Monday, March 12, 2012


This one is one of my stories, that occurred many years ago. The year was probably 1988 or 1989 . I was in the office . I was about to leave the office, when I got a call .There was a new consult for the 'vent management ' , . Which means someone had difficulty breathing and needed to be put on artificial support to help breathing , with respirator and I was asked to help manage the respiratory failure.
      When I called ICU and talked to the nurse I came to know that this was a young patient, 35 years of age, and had cardiac arrest, and had heart attack, and he was luccky  to be in the hospital delivering flowers. So he was in "right " place and so got quick help, got put on respirator, was seen by cardiologist, got help.Now I was called in . I was some what surprised to know that this was only 35 years old patient with the heart attack.
      I used to live very near my office , so I decided to call home , so  I could go home and have some time spent with the kids and then go back to the hospital . I went home , had a cup of tea, and decided to go back . As I had thought my older son wanted to come with me , he was about 6or 7 years old and quite well behaved. So I agreed.
      When I reached Intensive Care Unit, I told my son to sit at the desk and I went to see the patient. Usually with these type of patients or cases not much needs to be adjusted. When I entered the patient's room , his nurse was there and his girlfriend was also there. I talked to the nurse, examined the patient, and talked to his girlfriend. The examination was unremarkable. His pupils were big and did not respond to the light, a bad prognostic sign, though it could be due to number of medicines that he got with resuscitation. He was not breathing on her own , was unresponsive,though blood pressure pulse were OK.
       When I talked to the nurse and saw the chart I realised that this guy came to the hospital to deliver the flowers to some patient and as he was leaving the hospital , he had heart attack right in the lobby. His DRUG SCREEN was positive for COCAINE. Now it was easy to make diagnosis, 2 and 2 always make 4. He must have taken cocaine and then had cardiac arrest. I was about to start dictating the note , when the nurse told me something. She said , 'I don't know why , but he is oozing from any site that we take blood from . His coags, ( tests for the checking of clotting of the blood ) are OK. 'I could not figure it out either . So I decided to talk to the girlfriend again . I asked her if he was on any medicines, any drugs that she might have forgotten to tell us.Her answer was shocking and eye opening. She said , " now that you are asking me I remember that he used to take lot of aspirin whenever he did cocaine, you know that he knew that cocaine can cause heart attack and you know that aspirin prevents it !!!! "

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