Critical Care is So Not for Me!

Over the past two days one of my patients has deteriorated rapidly. His liver is not functioning anywhere near par and he's become much more confused, to the point where he doesn't recognize his wife. The problem is, we can't figure out what's wrong with him. We have run a laundry list of tests to no avail and have not found anything to explain his symptoms. Just last week he was in great spirits joking with me and I really thought he was making a turn around. I knew yesterday was a bad day, but I hoped so much today he would be back to the happy guy of last week. He's not. Right now the prognosis isn't looking good and when we were talking to his wife today I nearly burst into tears. She's done everything in her power to care for him and she sits with him all day everyday. It hurts me thinking about my patient dying, but it also hurts me thinking that this wife will be losing her husband. Fortunately she has kids in the area, but no one can replace the man with whom she's spent the majority of her life. None of us has a crystal ball, so I really don't know what will happen, but today he did not look good.

I know in pediatrics I'm gong to have patients who die, but fortunately most of my patients will be healthy and only the minority will be chronically ill with a poor prognosis. I'm glad there are people who can deal with critically ill patients, but I am not one of them and will never pretend to be.