Death. This whole charade revolves around death and no one ever bother to tell us that it’s going to get this ugly. They really sell it too high. Being one of the biggest health centers in Indonesia, RSDS bond to receive the most complicated patients out there. You won’t get any diagnosis as simple as Diabetes Mellitus. Dengue Fever. Acute Viral Hepatitis. It’s followed by at least 5 other grave conditions. So death does revolve around here. We get used to do CPR in any of our day-night shift. There were nights when we did CPR on 5 patients in a row; left us with long lasting soreness on our back. The thing is, no matter how many CPR you performed, how terminal the condition was, how predictable the outcome was, you- I would never get used to the sight of a person, human struggle til their last breath. Watch as the light faded from their eyes, as their bodies went cold. I could never do a CPR without shedding a tear or two. Silly I know. But as you push your fist down on their chest, you get this torn feeling of wanting to just let them go in peace or helping them back to life. Well, that what gets me upset the most, like they’ve suffered enough, their bodies literally have been stuck by every size of needle existed, nasogastric tube, urine catheter, and stuff. I can assure you it’s nowhere near comfy. Not to mention in certain condition where their bodies were swollen, blood and liquid oozed from every pore. I was like, what’s the point? Let them die in peace. For the record I’m talking about CPR in terminal cases. It’ll only add more harm, I think. Add even more bruise and broken bones. Even if their heart starts beating again, even if they get to breathe spontaneously, what’s the point? Can we guarantee their life’s quality? Will they be able to function? Independently? Sadly people still think that CPR will fix everything. So yep, don’t blame me if I get emotional over CPR.
Or is it the family that gets me so emotional? It’s not easy to watch the family get their hopes up only to get it crushed down. And the aftermath is the worst. Worst worst worst thing. Some people make an outburst. Lots of wailing and crying and talking nonsense. Some people take it rather calmly, already know what to expect. But there are also a few people who are angry, finding it hard to accept the fact that their loved one is gone, blaming us for not doing the best we can. As if.
Last night a 20 yo girl was being admitted for Acute Leukemia with very low platelet count (30.000). In the afternoon she had high grade fever, up until 40C. She was delirious. Kept asking her parents to set her on the ground as her hands continuously grasped into thin air for God knows what. Her parents tried so hard to calm her down. Her mum even had her old pink stuffed bunny and asked her to hold onto it, hold onto “cinta” she called it, probably hoping that the stuffed bunny would somehow anchored her to reality, present time. A flask of paracetamol later her fever subsided, she calmed down, but somehow her breathing was becoming faster and deeper; khusmaul. Sensing the end was near, her dad burried his head in her neck and started whispering “Allah” non-stop, guiding her, just in case. Her mom could only sob. Soon she was gasping, then stopped breathing. CPR was being performed; drew some attention in the already quiet ward- it’s literally in the middle of the night. Some of the old patients gave that understanding look, already familiar with the procedure and outcome. Other stared at us in shock, as if couldn’t believe they get to witness CPR in real life. I have to admit sometimes it looks more dramatic than what really is; depends on the PPDS, really. Seeing the pupils have dilated fully, our PPDS called it off. It’s only been like 10 minutes but I was relieved. Do no more harm, please. My eyes were glassy already. I felt as the wave of frustration hit me. She’s gone. She’s young. Too young. She’s only 20 and had like the world to explore. I instantly thought of my sister. The sound of her parents’ cries didn’t help at all. They clutched her body tightly asking her to come back, they have no other kids now, they’re all alone now. I grabbed the resuscitation kit in a flash, took her stuffed bunny off the floor and tucked it underneath her arms, then quickly went to KDM. Tears tempted to fall down. I was one click away to call my mum. I needed to hear my mum, or my sister; needed to hear her voice and know she’s still alive. But it was a bit after midnight and I knew I was being completely a sap. So I just sat there in the darkness, the sound of cries still prominent. I tried to focus on the sound of the old fan cracking instead. Making a melody out of it.
The other time I was in RPI (ICU) the patient; a 75 yo man with DMND V fell into cardiac arrest when his family wasn’t around. Apparently they went to pharmacy. When they’re back it was to the sight of their dad being resuscitated. The emotion doubled you know, having the whole family stared at your back, crying and sobbing as you “pushed hard and pushed fast“. (Not gonna lie, I always get carried away, something to work on in the future, I guess). The doctor gently informed that he’s gone and his daughter was like stunned and zoned out, while the other family members broke down to -more intense- cry. Then she came to me, hands clutching a plastic bag tightly, she started to ramble, “Doc this is the meds. Dad doesn’t need meds anymore does he, where do I put it down, it’s a lot of meds, there’s IV fluids, here’s the antibiotics, and some pills, here’s the spuit, quite a lot, it’s kinda heavy… He doesn’t need it anymore does he?” And my heart literally broke. I grabbed the plastic bag away and softly said no and that’s when she came into her senses, hard. She hugged me and cried. I let her. I patted her back and offered her my deepest condolences. I mentally chanted it’s okay it’s okay it’s okay it’s okay til my head went numb. Sometimes family need time to adjust and process what’s exactly happening. Trying to keep up with reality even if their heart refuse to. Sometimes it’s just too much and their subconscious mind take the short way and shut down instead. Render them completely unconscious, senseless; protect them from more heart-breaks. And it’s just…
I will never get used to this kind of scene? Situation? Ambiance? It’s one of the worst feelings in the world. No matter how much TOD and bad news you’ve announced, I guess there would always be a tiny tiny part of you that went soft for a minute or two. Even if you’re not in the tiniest way related to the patients, you would always find your day a bit gloom too. And I don’t give a flying fuck if sometimes you have the need to cry for no reason or just simply feel awful. It’s okay, I think. It’s what makes us human.
Rest in peace, Hilda. Your parents love you dearly. Love. Present time. Always.