Tony’s Anatomy-#6:Unforced error and ACE

It’s at the last day of my internal medicine program. The emergency department(ER) transfered a man presented acute progressive back pain to our pulmonary medicine ward.Initialy,he was diagnosed as pnuomonia(lung infection) by ER doctors.However, after detail analysis, we suspected he may have a internal bleeding.We arrange a CT image scan for him which showed internal bleeding and colon PERFORATION! Oh~~~my god! Comparing to ER’s impression,it’s totatly different impression. This man was dyeing! Then we arranged endotracheal tube insertion and intra-venous(IV) line on the man. However, until one anesthesia doctor came , we found we forgot to insert a larger diameter IV tube(CVP) on this patient. Without this large IV tube, it’s quite impossible to infuse sufficient blood to compensate acute server internal bleeding.Thanks god.We did it before acute internal bleeding happened and arranged emergent surgery immediately. However, when I was writing medical summary note, I found my team member,the decision marker, was crying. Why? She felt guilty for making a unforced error( a term from Tennis). I told her it’s really a mistake but we also made an ACE  ball that we found the most life threatenng disease he got and fix the problem in time.A great docot bears strong resemblance to the great Tennis player like Roger Federer that they rarely makes double fault and learn from experience. I am not a great doctor yet.Hope I can make many ACE balls in the furture.

 

Tony