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The inevitable, as myocardial tissue that had been used to buttress the repair, itself became ischemic, necrosed and died.
With it went the repair, and with that, the dam that had helped this man survive- failed and was now beyond the point of fixing. We reassembled in a heart room this time, and through the thick of our efforts, could not replace volume fast enough to keep this patient here on earth.
40 % was what the surgeon said…
40 % of the ventricle can be lost and the possibility of surviving the repair still remains. We had gone past the 40 % margin, and that was the end of it. Perhaps it was for the best, but it isn’t for me to discuss or expand on. He was going to be missed by his family; his wife, a daughter, son, grandchildren…
What we did do- we did to the best of ability under the circumstances.
A Very Salient Comment
One of the comments regarding this story was particularly well said, and I think summarizes the impact of events like this on me in particular- and perhaps the profession in general.
“Somehow at the end of these cases, we have to come to terms with the emotional, mental and psychological components of lingering questions that inherently go unanswered because there’s just not enough time in the day to think about it all.
Perhaps compartmentalization helps, but how often do we revisit the rooms we stored our proverbial stuff in, sort through it, keep what we need and throw out the rest so we can rent that space out again the next time something like this happens?”
That summed it up for me.