My first patient to die

I knew it would happen sooner or later. Everyone eventually has a patient die. I'm sure other patients of mine had died before, but this is the first one I knew about. She had serious emphysema. You get that from smoking.

Anyways, she came in for an exacerbation of her emphysema. She could hardly breathe. And she was only 50 years old. We gave her breathing treatments. A chest X-ray suggested pneumonia. That would explain why she suddenly had trouble breathing. We treated her with antibiotics. She got better for a while.


The trouble with antibiotics is this: They wipe out ALL bacteria. This leaves room for bad ones to grow in the place of good ones. We all have C. difficile in our colons, but when you wipe out all of your normal bacteria, C. difficile can overrun everything. And the result is horrible diarrhea. Most people get over it.

But in some peple, this diarrhea progresses to something worse. She developed "Toxic Megacolon," where the gut simply is overwhealmed with the bacteria and ceases to function. This bacteria got into her bloodstream. The only option was to surgically remove part of her colon. However, she was in such bad shape that her mortality from this procedure was 100%. And without the procedure, it was 100%. There was nothing we could do, except let her die. And that is what she did, after a few hours.

I plan on going to the autopsy tomorrow. It seems right to see everything through till the last steps. The permanence of it all is stifling. From joking about her kids just a few days ago.... to this. I hope she did not suffer too much through it all.

My Backpack

I'm going to Portugal in about a month. I always travel with my large camping backpack, a trusty REI Valhalla. I first got it in the 8th grade, when I figured it would be easier to carry everything with me rather than keep going to my locker. Other kids called it my "body bag" and suspected that there might be some dead person deep in there. After all, it was about as big as I was at the time.
However, after 12 years of service, it didn't look quite up to the trip. The stitching on the bottom was starting to come apart, and the waterproofing on the inside was flaking everywhere.
I remembered that REI has a 100% satisfaction guarantee. So I put it in the car and drove to a nearby store. I went to the customer service counter. The man was very nice, but he couldn't find the bag in his computer system (it was too old). So after a bit of discussion, he offered me a $60.00 credit. Sounded fair to me.
Then I went backpack shopping in the store. The salesman was very helpful, but when I inquired about one of the packs, he said, "Oh, no way. If you think a 12 year old bag is returnable, that won't be nearly tough enough for you!" Point taken.
So I shelled out a hundred bucks on a Kelty Coyote 4900. Hopefully it will last me many more years. And it too has a lifetime warranty! I'm keeping the receipt though.
But right now I'm really missing that purple REI bag. It went to school with me for years. Countless camping trips. Probably 10 times across the Atlantic. London, Paris, Rome, Nice, Naples, Avignon, Cambridge, Frankfurt, Montreal..... I kind of want to drive back to the store right now and get it back. Maybe I can sew it back together.