"I had this patient before medical school when I was an EMT and he still sticks with me:
A 20-year-old male, motorcycle vs SUV; SUV won. We arrived on scene to a man face down in a pool of blood. We were told he was wearing a helmet, but it was nowhere to be found. He was about 30 feet from his bike, and there was a clear trail of blood to the bike because he wasn't wearing leathers. We rolled him onto the board, and that was the first beating heart I ever saw. His road rash was so bad it eroded his chest wall, and we were staring at his heart, a collapsed lung, his great vessels, and the branches of the brachial plexus. Amazingly, they were all intact. Of course, he had multiple injuries to his other extremities, mandible, zygomatic arches, etc. but we frankly didn't care at the time. We were on scene for no more than two minutes before we sped off to the trauma center. I remember transferring the patient to the chief of trauma surgery whose first words when the trauma pad was removed were 'Holy crap!' I thought for sure he died.
Fast forward two years when I was at my primary care physician's office for a checkup after my medical school interview and saw a collection bin for a veteran's wedding. Guess who? Yup, it was him. They had taken his left arm to reconstruct his chest since the nerves were shot and he recovered."
"I had a medical rotation where my consultant was an endocrinologist. We had a young man with type 1 diabetes who would present weekly in diabetic ketoacidosis (DKA - actually a medical emergency as can cause coma and death) from not taking his insulin and just eating whatever he wanted. Always self-discharged once he felt better.
In my last week of the rotation, he came in after overdosing on IV opioids - found by his family after no one had any contact for about 24 hours.
His temperature was 24 degrees Celsius in the ambulance, and the pH of his blood was 6.76 (7.35-7.45 is normal, less than about 6.8 is not generally compatible with life). The paramedics (who all knew him) genuinely thought this was it for him, as did all the ICU. But as the old saying goes, you're not dead until you're warm and dead (in that at cold temperatures, your metabolic rate can be slowed to the point where it appears you're deceased however on warming, your body resumes more normal metabolic function).
Warmed him up in the ICU, treated his DKA, and he survived. I rotated away to another hospital before he was discharged, but he was out of ICU when I left - awake and interactive."
"When I was in trauma surgery, I got a notification about a man who was shot three times in the head. He comes in, one eye hanging out of the socket, blood everywhere, and he's slumped forward. Apparently, he was shot in the temple, exited out his right eye socket, in the nose exited from the roof of the mouth, and in the cheek one with an exit from the side of the head. At this point, I'm thinking they just brought him in so we can pronounce him in the ER because he looked dead. I go to examine him and tilt his head back, and he says 'Yoooo be gentle!' I jump back and scream like a little boy, as did everyone in the room. The bullets missed his brain in every single shot."
"My family has had trouble holding on to health insurance for many years, but my sister's annual heart checkups have been a priority. She was born with Ebstein's anomaly of the tricuspid valve, which basically means blood leaks backward and pumps oxygen inefficiently. One year, her appointment got postponed a few months due to a switch in providers.
My sister was in 10th grade gym class and having trouble running every day. That's what she told us -- 'I feel sick after class' which we thought would mean she got lightheaded. Turns out she was puking every class due to the exertion. My parents immediately decided that checking up on her heart would be the best decision and thank god they did.
Her cardiologist said her heart was 'the size of a small watermelon' and it was 'an absolute wonder' she was only puking and not passing out or dropping dead if she was running a mile in less than 30 minutes (and I think her mile was under 15). He said it was one of the most advanced states of Ebstein's he'd seen, if not the worst currently unoperated case in the country (US).
Basically, she had to have an emergency open-heart surgery (Cone procedure and Bidirectional Glenn at Boston Children's), and now, four years later, she's still on medication and is looking to get a pacemaker. Unbelievably, the jerk gym teacher still gave her a B- final grade."
"I got sick when I was 19 years old. Soon after, I had returned from hiking the Pacific Coast Trail. I was sick enough to be hospitalized, sick enough that all of my family flew out to talk to me, sick enough that my doctor told me, 'You're going to die soon. This is a reality. We do not know what is wrong with you, and if you live, it will be under a power greater than me and my colleagues can muster. I'm keeping you in my prayers.'
It was at that point, while enduring multiple organ failures, that I tried to make peace with my short time left on earth. For a week, I was as ill as anyone who was dying in the ICU with me. I spent 80 of those hours in a coma, and the rest in a partially waking/resting state that was painful and awful. On the eighth day, I could feed myself. Although it was difficult because during the previous seven and a half days my body destroyed about 30% of its muscle mass in chunks in various places.
While I was making the attempt at feeding myself, the doctor poked his head in and said, 'You might be getting better. Whatever you're doing, keep it up. How's the pain?'
Well, the pain was bad, but I wanted to live. Within a week, I was standing, and six months later, you wouldn't have known I was ever sick.
The attending physician while I was in the hospital who said these things to me and talked to me saw me in his office about three months into the recovery process. He said, 'I do not know how you lived.' The doctor then told me that he had told my family to make arrangements for my death right after that initial conversation and that when I had slipped into a coma, he was sure that was the end of it.
