds max. The code team got there fast, and we got the first shock in less than a minute from when he first went into VFib. It was a textbook case of ‘time equals tissue,’ and it should’ve been a complete success. However, nothing we did could convert his heart out of his lethal rhythm.
It would’ve been just another ‘bad luck’ code, but the thing that made it difficult was that when I had started the CPR, he opened his eyes. He wasn’t talking or acting normal, but you could tell that the CPR was keeping enough perfusion going to his brain to keep everything firing. He wouldn’t talk, and later, he couldn’t tell when he was intubated, but he would look at us and track us with his eyes. They looked like they were alternating between confusion, fear, and pleading with us to help him. Every time we stepped away in shock, they would close. Every time we started up the CPR, they would open. As long as we kept up CPR, he was alive. Every time we stopped, he would start to drift away.
All of us tried to think of anything we could get to get him out of his lethal rhythm. We coded him and watched those eyes for over an hour. A ‘normal’ code where you catch it so late that the brain is already gone is easy to call it. A ‘normal’ code where there is already heart damage, and you watch the heart slip away from you as it goes from PEA to VTach, to VFib, to idioventricular, to flatline is also easy to call.
But this guy never had a single rhythm change. The CPR that was perfusing his brain also kept his heart tissue alive, which meant that it could hang out in VFib for however long we kept the blood flowing. However, no medication or intervention made a difference. I think in the end it all started with a massive heart attack that killed him right then and there. We just caught it at the right moment to take over for his heart, but there was nothing that we could do to fix it. Every intervention would have required us to stop doing CPR, and he would’ve been dead as soon as we would’ve stopped.
So, when every worker that could help was too tired to keep him alive, and when every idea had failed, with the guy watching us decide with that knowledge in his eyes looking back at us, we stopped. Our hands, my hands, kept him alive. And he watched me lift my hands off his chest one last time, and he knew that he was going to die. I knew that he would die. We all knew it, and we all watched the eyes that our actions kept open an hour after they should’ve gone closed. We knew that we couldn’t have done anything differently, but because his brain looked like it was working until the very end, it felt like we had just condemned him to death because we had gotten too weak to keep on doing CPR.”
Complete Meltdown
“I’m a psychiatrist. Twenty-two years ago, a visiting foreigner was referred to me. She had left her home and native country for the first time and found the experience rather anxiety-provoking and depressing. I sent her to a therapist.
The patient had poor comprehension of accents, and it was a bit difficult for her to express her self. No big deal at all. Well, I was wrong when it came to that, as far as, the therapist and the patient interaction was concerned.
The therapist came into my office the next day and started complaining loudly about the person I had sent.’She taxed my patience and drained my energy’ were her exact words. I was surprised. Frankly, I did not (and still do not) expect such a statement to ever come from a therapist or a doctor/psychiatrist. I suggested that she could have withdrawn if she had felt that way, and let some other therapists take over. She shrugged and said, ‘I will manage it. Have no worries.’
Three weeks later, I was greeted by the news the moment that I stepped into my department. There was a new case for me that the hospital administration wanted my opinion on ASAP.
It was the same therapist. The previous day while in session with the foreigner, she lost her cool, screamed, banged the table, and as the patient got very nervous, scared, began to cry, and lost it completely. She started throwing stuff in her office around and had to be calmed down. Another psychiatrist witnessed the meltdown, admitted her, and she was kept under observation.
She lost her license and her job.”
A Young Mother’s Miscarriage
“I’m a nurse who worked in labor and delivery. I’ve had to hold many dead babies from miscarriages or other premises before the age of viability. I never forget those families. We would usually get some keepsake photos after birth for the grieving family, prepare the bodies for whatever ceremony or funeral was desired, and then took care of fetus-specific body-handling (provide blankets that didn’t stick to the skin, warm blankets up before we could wrap the bodies so that the parents didn’t have to hold a cold baby, and talked to family members as appropriate).
One night, a 15-year-old came in suffering a miscarriage of 18-week twins. The first baby was born dead, but the second had a heartbeat (which you could see through his skin) for almost an hour. There was no way it was remotely salvageable. At 18 weeks, there were also other obvious deformities. The mom was exhausted, overwhelmed, and as a young 15-year-old, she was barely more than a kid herself. She wanted to cry with her mom, so she asked us to take the babies away (for now).
The patient was held in bed by her mother while both of them sobbed, and a coworker and I held the baby with his tiny useless heartbeat all wrapped up close to the body of his sibling in the next room. We kept on telling him it was okay to ‘let go’ and waited until he did. That night has stayed with all of us.”
