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So Much More Than A Business

Some days I shake my head at the choices we make behind the curtain.  Some times I remember why.
Yesterday, we watched hordes of people going in and out of a room crying over an intubated man.  Lung cancer had aged him beyond his years.  He was not healthy.  He was a respiratory arrest with a terrible lung disease.  He was intubated.  He coded... meaning his heart stopped.  Everything was done to revive him.  Hundreds of dollars worth of medicine to keep this man alive.  Resources were pushed into that room as other patients waited.  Every time he took a downward turn, weary nurses and techs dropped what they were doing and ran in.
His family got word.  And I mean allllllll of his family.  They all showed up.  In and out of the department they went, taking up space in the hallway.
We took care of over 180 other patients yesterday.  It seemed like a waste to keep pouring all of our resources into a patient who would never have much more of a life.
Years ago, my partner and I answered a call for an elderly lady in respiratory distress.  When we got to the house, I realized who the patient was.  The family was distraught.  There was mom/grandma lying on the dining room floor looking deceased.  There was no rise and fall of her chest.  I grabbed the bag valve mask and started artificial respirations with oxygen.  She was revived... miraculously without any other intervention.  We loaded her up and brought her to our local hospital.
The lady from years ago lived another week.  Turned out, she had a terminal lung disease.  The family knew it, but they weren't prepared for it when she collapsed. 
The lady had three children and many grandchildren.  The kind of old fashioned family that gets together for holidays and has many memories of their cousins being their first friends.  They all had time to prepare that the end, that death, was inevitable and ok.  In that week, they all had time to gather, support each other and to say goodbye to their beloved grandmother.  I know this, because months later one of the grandaughters saw me out, told me and thanked me for our efforts.
Emergency medicine isn't a business.  If it were, we made irresponsible business decisions keeping a terminally ill elderly man alive using expensive medicines and pulling resources from the rest of the department.  Emergency medicine is people.  This is why we fight so hard for life.  Not just for our patients, but for their families.  A reminder of a patient from years ago, gave me a reality check of what we did and why we did it yesterday.  We do this to help others who are in need of our help.  We do not do it for the money to be made.  Emergency medicine is so much more than a business.... it's people.

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