That's my story of medical trauma."
"I had a pedestrian vs train once. He was stumbling home wasted and passed out on the train tracks. He was hit by the front of the train, bounced to the side, got hung on the side of the train, and then dragged 100 yards while the train was stopping. He ended up being in a coma for a week and was paralyzed from the waist down, but he lived with no major neurological deficits.
I had a patient once with throat cancer and his tumor ate through his carotid artery. Due to cancer and a previous surgery, he had a fistula (a hole) in his neck. He and his wife were at home and he was dozing in the sunroom. Wife goes to the kitchen and comes back to see him covered in blood and bloody handprints on the glass door where he tried to open it and get help. He had perforated his carotid artery, and the blood was pouring (spurting?) out of his fistula. This tiny old lady pulled the drapes from the window, jumped on his neck, and pushed her life alert button. Somehow, she held pressure enough to keep him from bleeding out, and we actually saved the man with very little neuro deficit. People perf carotids in the ICU and don't survive the run to surgery, and he survived until EMSA got to him and got him to the hospital all because his wife thought quick and was strong."
Marcos Mesa Sam Wordley/Shutterstock
"I work with a dude that has a family history of heart disease. Not many males in his immediate family reach the age of 60. This man only has one vice, food. I've seen him in action. At one point, his caloric intake was over 10,000 calories a day. It's almost obscene how many burger meals and giant tubs of soda he puts away in a day. I don't know the count, but when he does need to see a doctor, they always marvel at how he is upright and not dead with his blood pressure so high. He's been told more than once that he should be dead."
"I do medical research which includes chart abstractions. I was abstracting a chart on a 90-year-old rancher in Montana, who was still an active dude without any major health issues. I was abstracting what led up to his minor heart attack and could hardly believe the ICD-9 codes, so I went into the more granular notes. A storm rolled in while he was checking on the cattle, so he hopped on his four-wheeler to get home. BOOM he gets hit by lightning causing him to wreck. He must have been okay because he got up and started hobbling home - only to step on a rattlesnake and get bitten. Shakes that off too and manages to get home only to have a heart attack while waiting for medical services to get to his rural home. This dude had ICD-9 codes for the lightning strike, motor vehicle accident, snake bite, and heart attack all on the same day. I spent four days in the hospital and went home seemingly no worse for wear. I hope I'm that resilient at 90."
"I was working as a helicopter retrieval doctor in Australia last year. I was called at 2 a.m. to a car crash in the middle of nowhere. The patient was 150 kilograms and five feet tall. She had been ejected from the front passenger seat of a car through the front windscreen and was wearing no seatbelt. She had lain undiscovered for three hours on the side of the road. The temperature that night was just above freezing. Her entire right scalp had been degloved. Blood pressure and oxygen saturation were unrecordable at all times on transfer due to shock, hypothermia and body habitus. Carotid pulse only. She was unconscious. Due to her ENORMOUS obesity, any movement of her head from the position she happened to land in obstructed her airway.
If she had landed in any other position, she would have had no way to breathe and died. It was a two-hour flight from the nearest trauma center. Unable to intubate her without prescriptions due to muscle tone. Scariest RSI of my life. (Prescription to paralyze then intubate) Middle of a paddock, on an ambulance stretcher, under lights, the patient placed in RAMP position. With best rewarming, we could do in the helicopter core temperature was 29 degrees celsius on arrival in ED. We didn't carry blood on the helicopter at that time. Survived and discharged neurologically intact."
"The patient was driving a motorbike. We were informed that dispatch had been sent to pick up a motorbike vs logging truck, and the bike was behind the truck when it lost its load of logs at highway speeds. The trauma team is activated; we have called for blood.
The guy walked out of the ER after a period of observation. When he saw the logging truck lose its load, he simply let go of his bike and fell off the back. Rolled a bit and got some bumps and bruises.
The second case, off the top of my head, was a 92-year-old lady with urosepsis (bacterial infection in her blood from a urinary tract infection). Her initial gas had a pH of around 6.7, and a lactate of 12 (too acidic and too high for the non-medical peeps - young patients would have a hard time surviving that let alone the very elderly). She was unconscious but had received one dose of Cipro (an antibiotic) by mouth from her family doctor before becoming altered.
The family agreed to a comfort (do not resuscitate) level of care and said their goodbyes.
The next morning, the resident on call got pages asking if Mrs. Blahblahblah could eat - she was awake and hungry. Guess the dose of Cipro kicked in."
"When I was in pharmacy school, I had a clinical rotation in a hospital with an infectious disease doctor. One of his ICU patients was in a coma. He had severe trauma from a motorcycle accident. My doc was just one of the doctors following him -- in our case it was because of sepsis from a perforated colon.
Things were not going well. He'd been in a coma for two weeks and showed no signs of coming out of it. The team of doctors (and me) sat with the family and discussed taking him off of life support. The family decided that it was the right decision. They said their goodbyes and I figured that was it.
But the next day I came in and he was still on my patient list. I went to the ICU, and there he was. Alive and actually awake.
