Sometimes, the hardest thing to protect someone from is themself.

At age 30 the patient has been responsible for their own actions long enough in life that you shouldn't beat yourself up worrying if there was anything else you could have done.

Generally people know when they are sick and it's up to them to seek help.

Saying that now doesn't preclude you from having a memory and caring. In 1982 6 months after becoming a EMT we had a call for a 8 yr old who hung himself. That bad memory is as vivid now as it was the day after it happened. It's not someone you know and you did your best, that's all that is expected of you.

Thanks for all you do, Rick.

You're a good man.

All the best,
Baz

Some good news, I called the hospital this evening to check on him and his nurse said he is starting to follow some commands. Not normal yet but at least making some progress.

I swear if this guy makes it through with no brain damage he is either the luckiest guy I know or someone upstairs likes him.

Rick,

You are the type of Doctor that I searched for, and luckily found, for me and my family.
Your patients are lucky to have you care for them.

Matt

P.S. You were correct in my using the term "liquefy" as hyperbole.

negative feedback fuels mastery...it sucks not being able to choose the form or magnitude of that mechanism.

http://faculty.chicagobooth.edu/ayelet.fishbach/research/FF_JCR_Feedback.pdf

You do everything you know to do, and if you figure put a way to better that, then you do it the next time.

That is the best anyone can ask of you, and that is what makes you good at what you do. We strive for progress, not perfection. Well we strive for perfection, we get what we get, and try to learn from it.

Sometimes we don't know the answer, because we can't figure out what the question is. When you figure that out, you will know what you are seeking.

I'm not above asking for that kind of help. :)

People who do things, at risk, in the moment, are my favorite folks: Situational awareness, training, composure and accomplishment.

That said, nobody bats .1000, Doc: no bu dee.

We all know and understand just how simple and powerful this statement is: "The credit belongs to the man who is actually in the arena..."

Keep doing what you do, Rick. It is important, vital work. I admire you.

Rick,
I've been in this for 25 years(Emergency Medicine). You and I know that bad outcomes happen regardless of the best decisions and actions. I have cases that still haunt me years later. I replay them in my mind, still lose sleep but apply the thought processes behind my decisions everyday. If these things didn't bother and upset you, there would be a problem. You can't be responsible for the factors that led to a patient presenting for your care. You're only responsible to provide sound and objective evaluations and management. Very few understand what we're faced with minute to minute, hour to hour and day to day. Your commitment to your calling demands that you continue your thoughtful, intellectual and caring approach to your patients needs. What you're experiencing is unfortunately what we must endure. The alternative is partly what keeps me going.
Warmest Regards,
Chris

That being said, Shania Twain is HOT!

Thanks Seahawk, that means a lot.

Me neither, I do it every day.

Thanks Matt and I apologize for coming down hard on you in that thread. The whole media frenzy over Ebola was just really getting to me that day. Seems like the news is more interested in scaring people than telling them the truth sometimes.