The double doors burst open breaking the anticipatory silence. The ambulance had called ahead. The paramedics rushed the gurney into the emergency room bay. One person was on the gurney doing chest compressions. One of the other voices yelled, “62-year-old African American female found unresponsive…”
As the medical student, I had been prepped by my supervising resident. “Your job as the medical student is to get the ABG from the femoral artery. Do you know how to do that?” This was my first day in the emergency room, and my first time meeting this resident.
“Yes,” I nodded. I ran through the process in my head. ABG stands for “Arterial Blood Gas.” I had done one before. Palpate for the femoral artery in the groin, open the kit, put the needle into the artery, draw out blood, send the syringe to the lab. Wait for the results.
I stared into the face of the patient. Her eyes were closed, and her hair permed. She looked so peaceful, as if sleeping.
“Ventricular fibrillation! Continue compressions.” The compressions were the only thing keeping her pulse going.
The emergency room staff took over and hands went everywhere. Industrial scissors cut through the clothing to expose the chest and then the groin. Hands flashed, placing IV’s, central lines, and ekg leads.
In the middle of this, I froze. I had to navigate to get a needle across all these flying hands to the groin of the patient.
“Hold CPR. Still no pulse.”
Then everyone looked around, “Where’s the ABG?”
My supervising resident took the syringe out of my hand, deftly drew blood, and called for the nurse to send off the blood gas to the lab. A minute later the results came back and were yelled out into the room. Hands continued to move.
Fifteen minutes later, I was following the resident to talk to the family.
“When you deliver bad news, always get their side of the story first. Otherwise, you might never get the full story.”
We entered the room. “Can you tell us what happened?” said the resident.
I listened as the daughter spoke of her mother’s collapse. I listened as the adult granddaughter told us that she hadn’t been feeling well all day, complaining of stomach problems, that she knew something was wrong. I listened in painful silence as they spoke in the present tense as if their loved one was still alive.
When they had finished, the resident began. “Your mom was wheeled into the emergency room. We did everything we could. She had a massive heart attack. We attempted to resuscitate her, but…”
I don’t remember the rest of the words. I only remember how the slow realization came over the daughter. It was as if a black cloud slowly descended. Her face turned dark. “She’s dead,” her voice at first a question, then repeated as painful cries escaped her. The family immediately gathered around her, hugging her, and each other.
I left that room in a daze wondering: if I had gotten the blood gas results earlier, would her mother still be alive? Was this my fault? This is not the last time that the lingering ghost of a patient would haunt me. Her face peacefully sleeping. Did I kill this patient? Would I ever be a good doctor? Would I ever have the courage to step up and run a code blue some day? Should I quit now? This was not the last time that the questions would come up.
I had given up a lot to get to medical school… I can’t give up now. I’ve got too much invested.
In 2017, Adam Kay published his memoir, This Is Going to Hurt: Secret Diaries of a Young Doctor. After six years of practicing medicine as a doctor-in-training, surviving many painful moments, almost a full doctor, something happened that caused him to walk away.
What could hurt so much that he would give up something that had become his identity?
His book became an instant best-seller and helped the lay public to understand the training of a doctor in the National Health System (NHS) in the United Kingdom. Winning many awards, translated to many other languages, the book speaks to something universal about the training of doctors and the modern system of medicine.
Adam Kay is now a TV writer, the profession he entered after medicine. He translated the book into an AMC Original comedy-drama starring Ben Whishaw. I laughed at the main character’s irreverent personality, I cringed, and I cried at how closely he touches the truth. After binging through though the TV series, I listened to his narration of the audiobook and now I have to share it with you.
Catch the AMC Original Series, based on the book by Adam Kay, This Is Going to Hurt
Read the book by Adam Kay, This Is Going to Hurt: Secret Diaries of a Young Doctor
As with most medical stories, many details are fictionalized to protect privacy, but the emotional content of the story remains. The movie adaptation further fictionalizes the story, but masterfully creates a comedy-drama for the screen. You can find the seeds of the story in the book, rearranged and germinated into the full life of a television series.