Apparently, he woke up that evening after I left. And he actually started to get better. Less than a week later, he was out of ICU and in a regular room. And the next week he was no longer my patient because his sepsis had cleared and he no longer needed to be followed by the infections' disease doctor.
It was pretty dang amazing."
I once had a 20-something-year-old Jehovah's Witness as a patient who kept bleeding and bleeding after childbirth. Because of her religion, she refused blood transfusions. After other measures failed, we finally took her to the operating room for an emergency hysterectomy that saved her life. In a pregnant woman, the normal hemoglobin (the protein in your blood that carries oxygen) count is between 9.5-15 g/dL. When we took her to the OR, her hemoglobin was 3.1 g/dL. In the ICU after, it was down to 2.6 g/dL.
I remember talking to her before going to the OR, and all she could do was lie flat in bed. If she did so much as lifting her head, her heart rate would jump from about 130 to 180 and she started having chest pain. I also had to tell her A) that I didn't know if she would live through the surgery, and B) that I wasn't sure how much of an anesthetic I would be able to give her, so there was the possibility she might remember some of the procedure. Fortunately, she did survive and didn't have any recollection. If she wasn't otherwise young and healthy, I'm sure she would have died."
"I was an EMS for a few years and one day we came upon an accident on the highway involving a motorcyclist and a minivan. Usually, that is not good, at all. It's always a mess. We get there and find out he hit the minivan at 80 MPH while it was stopped on the side of the road and flew through the back window, through to the front and survived without a scratch on him, no broken bone, no AMS (altered mental status aka blunt head trauma). He even got himself out the van and asked if the people inside were okay. He was wearing a helmet and I think that saved his life.
It blew my mind."
Marcos Mesa Sam Wordley/Shutterstock
"When I was a paramedic student, I was doing a placement in my hometown which was a rural town of about 12,000 people, so there was a reasonably sized hospital. Around my former home, there were a lot of smaller communities ranging from 2,000 down to a few hundred people.
We get called first thing in the morning to the hospital to come pick up a guy who came in overnight and take him to the airport for transport via plane to Melbourne.
He's basically up in the hills where there's nothing but winding roads, wombats, and kangaroos where he came off his motorcycle after attempting to dodge some of the local wildlife that clearly didn't care about looking both ways before crossing the road. He's given himself a good old skittle down the road, picked himself up and dusted himself off and in true Aussie fashion decided, 'Bit messed up, better go get someone to take a gander at this.'
He self-presented to the local police station in a small town of about 1,500 people to say, 'Yeah, messed up a bit. Need some help mate,' at which point they've immediately called the ambos to come and collect him.
It's a two-hour drive to the hospital where they X-ray him and discover a cervical spine (neck) fracture and refer him to the surgical unit in Melbourne. Not bad for a bloke that's broken his neck and decided 'Screw it, better rock around to the cop shop to get this sorted out.'"
"We have a patient we see at our hospital monthly. Young guy, early 20s, absolute turd to take care of. He has diabetes and essentially refuses to take his insulin. He comes in every time with diabetic ketoacidosis, which is essentially your body going into a coma-like state due to your blood pH becoming acidotic.
The impressive part isn't that he survives this; most people do. It's that this is a recurring event every month, and each time, someone manages to find him/get him to the hospital. If he was ever alone when this occurred, and no one found him in a timely fashion, he'd be toast. I've been seeing him regularly at the hospital for the last 18 months I've been here."
"I'm a former vet tech and my neighbors had moved out and dumped their cat, a cute muted orange tabby. With a house full of animals already, there was no way I was going to take this one in. I decided to wait three days, and if the owners didn't come back, I'd call the shelter. The morning of day three when hubby and I were driving down the road, she did an in the middle of the road standoff between our Explorer and stubborn cuteness. We gave in.
Six months later, my daughters came running to me, telling me 'Thumbs' was acting funny under their bed. Vestibular out of nowhere, head tilt and eyes darting back and forth. Ugh. Piled everyone in the car and rushed to work on my off day. By the time we got there, she was dead, but having the kids with me and decided to go ahead and run her in as an emergency. All hands on deck and they did a full code on her. Epi to the heart, hooked up to a bag and they were breathing for her, and after an hour with some miracle happening, she started to come back.
We left her there overnight. I left strict instructions that if she passed again to please just let her go. I had no idea how long she'd been without oxygen when she died in the car and had to explain to the kids that she'd probably never be the same. Family decision made, we all headed home.
Middle of the night she coded again. Dead. Gone. Doc went against my express wishes and they did the same dance again. Epi to the heart, bagged breathing for hours and darned if she doesn't make a second comeback.
Dateline ten years later. Thumbs is still with us and enjoys her days living on her special windowsill. There's no reason whatsoever that she should still be alive. She has obvious brain damage. Does a lot of head pressing, has head bobbing like a Parkinson's patient, and yowls instead of meows. The strange thing is that she has super feline strength. Last time I took her in for a nail trim, it took three of us to hold onto her while the vet attempted it. She can get out of a burrito towel within seconds. If you try to bathe her, she can climb a wall while you have her scruffed. Oh, and chronically goes just outside of the litterbox because her depth perception is off."
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