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Fighting for life: inside an emergency room during a medical crisis

Ton La, Jr., MD, JD
Conditions
April 16, 2023
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The emergency room was bustling with activity as the medical staff worked to stabilize the patient, who was lying unconscious on a hospital bed. His wife sat anxiously by his side, tears streaming down her face.

It wasn’t the first time 70-year-old Mr. Smith had been to the emergency room. His past medical history included high blood pressure and cholesterol, but his non-compliant attitude towards medication had put him at risk. For the past month, he had not been taking his antihypertensive medication, a fact that his wife had been concerned about but was unable to change her husband’s stubborn attitude.

Today, however, was different. Mr. Smith had woken up with left-sided weakness and numbness, which quickly spread to his upper and lower extremities. He also had trouble speaking and was disoriented, all signs of a stroke. He was immediately rushed to the emergency room, where they ran tests and scans to determine the root cause of his condition.

The CT scan of Mr. Smith’s head revealed an intracerebral bleed, a hemorrhage in his brain that had caused damage and swelling. The doctors had to act fast to try and reduce the pressure on his brain, but the situation was dire. A repeat CT scan showed a right thalamic intraparenchymal hemorrhage extending to the third and fourth ventricles, with increased diffuse cerebral edema and increased midline shift from 5 mm to 11 mm. The swelling was putting pressure on the critical structures in the brain, and something needed to be done to alleviate it.

The decision was made to intubate Mr. Smith. His slurred speech and confusion made it difficult to communicate, and the doctors needed to make sure that he had a clear airway to keep him breathing. His wife watched in fear as they inserted the tube into her husband’s throat, knowing that he was fighting for his life.

The neurosurgeon was consulted immediately. They worked tirelessly to reduce the pressure on Mr. Smith’s brain. They injected medications to try and reduce the swelling, but the situation was bleak. The bleeding was causing severe damage, and the edema spread throughout his brain. They were fighting a losing battle.

The medical staff worked around the clock to monitor Mr. Smith’s condition. His wife was there by his side, holding his hand and praying for a miracle. She knew her husband’s stubbornness had put him in this position, but she couldn’t bear the thought of losing him.

For the next few days, it was touch and go. Mr. Smith’s condition remained critical, and the doctors were unsure if he would recover. But slowly, his body began to respond to the treatment. The swelling in his brain started to decrease, and he began to regain some of his movement and speech.

It wasn’t an easy road. Mr. Smith had to undergo weeks of physical therapy and rehabilitation to regain full control of his body. His wife was his constant companion, supporting him throughout his recovery. But with time, he slowly made progress. His strength and mobility improved, and his speech returned to normal.

Eventually, Mr. Smith was discharged from the hospital, much to the relief of his loving wife. It was a close call, but he had survived the intracerebral bleed against all odds. Looking back, he knew that his non-compliant attitude toward his medication had put him in a dangerous position, but he was grateful for the second chance at life that he had been given.

The experience had changed him. He no longer took his health for granted and was fiercely determined to live life to the fullest. His wife smiled as she watched him do his daily exercises, knowing their love had helped him return from the brink of death. Together, they knew that they could face any obstacle that came their way.

Ton La, Jr. is a physician and can be reached on LinkedIn.

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