Saturday, May 24, 2008

Some Things are Worth Waiting For

Back as resident we had a 30 year old man come in for a bunch of extractions (I'll call him John). John was born with trisomy 21 (Down's syndrome) and all of the associated complications associate with the genetic abnormality, not the least of which was a severe cardiac defect, a bleeding disorder (von Willebrand's disease) and development delay. Where a normal oxygen level is 97-99% John's was 50-60%. Even this minor surgery was not taken lightly (he had multiple abscesses and the concern was that it would affect his heart) so cardiology, anaesthesia, hematology and several other specialties became involved.

Despite John's health concerns, however, he was the sweetest, nicest person I'd had the pleasure of meeting with a heart of gold. His mother stayed with him continuously. John showed up for the OR with an E.T. doll for security and kept it with him his entire hospital stay. He thanked us everyday, would not let us leave his room after morning rounds without a hug and was an all around pleasure to care for. Anyway, after the extractions and anaesthetic he stayed on the ward for close to a week as we tried to get his oxygen levels back to normal. Everything was going OK until post-op day six when I was called to the ward and found my friend in dire straights and his mother screaming "he's dieing". John had developed a pulmonary embolism which lowered his oxygen levels even further, decompensating his fragile heart and within 10 minutes it had killed him.

Jump forward 15 years and I'm running around trying to keep up one day when I walked into a room to be faced by a 30 year old female with Down's (I'll call her Deborah - not her real name). The first words out of her mouth where "sorry I'm late Dr. Furst but I had to have my lunch and brush my teeth before I came". It's easy to look at the day and worry about running 15 or 20 minutes behind but it is memories and people like John & Deborah that remind me why we work so hard to make health care accessible to people. Some things are definitely worth waiting for.

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