I should have let my patient die

I’ve never been a squeamish person. You need to have a strong stomach in a profession like mine. Ten years as a physician will force you to see all kinds of things to keep you up at night: 3rd degree burn victims with skin like rusted metal, harlequin babies that won’t live past 12 hours, and grown men sobbing after pulling the plug on their mother that their health insurance wouldn’t cover to keep breathing. I’ve seen it all. Sometimes I wish I hadn't. And yet, it was something so simple that broke me. It was a case you see every day. At least that’s how it started.

I still remember it all so clearly; A man was rushed into the emergency room after losing control of his car and landing it squarely in a ditch. He had three fractured vertebrae in his spine, as well as a rib going directly into his heart. It was a miracle he was still breathing. It was standard procedure. We carted him in and immediately began blood transfusion and monitoring his heartbeat. He kept murmuring as we hooked him up to our equipment. So faintly, but you could almost make out “Please… stop…” At the time I assumed it was shock getting to his head. Retrospect has such a cruel way of working, the things you see when it’s already too late. We were just about to begin an emergency thoracotomy to revolve the rip when he flatlined.

We immediately got the defibrillators and began trying to resuscitate him.

“Clear!”

BMMFT

“Clear!”

BMMFT

It was no use. His heart hadn’t beaten in 10 minutes. He was dead. Was dead. And then, something odd happened. His heart began beating again. It didn't make any sense, we hadn’t used the defibrillators in the past 5 minutes. I didn’t bother speculating on what restarted it. I was just happy to not lose a patient. As I walked beside him to transfer him for surgery, I saw tears had streamed down the man’s face. At the time, I thought it was an involuntary reaction or subconscious relief of surviving. I know better now.

I couldn’t let a miracle like this slip through my fingers. We carted him to surgery for the emergency thoracotomy. Those two hours are seared into my mind. The first incision made it clear something was terribly wrong. The smell, my god the smell. It was like roadkill mixed with raw sewage that had been left out in the sun. Even through my mask it hit me like a freight train, filling the room like a blossoming spore. One of the other surgeons began dry heaving, and it took every ounce of strength in my body not to vomit. That should have been it. I should have just walked out right then. I don’t know why I pushed through, maybe some misplaced sense of duty. Whatever it was, it forced me to continue with the operation.

The blood that came out of him was thick, like rotten molasses. The more we opened him up, the more unexplainable horrors we saw. His ribs, which by all reason should have been broken, appeared to be in the process of healing. Actually, healing isn’t the right word. It was more like regrowing, thin blood vessels and bone marrow peeking out like botflies in skin, wriggling as if gasping for air.. His lungs were filled with giant keloid covered wounds. It was as if someone had stabbed him over and over. Any hole this big should have killed him instantly, let alone twenty in each lung. And yet, every single hole had been crusted shut with dried blood, as if they were nothing more than annoying scabs. Then veins around the scar tissue of each hole were black and green, clearly infected. The worst was his heart. Jesus his heart. It was brown, rotten blood and mucus seeping through it like water through a towel.There were tendrils of tissue growing from the base of it around the broken rib, like the roots of a tree. It was as if the body had healed around it. Each tendril was throbbing, slowly burrowing into the bone, anchoring it in place. A silence fell over the room for what felt like hours, but it was probably only a minute or so.

“W-what… what the fuck am I looking at?”

The other surgeon’s voice was shaking. I’d never heard him so scared before.

“Necrosis.”

“That is not necrosis. I’ve seen necrosis. It doesn’t turn your blood into f…f-fucking syrup.”

“…The smell and the tissue as well as the discoloration indicates necrosed tissue and sepsis. We’ll treat the sepsis and remove the dead tissue after we remove the obstruction.”

“Necrosis from what? The rib has only been in there a few hours, there wasn’t enough time for any of that tissue to die, let alone rot! And besides, look at his heart! He…He shouldn’t even be breathing!”

“We can speculate later, but right now our priorities are keeping this man alive.”

“…”

“Scalpel.”

“…”

He handed me the scalpel, and I slowly began cutting the tendrils that had latched onto the bone. With every incision. A small hiss would emanate, screaming like a dying animal. It took hours, but we finally got the rib removed, along with some of the necrosed tissue. There was no way to get all of it out at once. There was no way to get it all out at all actually, how are you supposed to remove two lungs and an entire heart and expect someone to live love enough to perform a transplant? The best we could do was hook him on some incredibly strong antibiotics and pray that worked until we came up with further treatment. That treatment never came.

Two nights after I sewed him shut, the man jumped out the window of his room. He was on the 11th floor, or in other words, roughly 110 feet above the ground. I wish I had stayed behind when we all ran to the parking lot that day. His body was writhing reddish brown mess, screams of what sounded like at least a dozen men emanated from the air, piercing the ears of everyone near it. His ribs stretched like millipede legs, scratching at the cement of the parking lot, trying desperately to get traction. His spine flailed like an unmanned watering hose. The worst part was the face. His head had been partially crushed from the impact, but his upper face was still mostly intact. His eye, ever so slightly pushed out of socket, looked at me, begging, pleading, praying to be put out of its misery. There was something else in there. Hate. Red hot boiling hatred for me. Me. My god the way it looked at me. That bloodshot abyss poured into my soul, into my very being. I could practically hear it scolding me. Streaming at me. “You did this to me. You kept me alive. How dare you think you could do this to me. Look at me. Look at what you’ve done.”

I didn’t even realize I was screaming till the police came. I don’t really remember what happened after that. The sound and smell of it all is the only thing that sticks in my mind. Yelling. Gunshots. Crying. Cursing. Crunching. Smoke. And then finally silence. I never saw the body get carted away. I couldn’t bear to look at it again. Any of it again. I resigned the next day and never looked back. I’m in therapy now, and from what I’ve been told I’m recovering quite well. The nightmares have stopped. I can sleep peacefully now. Almost. I still see it all when I close my eyes. The blood. The bones. The torn skin. And that eye. That eye. No matter where I go, that eye will follow me. And I will always feel its gaze. Its hate.