The lesson every medical student can learn from emergencies

Finishing my ER shift for the day, I waited for the shuttle at a busy intersection. Within a minute of drowning myself in music, I saw an obese man at the bus stop suddenly collapse to the ground.

I removed my backpack and ran the fastest I have ever run in my life across the street to him.

His body was shaking violently, and I waved and yelled to the nearby police officer.

“Hey! Help me over here officer!”

I wrapped my arms across his back to pull, and the moment the officer came to push we slowly rolled him over onto his back. I immediately recognized him; he was a patient seen in the ER earlier for a breakthrough seizure.

Foam was quickly forming and exiting out of his mouth, and we pulled him upright against the bus stop sign and leaned him forward.

“Sir! If you can hear me what is your name?”

No response. His uncontrollable jerking movements were in the driver’s seat, and I knew we had to bring him into the ER somehow.

“Look after him I will be back with a chair,” said the officer. As he ran through the ER sliding doors, it was only the man and me.

That morning around 10:30 a.m., I was with Team A seeing patients at one end of the ER bay. A man in his 40s wearing baggy jeans and a Cowboys sweatshirt was rushed to an open bed as he was actively seizing. Team B saw this patient, but the immediacy and urgency of the matter kept me aware of the man’s presence during my entire shift.

An hour later at 11:30 a.m., I saw a towering woman storm the ER and demanded to speak to the head person.

“Why is my brother being discharged? He hasn’t had a seizure for two years on meds — but out of all days, he has one today. And you people are discharging him without finding a reason?”

“We have stabilized your brother, and he’s regained consciousness. If he begins seizing again once home, please call 911 immediately,” I overheard a Team B resident say to her.

“Curse you all! All you do is put bandages on things and not find solutions!”

She abruptly left the ER without coming back. And about 20 minutes later, the man left the ER too with his belongings. As he slowly walked past me, we made eye contact. I immediately sensed he was not entirely himself. He was absent from what was going on in the present. He was not a patient on my team, and as a medical student, I was scared to overstep boundaries. Looking back, I should have spoken up for him.

Only 30 seconds passed before I saw the officer with two nurses wheel the chair to the man and me. He was slowly regaining consciousness as we all lifted his body on to the chair, but as soon as we finished strapping him in, he started to seize again. Now more violently.

At that very moment, I thought he was going to die.

“Let’s move now!” said a nurse.

I found myself controlling the chair into the ER and through the winding hallways. At sharp corners, I slowed the chair down while avoiding people that stood by and watched. As we made it to the shock room area, a doctor motioned me to shock room B. All of us with great haste removed the straps, lifted him onto the bed and strapped his torso and limbs to the bed.

“We’ll take it from here,” the physician told me in the calmest voice I’ve ever heard in an emergency.

I anxiously stood outside the shock room as I witnessed the orchestra unfold. One person pushed medications, another started an IV, someone was checking vital signs, another was calling family members to get a history. I’ve never seen anything like it.

A few minutes into the action, a resident was asking me for my story to have in the patient’s note. I told her everything I could remember.

“Here is your backpack, by the way, thank you so much for staying around and being the first responder.”

I still had adrenaline pumping through my veins, and all I could do was nod.

When I returned to the ER the next day, I learned that the man was transferred to the neurology inpatient floor for further assessments. Probably an EEG and reevaluations of his seizure meds. I don’t know what became of him, but I hope he is well.

In a few short years, I will be a resident physician where I will encounter more situations like this one. Even though I never wished I had this experience, I am thankful I did. I am even more grateful that the outcome was a positive one because sometimes the result is unfavorable and even sometimes lethal. The one lesson that I will carry with me forever is always to be aware of those around you because you do not know when someone will be in need of your immediate help.

All names and events have been altered to protect confidentiality.

Ton La, Jr. is a medical student and student editor, The New Physician.

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