The Case I Can’t Forget is a weekly series that hears from the people working at the coalface of public service about the cases they have carried with them throughout their careers.
This week, junior doctor turned author and comedian Adam Kay describes witnessing his first patient death.
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To give myself a bit of credit, I didn’t panic when the patient I was reviewing on the ward unexpectedly started hosing enormous quantities of blood out of his mouth and onto my shirt.
To give myself no credit whatsoever, I didn’t know what else to do. I asked the nearest nurse to get Hugo, my registrar, who was on the next ward, and in the meantime I put in a Venflon and ran some fluids.
A Venflon, or cannula, is the plastic tube that gets shoved into the back of the hand or the crook of your elbow so we can run drugs or fluids intravenously through a drip.
Putting in Venflons is one of the key responsibilities of a house officer, although I got through medical school without ever having tried it.
On the night before my first day as a doctor, one of my flatmates in our on-site hospital accommodation stole a box of about eighty of them from a ward and we practised cannulating ourselves for a few hours until we could finally do it.
We were covered in track marks for days.
Hugo arrived before I could do anything else, which was handy as I was completely out of ideas by that point. Start looking for the patient’s stopcock? Shove loads of kitchen roll down his throat? Float some basil in it and declare it gazpacho?
Hugo diagnosed oesophageal varices, a horrible complication of liver cirrhosis, where you essentially get huge varicose veins inside your oesophagus, which can rupture at any point and bleed heavily.
The diagnosis made sense as the patient was the colour of Homer Simpson – from the early series, when the contrast was much more extreme and everyone looked like a cave painting – and we tried to control the bleeding with a Sengstacken tube.
As the patient flailed around, resisting this awful thing going down his throat, the blood jetted everywhere: on me, on Hugo, on the walls, curtains, ceiling. It was like a particularly avant-garde episode of Changing Rooms.
The sound was the worst part. With every breath the poor man took you could hear the blood sucking down into his lungs, choking him.
By the time the tube was inserted, he’d stopped bleeding. Bleeding always stops eventually, and this was for the saddest reason. Hugo pronounced the patient’s death, wrote up the notes and asked the nurse to inform the family.
I peeled off my blood-soaked clothes and we silently changed into scrubs for the rest of the shift.
So there we go, the first death I’ve ever witnessed and every bit as horrific as it could possibly have been. Nothing romantic or beautiful about it. That sound.
Hugo took me outside for a cigarette – we both desperately needed
one after that. And I’d never smoked before.
This extract first appeared in This Is Going To Hurt. Tickets and details about Adam Kay’s live tour are available from adamkay.co.uk
The Case I Can’t Forget is a new series from HuffPost UK that hears from those on the frontline of public service about the cases they have carried with them throughout their careers. If you have a story you’d like to tell, email email@example.com.