Hope – Chapter 01

“Our mistakes should neither be forgiven nor forgotten. Otherwise, we’ll make them again.” – Yousef Nabeel.

——————–

Beep… Beep… Beep

I woke up to the sound of my pager bleeping. It took me a few seconds to realize where I was, the Emergency Department’s doctors’ room, or lounge as it was officially called. It was a small room that contained nothing except for a single bed and a rusty closet in addition to a plastic table that had a water boiler and a Nescafe jar on top. The room smelled of coffee, every doctor’s best friend. I had just put my head on the pillow and lied down less than ten minutes ago. Every time I think I can escape and get a few minutes of precious sleep, I get awakened by a nurse paging me, hardly ever for an urgent matter. I thought of calling to ask what the matter is but I had lost all hope for sleep that night. I glanced at my watch to see that it is almost five in the morning. I had lost track of time. I was yet to get used to these night shifts. I washed my face and headed to the ER where I was doing my first rotation of the internship year.

 

“Dr. Yousef, hurry,” said Alice, the head nurse of the ER as she saw me approaching. “What is the problem?” I asked, still sounding sleepy. “RTA victims have just arrived. Man with his wife and two daughters,” she said, jolting back my senses into me. RTA stands for Road Traffic Accident. “Page Dr. Mazin immediately and page the surgical on-call too,” I said as I ran toward the room she pointed at. Unfortunately, I was not prepared to deal with what was inside of it.

 

“Dr. Yousef Nabeel. What happened?” I said as I entered the room. I was able to hear the wailing even before I came close to the room. The wailing was coming from a lady in her early forties who was crying her heart out. “Ya Allah, Ya Allah,” she kept on saying. A man in his mid fifties was pacing around in his place saying over and over again, “Oh please God, save my daughter. Save her.” There was a young lady in the room too, probably my age. She was sitting on the chair at the distant corner and seemed to be in shock or lost in her own world. The man had a relatively large bruise on his face. The upper part of his thobe was torn apart and he had multiple lacerations on his shoulder, chest and left arm, none seemed particularly dangerous. The two ladies were disheveled but seemed to be fine with the exception of minor bruises and lacerations on whatever showed from their bodies. The reason for their concern was the girl lying on the bed in the middle of the room.

 

“Doctor, please help my daughter,” the father shrieked at me when he first saw me. She was unmistakably in a bad shape. It was the first trauma case I have ever encountered and I was not prepared. I did not know what to do. I froze in my spot for a couple of seconds before I shook my head and said, “Inshallah khair. We’ll do the best we can. Just keep praying for her.” “Karin, please take the family and check on their vitals and see if they are complaining of anything,” I addressed the nurse that was present. “Please go with the nurse and someone will be there with you shortly to check on you,” I told the father. “We are not going anywhere until we are sure that Amal is fine,” he said, firmly. I turned my attention to the girl because there was no point of arguing with a worried parent.

 

“ABCDE; Airway, Breathing, Circulation, Disability, Exposure,” I was thinking rapidly in my head as we were taught. She had a neck collar on. Do we do the head-tilt/chin-lift maneuver in this case or not? I wondered. I just opened her mouth and looked to see if there was anything obstructing the airway. I did not see anything. “Okay, good,” I thought. Her chest was rising up and down but on auscultation, her breathing sounds were muffled on the right lung. Her oxygen saturation was decreased. Her blood pressure was very low and I could barely feel her pulse. She had clearly lost a large amount of blood whether it’s from the openly fractured arm of hers or even worse, internally. Her limbs were cold.

 

“Insert two large bore IV cannulas and give her a 500ml bolus of Ringer. Send for CBC, Type & Cross Match, U & E’s.. umm.. PT and PT too,” I told the nurse then asked the family, “What is her blood type?” “A+,” the mother replied. “Do you have a document that proves that?” I asked her. “Yes, it’s written in her medical ID card,” she replied. “Tell the blood bank to send four units of Packed RBC’s of A+ immediately. Tell them we have an actively bleeding patient,” I ordered the first nurse I spotted outside the room because Karin was busy with the IV lines. “Quickly, please,” I yelled.

 

“ABCDE,” I repeated it silently. Disability, I did not check for that. I looked at the girl and she was obviously drowsy. “What’s your name?” I asked. She mumbled something incoherent. “Can you lift your arm?” She did not move a muscle. I pinched her left hand and she withdrew it away. “What is her GCS? There is something missing,” I thought to myself. Shit. My mind went blank and I could not remember the details of the scoring system. It did not matter anyway.  “E is for exposure.” I started taking a quick look at her body to see the extent of her injuries. “Her lower limbs suffered only minor abrasions. Her right arm has an open fracture. Her right lung has muffled breathing sounds but the left lung and arm are relatively fine. Her face is bruised but other than that…” My thoughts were halted when I noticed blood oozing from the back of her head. I turned it to the side to see that there was gauze completely draped in blood and soaking. The paramedics must have had put them there. How did I not know there was an injury to the back of her head? Just as I was inspecting it, I heard the vitals monitor’s loud alarming sound.

