Friday, December 16, 2016

A good save

There are very few diseases/illnesses that I see each day that are really rewarding, as a doctor, to treat.  There are very few conditions where the medicine I give a patient makes a significant difference that they or I see.  Treating someone's asthma exacerbation is definitely one where I have seen patients on the brink of death and have seen them come back after treatment, and it is quite rewarding as a doctor, to know you played a part in helping that patient come back from the brink of death.  Outside of asthma, almost all of the other patients I see have a chronic condition requiring medicines to control their illness or an acute condition requiring medicines to help them feel better, but few medicines change the condition significantly.

Cyanide poisoning is definitely, one of the other conditions where administering a medicine can make a life saving difference.  In the past 9 years, I have seen numerous kids and adults present to the Emergency Room in varying stages of Cyanide poisoning after eating undercooked bush beans or tapioca.  A few times I have, helplessly, stood by their bedsides and have had patients die because we didn't have the medicine we needed to treat them, but thankfully more times than not, I have stood by their bedsides administering the medicine and seen them go from near death to life in just a few minutes.  Even when I haven't been the doctor at the bedside, I still find it rewarding that we are able to seemingly alter the course of one's life by administering the cyanide poisoning antidote, and kids/adults go from near death to life.

Last night, Bill was called to the ER for a kid that was unconscious and near death.  The family had little to offer history wise, when they last saw him, he was healthy and fine, and then they found him unconscious hours later outside and rushed him to the ER.  As Bill started to ask questions, he quickly focused on the things that can cause someone to go from being healthy to almost dying within hours.  In our setting, cyanide poisoning has to be right up at the top of that list.  The poison beans grow everywhere (including my garden) and tapioca is a staple in many's diets, but if they aren't cooked well cyanide poisoning results.  The family didn't know if he ate beans, but knew he was often out in the bush eating the foods he found, there were no other leading diagnosis, so Bill started treating him and very quickly the unconscious kid started to respond.  As he kept giving more of the medicines the kid continued to respond, to the point that he was able to talk and when asked he told his family about picking the beans in the bush and cooking and eating them.

The next day, the kid is sitting in bed without any complaints wanting to know when he can go home.   We reminded him that he should never eat the bush beans again and was sent home.  I don't know if he or his parents will ever understand how close he came to not being with us today, but their understanding or gratitude doesn't change the joy that I felt in seeing this boy alive and well.  This is one medical save that doesn't get old.