Day Fourteen: Holiday with a Bittersweet End

I went to work this morning, fully prepared to help M with his fever study database when news arrived that there had been a patient death sometime in the early dawn. V, a staff physician who had just gotten back from the U.S., came into the microbiology room with the report that a young child with acute gastroenteritis (whose parents I had spoken to a couple of days ago) had needlessly passed away due to medical error. Apparently the residents were too afraid to give the child much fluid due to his malnutrition, and the child started developing worsening diarrhea and an increasingly slow heartbeat. Eventually he was taken to the ER, and given pressors (drugs that make the heart beat), but for some reason, no the child still did not get adequate fluids during this entire time. "It's sad," said M, when he heard the news. "This child probably wouldn't have died if he was watched a little more carefully. Basically he died because it was Khmer New Years..."

And as much as I hate to admit it, M was right. Even though the hospital was still open during the holidays, it was run with as skeletal a staff as I've ever seen. With only a few residents managing the ER, ICU and the Inpatient ward all at once, it is in a way inevitable that something bad was going to happen.

For me, the fact that this happened to a patient whom I had examined just a couple of days before really hit home. I had spent the past two weeks floating around in the periphery, not saying much and writing random notes in charts that I assumed would never be read. But surely I could have been a better patient advocate? After all, M and B were there and had written a note for the residents to the effect that the child needed to be watched. Perhaps I should have stayed longer and reminded the resident to look for their note.

In any case, it was clear that M and B felt bad and even a little guilty too. What a way to dampen Khmer New Years.

But on a lighter note, I was able to get away in the late afternoon for a look at Bayon and Angkor Thom. Here's unfortunately the only view I was able to take before my batteries went dead:



True, it's not the sunset I was hoping to catch, but at least it was a bright ending when compared to the events of my day!