Wednesday, October 14, 2009

Till Death Do Us Part


An 85 yo man and 84 yo female married couple arrived to the trauma bay after a head-on-collision in which the man entered the freeway going the wrong direction. Both of their injuries were critical. The man sustained a severe pelvic fracture, and his wife had a hemothorax (blood in the chest cavity). The wife was more critical than the husband, so we intubated her and placed a chest tube to drain the blood.

Shortly after placing the chest tube in the wife, she became bradycardic and lost a pulse. After about 30 minutes of resuscitation, she died. Afterwards, I went over to the husband to reassess him. He kept asking me "how's my wife?" I couldn't answer him. I proceeded to get the CT scans that he needed. He again kept asking everyone "How's my wife?" At that point, we debated not telling him until he got to the floor. He kept asking and then said "We have been married for 65 years." We told him....and it seemed he let go. He died later that afternoon, shortly after he was told that his wife passed away.

-Doc senstive

12 comments:

TechnoBabe said...

That would be such a hard decision to tell the man about his wife. Maybe he knew he had a decision of his own to make.

Mel said...

My maternal grandparents will have been married for 73 years assuming they both make it to their anniversary in December. The expectation is that my grandmother will likely go first, but my grandfather will likely just give up and follow closely behind her.

enthusiastic said...

Why didn't you tell him the first time he asked after she had died? I don't understand why you withheld that information.

ERRN4U said...

Sad and beautiful. I'm lad for them that they passed together.

Reality Rounds said...

"Why didn't you tell him the first time he asked after she had died? I don't understand why you withheld that information."

If you ever had to give this kind of information, you would understand enough to never ask that question.
It does give me comfort that they died together. It is very possible for someone to die from a broken heart. I have seen it. May they rest in peace.

Suicide Barbie said...

A poignant tale. It must be utterly unbearable to be the bearer of such sad tidings and truly terrible to die of a broken heart.

tracy said...

i think this is what will happen with my elderly parents. Bless them.

Gert said...

"Why didn't you tell him the first time he asked".....

A patient of mine was in the hospital for chemotherapy when we got word that her family had been in a car accident while en route to visit her in the hospital. Her husband was killed instantly.

There was a lot of dithering....no one was in a hurry to tell her, but she was expecting them. Her son was trying to avoid coming in to tell her, while we made several phone calls trying to get someone in the family to come in to be with her when she was told. Hours later her son finally came in. It was the most difficult shift I can remember.

It ain't easy. Docs and nurses are sensitive and it doesn't come easily. No one with a heart just blurts this stuff out.

Anonymous said...

Plus we are supposed to do no harm and sometimes that info Canberra harmful

enthusiastic said...

You're right, thank goodness, I've never had to tell someone that someone they've loved has passed away. But I am a nurse and I do have to share bad news when patients take a turn for the worse with families. And I believe in honesty. I take issue with the fact that the patient was asking and nobody would tell him the truth.
It was a frustrating thing when my dad was a palliative patient in the hospital several times before he died, that nobody wanted to be straight with us. Of course it's difficult to hear and I am thankful for the doctor that took the time to talk to me honestly about the chances of him dying at home, blood clots, SBO's and whatever. And no, I didn't burst into tears or rage during the discussion, if that's what you're afraid of.
What I don't understand is how telling someone now when they first ask is worse than telling them 4 hours from now after you have ignored their concerns, increased their stress levels, had them worried for hours, and withheld information.
Anonymous, I know that information would be hard to hear and possibly "harmful", but I don't understand how waiting a few hours would make it less "harmful".

Anonymous said...

This is doc sensitive. We didn't tell him right after her death b/c it was chaos. Tons of people in the other room coding her and people in his room trying to stablize his pelvic fracture. Our thoughts, at the time, were to wait and let things settle- especially stablize the husband. Not sure if it was the wrong decision, but telling him in the middle of chaos with him unstable seemed like adding fire to the flame. Doc sensitive

enthusiastic said...

thanks for the response.