‘Pull The Plug’
“I worked in intensive care and have had to withdraw (‘pull the plug’) on patients many of the time even when it was clear that they would never survive without all of our machinery. The patients were almost invariably unconscious, and I was quite used to making that difficult call and having to have that unpleasant discussion with their family.
The hardest one, though, was a man who had always lived his life to the fullest despite having a terrible heart. However, after an emergency operation, his heart worsened to the point where he simply couldn’t breathe without a ventilator. Every time we tried to take him off of it, he looked awful and must have felt like he was suffocating. Unlike most of our patients, though, he remained ‘all there’ mentally and knew what was going on. Eventually, he asked us to stop while being fully aware of the consequences.
Turning off his ventilator was by far one of the hardest ones I had to do before or since (with unconscious patients), even though (and maybe because) he had made that call himself, and till today, I still don’t fully understand why.”
Code Blue
“Having a code blue called on a kid is always hard. There was this cry of despair that you would hear from every single parent when they saw that their child was being worked on that would wretch at your soul. It felt like something inside was being crushed, and the world was becoming a little smaller and a lot darker.”
Struck By Lightening
“I’m not a doctor, but an EMT. My high school was pretty big in career technical education, so when senior year came along, I decided to try the after school and year-long EMT basic course as a part-time job for college. Twenty-four hours or something like that of ride alongs was necessary for us to complete the course. So, after the first semester, we were shipped off to local fire stations. Most of the calls were pretty cut and tied. A transport here, and an elevated blood sugar there. However, one of my last calls was something that I could have never mentally prepared.
Lightning struck a girl. The dispatcher said that she was walking home from the mall and was struck in the fast-moving thunderstorm. She was only 18. When we arrived, a few of the mall employees were performing CPR on her, and I just knew that there was nothing that could be done. Even with no pulse to be palpated or visible breath, protocol calls for CPR to be performed with an AED until the paramedic calls the time of death.
I was allowed to intubate her under the direction of the paramedic and rotate in the chest compressions. However, through it all, I felt helpless for her. This girl was the same age as me probably getting ready for college, and yet, she was now gone too soon.”
A Human Life Is Not A ‘Teaching Tool’
“My battery (artillery company) worked side by side with the Iraqi police in the province. It was the same group for the entire 15-month deployment. I routinely went on convoys throughout the province with them as their medic, so I was pretty close with all of them. They were like my extended family. I even taught them basic trauma care like tourniquets, emergency airways, and pressure dressings. When I wasn’t on a mission with them, I worked in the CSH either in the clinic or the trauma bay.
On one of my trauma bay days, I got a radio call that the medic who went on a convoy that day was bringing in a casualty from a firefight that occurred towards the end of the mission. I tried to remain calm and told myself that maybe it was a wounded insurgent so that I could just be numb and do my job without any emotion. When they sent the 9 line (a radio report detailing the type and amount of casualties), they said that a coalition force was wounded by enemy fire.
Once they backed the MRAP up to the trauma bay and pulled the litter out, my stomach sank, and my fear was confirmed. It was one of the IPs that I sat next to on every mission and talked to about random stuff like future goals (once the war was over) and whatnot. His commander came out of the vehicle crying for us to help him. The casualty had a bullet wound through his right eye that penetrated through and through.
The officer in charge of the trauma team sent the casualties commander out of the room to the waiting area. We got to work getting large-bore IVs in each arm, X-rays, and meds. We bandaged other injuries and did whatever the doctor told us to do. There wasn’t much that could be done, though. We knew that we had limited resources we had to maintain in case of another casualty or mass-casualty because the resupply was a month away, but we were all close to this man and didn’t want to lose him.
The OIC made the call to stop life-saving measures because the casualty was bottoming out. I would have been fine with it (sad but understood) had he treated the man with dignity. Instead, he decided to use this man’s death as a teaching tool for the junior medics that had just arrived in the country and didn’t know him.
Each phase of the guy’s death, the doctor would say something like, ‘If we were in the US, we would do this. If he were a US soldier, we would have evacuated him here…’ and similar statements. The worst part is, the man’s commander was right outside the doors, crying and praying, and could hear his colleague being treated like a cadaver. I was pissed, but as a junior enlisted soldier, I had to shut up and listen. The doctor was a Colonel.
I finally had enough and asked to be excused. I went out to the hall with the IP commander and brought him with me to the breakroom, and let him cry to my platoon sergeant and interpreter and me. I’m not religious at all, but he wanted us to pray with him. So, we did.”
