This Med Student Gets Real About How She Handled Her First Emergency Case

It was panic-inducing, even for someone who's so close to becoming a real doctor.
by Mylene Mendoza   |  Feb 3, 2021
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You'll never know just how much you've actually learned and understood in school until you find yourself in a situation where you have to apply years' worth of lessons in real-life events. For Jo Go, a fourth year medical student at University of Santo Tomas, a few minutes' worth of an emergency case involving a loved one became a life-changing "wake up call."

Jo completed her bachelor's degree at University of Melbourne in Australia. She is also distinguished with First Class Honours and is the top student of her major. Jo narrates how she handled her first *actual* emergency case involving her aunt where she, as a medical student, had to respond immediately to alleviate the situation. 

She also gets real about how it felt (it was panic-inducing, even for someone who's so close to becoming a real doctor) and hopes that others may pick up lessons from her own experience and realizations.

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Read on to see Jo's full story: 

I encountered my first real emergency case today.

I did NOT handle it well.

I was editing our rotation schedule to fit around the sudden unavailability of some of my co-clerks who had important matters to attend to on the day of their e-SGDs. Background noise to the tap-tap-tapping of my keyboard were the soft dialogues of a YouTube series my aunt was watching on the easy chair beside my desk. Suddenly, ambient nose was overpowered by violent, non-stop, forceful coughs. I looked over, alarmed, and what I saw confirmed that I had every cause to be.

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My aunt was bent over the easy chair, arms around her throat in the universal choking sign. "Oh sh*t, oh sh*t, oh sh*t!" I had time to think, before my heart started palpitating and I was rushing out of my chair. I started giving her back blows with the heel of my hand, then attempted two Heimlich maneuvers before she shoved my hands aside. Okay. I can do this. Continue on with back blows, less forceful this time because she was trying to get away from the blows. Okay. Breathe, Jo. I can do this.

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Fast forward immeasurable moments later, and I caught a glimpse of her face. Circumoral cyanosis. One of the signs of respiratory failure. Always part of the PE checklist. Always something we ask in our patient or mock-patient encounters. And yet, I was not prepared for the sheer amount of mind-numbing panic that overcame me when I saw it. That particular shade of purple will be burned onto my retinas until my last breath, I'm sure of it.

Right, then. Cue panic. I was wrong. I can NOT do this.

Breathe. Mutter prayers to God above. Do not cry. Continue back blows. Breathe, Jo. Breathe. Keep praying. Keep thrusting. Do NOT cry. Tried Heimlich again, got shoved away again. Okay, Jo. That's fine. She's still aware enough to shove my hands away. That's good. Calm down. You have to breathe.

I called 911. After a few agonizing rings (pick up, pick up, somebody please pick up), a recording along the lines of "Your emergency can not..." I hung up. Another muttered curse. Went back to my aunt, who was still bent over the easy chair. Do not lose consciousness. Do not lose consciousness. Dear God above, please don't let her lose consciousness.

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I spotted a pair of scissors at my desk. Right, Jo. Breathe. Trauma 101. You've had 2 SGDs on trauma in the past month. You can do this. Remember what you learned. Do NOT panic. Okay. If she loses consciousness, be ready. Game plan: C-A-B. Circulation first. Get ready to do CPR. You can do this. Then Airway. Okay. You know the landmarks. You can do a cricothyroidotomy if the need arises. You have to. Never mind that you've never seen it done on an actual patient before, let alone done it yourself before. Never mind that your hands are trembling, your palms are sweaty, and your knees are shaking. You can do this. You have to.

I attempted Heimlich again. "Don't do that," my aunt rasped out. Finally. Finally! Her voice was extremely hoarse and those three words were interrupted by bouts of coughing and wheezing, but I can not describe the sheer relief that flooded through me when I heard her voice. "If the patient can speak, the airway is patent." Slide 10, Trauma SGD. Thank God. Thank God. Thank God. My aunt got lucky. I got lucky. Extremely, extremely lucky.

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I looked at the clock. The whole ordeal lasted a mere few minutes. And yet, it felt much more like a lifetime.

Even as I write this, I am still weak with relief. My aunt's fine now, thank God and all the angels and saints in heaven. I don't know if what I did was right. And yes, there were definitely a number of things I did wrong. I don't know if I was able to help my aunt medically, or if I was only there to offer prayers and moral support. Either way, I realized something - I am still woefully unprepared.

So to my friends, and to anyone who has read this far along, allow me to entreat you. I am a private person by nature. Look at my timeline, and you will find that I rarely post or share anything of a private or personal nature. But in this situation, I will, because the perceived gravity of what I realized trumps my desire for personal privacy. We are medical clerks. A few months away from graduation. A little more than a year away from our medical license. A little more than weeks away from being thrust into being a small part of the amazing team of health workers that saves lives, or gives their all in trying to. And so I implore you, from one clerk to another, to share in the urgency of the realization I had today. Learn everything. Learn everything that you can, while you still can.

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Learn everything, even if it feels tiring or boring or definitely less preferable to binge watching Netflix (I'm looking at you, self).

Learn everything. While you have the time and opportunity to do so, learn everything, and learn it well. Learn it so well that it becomes a reflex. What I did a while ago was not reflex. I had to constantly remind myself to not panic, to breathe, to think, to remember what I learned. It was scary. Terrifying. I felt powerless, useless, small. I never want to be that unprepared in an emergency again.

I am guilty of having said "Babawi nalang ako sa face to face," or even "Babawi nalang ako sa PGI." And I have heard my friends say that, too. And for good reason. Online learning is taxing, man. It burns you out. It's demotivating and depressing, even. I get that. I feel that, too. But what I realized now is that sometimes, di ka na makakabawi. Sometimes, it's now, or never. That the knowledge you learn now, right now, may be the thing that stands between your patient and his grave in the future. It becomes doubly worse when it's a loved one. It becomes triply worse when you don't have a trained medical professional around to tell you what to do. It becomes immeasurably worse when you realize that left to your own devices, you have very little idea what you're doing.

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I am taking a leap of faith in posting this on social media, despite potentially exposing what I'm sure are numerous flaws in how I managed my patient, among other things. But my conscience tells me that I have to, because this was my wake up call. Let this be yours, too. And if, God forbid, your first emergency case should be that of a loved one, it is my fervent hope and prayer that you are more prepared to offer aid than I was.

Allow me to close with a Chinese proverb my aunt (yes, this same aunt!) has told me a thousand times before. "Don't be afraid of the ten thousand, be afraid of the one in ten thousand." I used to roll my eyes whenever she said that, but I'm not rolling my eyes now. One in ten thousand is not zero, after all. And that one is something we have to prepare for.

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Para sa pasyente. Lahat, para sa pasyente.

You can check out the original post here.

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Mylene Mendoza
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