Friday, May 3, 2013

What's Going On

The medical field is full of heart ache and tragedy.  If you work in a busy hospital or trauma center you will encounter the emotional distress of the  face to face interaction with grave illness, terminal sickness, trauma, and the like on a weekly basis.  Medical professionals all have a common core belief system; Provide the best health care possible no matter the local, circumstances, or situation at hand.

Even though, my time at St. Francis Hospital in Port Washington NY was short, it was a roller coaster of activity and emotion.  As my first professional employment as a certified Medical Technologist,
B.S.MT (ASCP), there were many acts of drama the helped to shape my professional character.  It was a winter night that I remember vividly.

A relatively young patient was admitted to the Heart Center and he was uncharacteristic from the norm for St. Francis.  Most patients were older 50+ with some sort of cardiac malady requiring open heart surgery by one of the accomplished thoracic surgeons.  This guy was different.  He was pushing mid-30's, thin, dark hair, and apparently sicker than his circumstance presented laying in a bed at a cardiac specialty hospital.  This poor slob not only had heart trouble but had viral trouble as well.  He was admitted in the afternoon and kind of was just there waiting around but in a bed.  I was called in early during the mid-evening shift to help out for some short staffing. My first duty upon arriving to the lab was to draw this man's blood to prepare transfusion cross-match testing.  He was destined for the knife the next day.

Arriving at his room, I had no idea what to expect from this unlikely candidate.  After introduction of who I was and my purpose, he laid out the ground rules.  He told me I must wear gloves to draw his blood.  I replied that I always do and it is required for all patients.  He then pulled up the half sleeve of his hospital gown to show me the marks on his arm; track marks.  He said, "I am HIV positive and who knows what else I have - You need to be careful!"  During the phlebotomy, he told me his brief story of drug abuse and how it has now ruined his heart valves.  His surgery for the next morning was to replace his heart valves.  I said good night and assured him he was in good hands with the best surgeons around anywhere.  He smiled and said good night.  Back in the lab I set up his bloodbank testing; 8 units of whole blood.

The next night I was scheduled for night shift, arriving just prior to 11 PM at the hospital.  It was a crisp cold New York night with a slight breeze.  Pulling into the parking lot in front of the hospital I saw a familiar sight; the helipad lights were on meaning eminent arrival or I just missed a departure of a medivac chopper.  I parked and walked toward the building.  In the distance I could hear the whisper of an arriving chopper coming closer so I stood my ground to watch the arrival.  Descending quickly out of the dark sky was not the normal medivac chopper - it was a Nassau County Police chopper circling overhead once then diving in for a very quick touchdown.  Emerging from the cockpit was a pilot dressed in all black helmet to toe.  Quickly, rushing around the front of the chopper he opened the side door of the cab and pulled a white box with the all familiar red cross icon.  A blood shipment?  At 11 PM?  Transported by Police Chopper?  Something big was going down.  As quick as he entered the building the pilot returned to his running chopper blades a spinning, Jet-A fumes and all.  Within seconds the chopper was leaving the ground and headed into the darkness.  I knew then my night was going to be bad...even without the starting helipad drama this was going to be a solo night working the shift by myself.

Arriving at the lab I quickly took report and learned what was so big a deal this evening.  The patient who was the drug abuser had his surgery that afternoon and his condition was not good.  All 8 units I set up the night before were transfused, 6 more were set up during day shift of which he was given 4; two were left on the shelf.  The Police chopper just brought an additional 8 units of his blood type which was all that Long Island Blood Services would relinquish to St Francis for the day.  Drama was thick in the lab, lots of blood work for this patient and other patients who were post-op that day.  The drama was interrupted by the bloodbank phone ringing.  It was the BB supervisor.  He wanted report about what the chopper brought in and what was requested by the surgeon.  I said 8 received from the police chopper, 10 ordered by surgeon, 2 units still on shelf.  The supervisor told me set up all 8 - hopefully they will not need them.  He said I'll be in early before 6 AM.

It was not long into the shift when an ICU nurse arrived at the lab in hurried fashion requesting the two units on the shelf.  I had already started the cross-match process for 4 of the 8 units just delivered.  She said the patient is not doing well, he is bleeding, we need FFP and CRYO, and when can more units be ready?  I said you can have anything you want right now -  uncross-matched; just complete the form.  She said they are not ready for that yet - but hurry Please!  I started the cross-match on the additional last 4 units.  Now I had two sets of 4 units in various stages of the cross-match testing.  Just prior to the AHG phase spin what happened next I will never forget.  A small radio in the blood bank started playing Marvin Gay, "Whats Going On".  Just about 1 minute 40 seconds into that 4 minute song the ICU nurse returned to BloodBank.  There I was sitting in front of 8 whole blood units almost ready to sign them out for her.  She was not hurried, she was calm, she was distressed.  She came in and said "relax - he did not make it".  That is all she said.  She turned and walked away.  I sat stunned for a minute.  I looked at the scenery.  The lab, the bench full of whole blood units, the centrifuge spinning, the freezer full of FFP and CRYO, the two blood washers standing at attention against the wall.  That was it.  The song was ending.  Now just quiet.  Apparently there was some sort of technical difficulty with the station the radio was tuned to because there was radio silence for a moment.  The patient expired, the drama was over.  I placed the units of whole blood back in the refrigerator.  I left the bench to get a cup of much needed coffee.

Over the brew, I thought...what is going on?  A man destroys his body with drugs, another man tries to sew him back together.  Humpty-Dumpty's men and women could not put this man back together as whole.  The end.  I drew this patients blood less than 36 hours previous.  He would soon be occupying the morgue just steps away from me now.  Fortunately, there was plenty of room "At The Inn" tonight.

Life is fragile.  Take care of all around you.  Take care of your pets. Take care of yourself.
Good day my friends.


Anonymous said...

What a story, wonderfully articulated. I thoroughly enjoyed reading this. You never told me this story. Powerful. I follow your footsteps, career-wise. I will enjoy your blog, Dad. I love you. -Jes

Helen233 said...

That is so sad. All the hard work and worry of getting the blood ready and the patient slips into eternity.

I am glad I got my degree, glad I studied but not sorry I missed events like this. HIV was one of many reasons I decided to forgo laboratory science.
Interesting as it was I will live vicariously through your stories

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