Monday, November 15, 2004

A Natural Catastrophe

It’s 1 am in my CCU. I’ve barely had time to put on my jacket when the charge nurse called me with the news that one of my patients, a young lady, is in Ventricular Tachycardia (V-Tach). She also told me to “relax, as this happens to her all the time”. The words “Relax” and “Ventricular Tachycardia” sound funny to a novice when used in combination. Naturally, I panicked!

I must’ve done record sprint time from my call room into the CCU. As I entered the room, I found this too-young to die (TYTD) female quite comfortable, talking, slightly hypotensive and in Ventricular Tachycardia. The confusion and concern on my face, I guess, was evident. She looked at me and said “don’t worry doc, this happens all the time”. Really? Because every other time that it happened to me I was staring at an impending corpse (IC). So I chose to “PAGE CARDIOLOGY” STAT!

The fellow calmed me down and said that this particular patient has a rare disease called Errythmogenic Right Ventricular Dysplasia, a condition that predisposes these patients to all kinds of arrhythmias. Basically, she’s been walking the rope between suddenly dropping dead and life for quite a long time. Sure, that calmed me down. Of course! TYTD was now threatening to become IC and I was to stand by because she’s been threatening for quite a long time. Makes sense.

Faced with the sudden combination of deadly conditions with words of reassurance made me think of a few other well-constructed warnings:
“Hi, you’re having a deadly asthma attack, just chill out”
“You’re hemorrhaging internally, how about that”
“I can’t feel a pulse, how about we continue to observe”

You can make up some yourselves, I’m fresh out of ideas. Leave yours in the comment section.