I am a PGY 2 doctor doing a 1 year training position in internal medicine. Finished my intern year 2 months ago.
I had the evening/night shift (3.30 pm to 9 am) sunday-monday. I had 83 patient in my care between 4 different wards. Only doctor in my department at work.
It was a busy night. I was dealing with an obstructive ileus in a patient initially commited with a uti and a few with respiratory problems that were fairly easily managed.
I was called to the patient in question around 11.30 pm (don't really want to go into the specific case details – went over those with two different senior doctors). I examined him, asked for a consult from the appropriate specialty, made a plan and thought nothing more of it. He seemed well enough when speaking to him and his vitals was nothing out of the ordinary for him.
The nurses called me at 6 am telling me he was found dead in his bed. I had to show up and declare him dead.
I did not see this coming at all. I was totally shocked. I have had people die in my care before, but those times we had either stopped active care or it was not-so-surprising.
He was 77. He had several comorbidities. Still, I was in shock. I wasn't able to keep it together. I called my attending on call, my mother and a friend I knew was on shift at a different hospital, who luckily was having a quiet morning. I made it through the morning conference without crying, even while presenting this patient. But I couldn't hold back the tears afterwards. Talked to another senior colleague for 30 minutes after. Everyone was really nice.
I went to eat and have two beers with some intern colleagues yesterday. Talked it out again. Managed to have a nice evening. But I couldn't get myself to work today. I feel awful. I keep questioning myself – if I could have prevented it somehow – even though my seniors have assured me I did a good job. This was my first truly unexpected death, but surely it wont be my last. I knew it would happen some day, as all of us do.
I am going to go to work tomorrow. And I have an appointment with my psychologist on thursday, but any advice would be appreciated.
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