Doctor Stories

"It's a Beautiful Life"

I was an intern on call in the Coronary Care unit. This part of the hospital is for patients with acute cardiac problems requiring intensive monitoring. The most typical patient is someone with an acute myocardial infarction, known to most as a heart attack. Because these patients are at risk for serious complications, such as congestive heart failure. This happens when the heart is too weak to pump the blood efficiently and the lungs and other parts of the body fill with fluid. If the lungs are full of fluid, blood cannot oxygenate properly and the patient begins to feel short of breath. Most of the time this can be managed with medications that rid the body of fluid; these are commonly known as water pills. However, if it is severe enough, the patient needs to be put on a ventilator with air being pushed into their lungs by a machine.

It was a relatively slow night with all the patients being stable. At 3am I was awoken by a page. "We have a 93 year old woman with an acute MI. She doesn't speak English and is trying to climb out of bed. Please go see her STAT!" 5 minutes later I walked into a room to find a beautiful old woman in mild distress. Immediately I saw that she was frustrated because she could not communicate with the nurses. She was speaking in Russian, my native language. So we began to talk. She asked me to tell the nurses how grateful she was for all the great care and attention she was getting. I found out that earlier that day she was walking outside and became acutely short of breath. An x-ray in the emergency room revealed that her lungs were full of fluid. The culprit turned out to be a massive heart attack which weakened her heart muscle. Despite such dire circumstances, my patient calmly stated how thankful she was for everything that happened to her. I asked her WHY?

The woman first asked me where I was born. It turns out I was from the same part of Ukraine as she was. She then told some of her biography. During World War 2 she was hiding out from the Invading German army in a remote Ukrainian Village. I could relate to this as my grandmother was also on the run from the Nazis during the war while my grandfather was fighting in the front. Then tears started to well up in her eyes. She recounted how she was homeless with a new born daughter. It was the middle of the winter and there was no food or warm clothes. She could barely move with a high fever and cough from pneumonia. Realizing that her daughter would likely not survive, she found a shovel in a barn and began to dig. She wanted to bury her infant before the dogs ate her. Seemingly, at the last moment, a villager found them and offered refuge in his house, a very unusual act of kindness as the locals were afraid to harbor Jews for fear of retaliation from the Nazis.

At age 85, she had moved to this country and was now surrounded and cared for by a doting family, including 6 grandchildren. I now understood why she was so thankful. Just being here was a miracle for her. I spent the rest of the night trying to keep her from getting intubated with massive doses of diuretics, all the while translating her good wishes and countless stories to the nurses. I went home feeling drained but happy that my patient did not need to be put on a ventilator. Her story telling was an inspiration to us all.

I came to work the next day and went straight to my patent's room to say hello. The bed was empty. I found out she died earlier that morning from sudden cardiac arrest. The nurses were crying. I saw the patient in my dreams that night telling stories and laughing.