an itinerant observer

I will never forget the day when I learned the meaning of stress in the Emergency Department (ED). There was a massive multi-vehicle road traffic accident and many patients were brought in, pulling away most of the ED doctors and nurses on call, leaving the rest of the ED at my disposal. I was focusing on a procedure to save a man with a life-threateningly low blood pressure, when a nurse approached me with an electro-cardiogram of a new patient. Even at a distance, I could see he was suffering from a massive heart attack. And if anything worse couldn’t have happened, there was an overhead page for another trauma patient. I felt my blood pressure rise and I said to myself, “I can’t do this anymore!” What makes ED physicians not only stay calm, but function at the height of their game in face of an emergency? Some people may be a natural at this. But for those who are not, including myself, I have learned that we can rise to the challenge, eventually surprising ourselves. In or...

My ER shift started in chaos. “Does it have something to do with today being Friday the 13 th ?” I wondered, although not really being all that superstitious, I knew it was just a momentary thought. On bed 13 lay Aleya, a 13-year-old previously normal and healthy girl, youngest of 13 siblings. To add insult to injury she got ‘tubed’ (intubated), unsurprisingly, at 1300 hours. But I get ahead of myself, so let’s start at the beginning.       For the past 13 days Aleya had been running ‘very high’ fever, not confirmed by a thermometer. “Jism bahut garam tha” [body felt really hot] said her 18-year-old brother, repeating the fever-detection-by-hand story that I must have heard over a thousand times already since starting work in the pediatric ER, just a few years ago.  I didn’t say anything to Aleya’s brother then as I was tired of getting on the soap box about inaccuracy of that approach for fever detection. “Get a thermometer next...

Not too long ago I was on call as the resuscitation room supervisor. At the beginning of my shift I had no idea that the day was going to leave such a deep impact - one that would perhaps remain etched on my conscience for the rest of my life... The full narrative was published by Annals of Emergency Medicine and may be viewed at  http://www.sciencedirect.com/science/article/pii/S0196064416301883 [from   Narrative Medicine ] CREDITS : About the Author: Dr. Fareed Ahmed , recently graduated from the Emergency Medicine Residency Programme at AKU. He has also completed a Masters in Clinical Research from AKU.   Acknowledgement: A version of this narrative was first published by the Annals of Emergency Medicine .  Editorial Note:  This is from a 'phase II' continuation of Narrative Medicine at AKU - what started as a Workshop-based initiative on January 20 th , 2016. The editorial work was performed by  the Writ...

I am an emergency physician, and dealing with life threatening emergencies such as sudden cardiac arrest is something I do daily. I am not a storyteller, but today I am going to tell you a story that changed my life and my attitude toward being an emergency physician altogether. It  is the story of my mother.... The full narrative was published by  Annals of Emergency Medicine  and may be viewed at   https://authors.elsevier.com/ a/1UDwsib7DumPQ [from   Narrative Medicine ] CREDITS : About the Author: Dr.  Mirza Noor Ali Baig completed his MBBS in 2006. Since January 2013 he has been an Instructor in the Dept. of Emergency Medicine at the Aga Khan University Hospital. His areas of interest include medical emergencies and timely resuscitation.  Acknowledgement: The full narrative was published by  Annals of Emergency Medicine  and is available to be viewed at   https://authors.elsevier.com/ a/1...

“What the hell are you doing doctor, are you insane?” shouted the consultant at his trainee who was presenting a case, while standing in the resuscitation bay of the Emergency Department (ED), surrounded by nurses, patients and their family members. I was shocked and intimidated while observing this man scold a trainee doctor. He was tall, dressed formally in a red tie and a pristinely white starched lab coat. One look at him and anybody would have quickly noticed that he exuded authority. The poor trainee, visibly shaken, was trying to hold on to the medical files and other instruments from slipping out of his hands. He was also trying dearly to hold on to his wits, I could tell. The ED is a dynamic place that sees several consultants at any one time, called there for expert opinion on patients. But the ones that catch my attention the most tend to be the crankiest and meanest of the lot. How they cope with their lives outside of the hospital mystifies me. Being the ED superv...

Illustration / Photo-credit: Ansul Noor 1 am. The witching hour had passed. But for us ER doctors, the hours have no name. It was a chilly October night and a Twilight-Zone calmness gripped the steely corridors of the General ER of Dubai Hospital where I worked. The fog of silence languidly crept through every examination room lending an almost dream- like air of solitude to the usually jam packed and chaotic world of trauma and emergencies. For an ER doctor, lack of chaos can be distracting and I battled to keep my wits about me and stay busy in my head since the quiet had started to creep inside my soul as well. Before 1 am. I set about applying the finishing touches to a few admission notes; a man in his 50’s with liver cirrhosis, a child with febrile convulsions, and finally, a lady who had presented with an acute abdomen and anemia. With little gap between patient intakes, I scurried from one room to the other, preparing all the initial lab/diagnostic work-u...