My own grief lead me to Emergency Medicine

My mother was a long standing diabetic patient with heart failure. She had travelled to a remote area in rural  India for religious gathering when she went into acute flash pulmonary edema due to omitting  her heart failure medication for two consecutive weeks (diuretics + others ). There were certain relatives in the gathering who despite being trained medical graduates (no specific training in Emergency Medicine) did not know how to recognize a patient in volume overload. She had NYHA class III dyspnea that gradually increased to class IV, increased edema of lower limbs and sweating along with syncope like symptoms despite that she was given fluids and antacids over the period she was alive to relieve her of symptoms. She had sudden cardiac arrest at noon in a place no one knew how to give CPR.

I was attending a lecture on heart failure for my post graduate entrance  examination the day that she died. It was my niece and brother who called me crying. After coming to terms with my loss I started paying a lot of attention to all the topics I was studying or had studied in context of what can kill fast if I fail to catch it early and what is it that I should be fearful of  as a doctor daughter to a diabetic, hypertensive father recovering from losing his wife of 45 years. In my quest initiated by loss of mother and driven by the fear of losing my father while myself coming to terms with the fact that I no longer had a mother I found solace in all topics related to emergency. The lectures were all about quick assessment and quick action with statistic evidence of mortality benefit and better quality of life if one person knew well enough to ask the correct questions, order correct investigation and take immediate appropriate action.

There it was in front of my eyes how my mother could have been saved or be at least given a real chance at survival. A high flow oxygen mask, an IV dose of diuretics and ECG and rapid ABG, cardiac biomarkers with NIV. I knew what I wanted to do for the rest of  my life. 

A decade later I am the only trained emergency physician at an institute of national importance in my home country India. I admit its a long journey ahead  to convert causality into department of Emergency Medicine. Physicians and Surgeons still don’t get the idea of Emergency Medicine here. They still make it a point to remind me every day that I am doing a thankless job.

But I have known for long their is no job better than this and as I am assured of the same by every heart failure patient that I save each day (alongside others). I take immense pride in myself when an MBBS intern posted in our department leaves knowing how to recognize heart failure and understands what needs to be done next. I feel hopeful and grateful that the number of people who know what, when, and how is increasing in my nation slowly but definitely change is going to come. I am assured everyday that  I am a part of a system that has saved and will be saving a lot of mothers, fathers , children aunt and uncle just like mine…just like mine.   

To Emergency 24 x 7 !!!