Elderly Patient
“As an intern, I had an elderly man with some decreased cognitive function who apparently had hit someone with his cane in his group home. He was brought to the ER. I believe it was for ‘not acting right,’ and he was admitted until he could be placed in another group home. Placement was challenging, and we had to use restraints on him. One morning, he ended up throwing up and aspirating his breakfast. We coded him but couldn’t get him back. It was awful and all because he had hit someone with a cane (and a lot of other subsequent issues, obviously).”
Fighting Parents
“I worked as a CNA at an inpatient hospice. A 17-year-old boy was dying of bowel cancer and metastases and to his bones and liver. He was in agonizing pain but mentally still aware. The massive IV narcotics and other substances that he was on were only having a minimal effect.
As he was laying in bed, his divorced parents were arguing OVER their dying son demanding he decides whose family plot he wanted to be buried in, rehashing all the reasons they got divorced, trying to make him choose between them, and telling stories of all the horrible things the other person had done.
It was disgusting. We tried so hard to nudge the parents out when they were arguing or tried asking them to stop, but they wouldn’t stop or leave. All we could do was keep on giving him more medications when he asked. Palliative sedation was finally given as it was the only way the poor kid could die in peace. I’ve never been as furious at other humans beings before.”
Bleeding Out
“This occurred when I was a senior OBGYN resident. Another hospital had just done a 24-year-old’s third C-section on Good Friday afternoon and had encountered a placenta accreta (When the placenta grows into the muscle wall) that they thought they were able to control without a C-hysterectomy. A few hours later, she began hemorrhaging, and they took her back and did a hysterectomy, but she was bleeding quickly that the hospital began running out of blood. They had to transfer the patient to us on a 40-minute ambulance ride.
I thought we could save her so long as she didn’t arrest, and we were able to get her enough blood products. We met her at the ambulance bay with rapid infusers, and the full OR team scrubbed and ready to take her back to surgery. She eventually received 30 units of blood from 30 different individuals. The three other doctors and I worked furiously to stop all of her bleedings, but she had already entered into a full-blown DIC (When your blood no longer has any clotting factors, and all of the surfaces begin bleeding spontaneously). She began bleeding into her lungs and went into hypoxic arrest.
What hit me hardest is that I didn’t expect her to die until I began hearing the oxygen saturation monitor begin beeping at lower and lower tones, and I saw that it was in the 60s. I will never forget the deep groaning sensation you get in your belly when you know the patient is going to die. The patient’s father and her significant other didn’t expect it either. I had never heard a man wail until my attending, and I came to tell them that their loved one had passed.
I am not religious, but I was so thankful that our hospital had an on-call chaplain who helped me process the situation. I started my week vacation a few hours later. It may have seemed like bad timing, but it helped me get over the tragedy.
The other hospital suffered a huge lawsuit from this because of multiple lapses in care. I know that the doctor there sought psychiatric care afterward for depression and suicidality.”
Harvesting Organs
“As an intern, a lady in her 40s with a husband and a young daughter was dying from an incurable lung disease. Her family decided to withdraw care and donate her organs. It fell on me, the intern on call in the middle of the night, to go to the OR with the surgical team, order her extubated, keep her comfortable with pain medication until she died, and then pronounce her dead so they could harvest her organs. Her brother was allowed to come in the OR as well, and he was just holding her head and sobbing. I was sobbing. It took her 25 minutes to die.”
Skeptic
“I’m a nurse. I was working in a fairly busy hospital ED when a mom, who was 22-weeks pregnant, came in post slip and fell on her front steps. We did a workup, and I was in and out (She wasn’t strictly my patient, but I remembered being pregnant and was assisting. Her ultrasound was okay with some decreased fetal movement, but the attending said that ‘It was okay’ and that they would watch her.
When I got off shift, she was still there waiting for a follow-up from OB.
Around three days later, I was in the ED again when I heard this bloodcurdling screaming coming from the ambulance bay. This was like non-human groaning, or I’m not sure, it was like animalistic cries. It made me viscerally respond. I quickly got out there, and it was the mom. She was being pushed by her husband, and she was as pale as a sheet and was dying. Like I could look at her and tell she was dying. Vomiting, fever, extreme pain. It was sepsis. She was septic. Someone missed the fetal as the baby had died in utero, and now the mom was fully septic. Many washouts and many, many codes on the OR table.
I beat myself up so much. If I had stayed. If I had checked the chart (again). If I had questioned the radiologist. ‘If. If. If.’ I blamed myself for a long time. I’ll never forget her. I will never forget her husband who came in with a family and had to leave alone. I was so angry, too. I was angry we had missed it. I was angry at the Feres Doctrine for taking away any chance of justice, and I was angry that I felt like I couldn’t question my superior officers just because I was new.”