 

Her blood pressure and her oxygen saturation were dropping to dangerous levels. “Where is Dr. Mazin?” I yelled. What am I supposed to do? They did not prepare us for any of this back in medical school. I took the Basic Life Support course more than a year ago. What did they tell us? My mind was racing but my body was frozen in its place. “Call a code,” I almost shouted at the nurse that entered the room that moment. She ran out to give the order. “Please leave the room,” I told the panicking family. “I can’t work with you around. Please get out so I can help your daughter better.” They left the room unwillingly and the mother’s wailing became loud again after it has subdued a while ago. “Code Blue. Code Blue. Emergency Room. Adult Code Blue. Emergency Room,” I heard the operator’s voice delivering the message through the overhead speakers. “Where is that blood? Damn it.” I was losing my self control and starting to panic myself. The nurses came with the crash cart. They did not teach us how to use the defibrillator before! I was sweating profusely as the nurses stared at me expecting me to run the code. “Don’t you understand? I don’t know anything,” I wanted to yell at them. Luckily just then, Dr Mazin entered the room.

 

“What is going on?” he asked. “RTA victim. Open fractured Humerus. Apparently severe injury to the back of head. Muffled breath sounds on her right lung. She was given 1500ml Ringer so far. And as you can see, patient is coding,” I filled him as he was instructing the nurses on what to do. “What is her GSC?” he asked me. “I do not know,” I said. “What about her abdomen? You did not say anything about it.” “I did not check her abdomen. I’m sorry,” I said with shame building up inside of me. How did I forget to examine her abdomen? He gave me a look as if to say, “An apology does not make up for incompetency.”

 

I stepped aside and watched as he tried to save Amal’s life. Everything switched into slow motion and the sounds mixed together until there was no distinct sound except for that of the vitals monitor. Her heart flat lined. I saw Mazin doing everything that is medically possible to keep Amal alive. I looked at him with admiration and wished in myself that it was me doing all of that. For nearly thirty minutes, he was trying to spare Amal’s family the tragedy of her loss. Unfortunately, there was nothing he could have done. She passed away. “Time of death: 5:41,” he said mournfully then paused for a second before leaving the room. 

 

“I’m so sorry. We have done all that we could but she was severely injured. We tried to save her but it was her time. I don’t know what to tell you. My sincerest condolences. May Allah grants her entry into His heaven. May Allah grant you the patience and strength to make it through,” I heard Dr. Mazin delivering the horrible news to Amal’s family as I watched from afar. Her mother screamed in a way that I know for a fact that I will never forget in my life. Her father’s eyes were widely opened in disbelief in a clear state of shock. Her sister broke down in tears. I just watched. Her mother and sister could not hold themselves standing anymore so they sat on the ground and continued sobbing. The father tried to hold his composure. “La hawla wla gowat ella bellah,” he started saying over and over again. He had an empty gaze in his eyes and he was looking directly at nothing. He was shaking his head every now and then. I just watched. There is no dignity in death. It strips you down of all that you are and leaves you bare with nothing except for your beliefs. “Rabby Ajerny fy mosebty hazeh, Rabby ajerny fy mosebty hazeh,” he was saying. I wanted to tell them that I was sorry for their loss but I did not.

 

I just watched from afar like a coward. If I were brave enough I would go to them and tell them that I have failed them and failed their daughter. I should have been more prepared. I should have known what to do. I should have acted quicker. I should have been a better physician. My heart ached for them. I felt my eyes tearing up so I stepped outside the hospital for a moment. Guilt was devouring me and I needed to escape. The walls were closing in on me. Perhaps the air will cool down this fire inside of me. “It is my fault,” I thought to myself. It is my fault. It is my fault.

 

To be continued…

 

 

PS. This is the first chapter of a new story that I am working on. Don’t get excited yet about anything. I’m still not sure that it will evolve into something big but it’s a beginning nonetheless and Layla started as a single chapter one night two years ago. I hope you enjoyed reading this post. As always, comments and feedback are much appreciated. Thank you.

31 thoughts on “Hope – Chapter 01

  1. God bless ur hands ya man >> and hope al nehayaa tekoon a7laa min al bedayaa mafehaa mooot neb’3aa bellah nenhehaa bii 8e9at 7ob 7elwaa 😀 ,,

    keep n up wallahi GREAT 🙂 rabe ye7meeek

    Reply
  2. Oh new story from Dr. Kurdi! 😀 I am excited whats going to happen there, i hope its not a happy love-story :p

    so you really want to work as a physician? in a hospital? hehe…sounds like a nightmare-job to me…and i really understand why (in my country) almost every physician is drug-addicted 😉 but one has to do the job…

    p.s.: i hope next chapter will come soon! 😉

    Reply
  3. Roa’a, Thank you 🙂 lool enty betfkry fy alnehaya min da7en! lessa badry 😛

    Katty, lol thanks for the enthusiasm! And nope it’s not going to be as romantic as Layla was. This is a little bit different.
    And I completely understand why physicians would be drug addicts! They strike me as the perfect candidate!

    Samaher, Glad you liked it

    Reply
  4. I like how you seem to integrate personal life into your stories. I could be wrong of course, but then again, if that is the case, it just goes to show how truly effective [magical] your writing is.

    Good work.

    Reply
  5. sawsan, lol ok I’ll wait for your comment after your exam 😛

    manutdfanatic, thank you. Well “You write what you know.” And when the writing is personal, it rings of truth and reaches easily into people. This did not happen but it is how I “picture” it will happen if it ever does.

    Reply
  6. Just stumbled upon your blog! I bet you’ve heard this a lot, but you have a talent that is quite charming.

    The way you write is elegant, and your choice of words is creative.

    Please, keep on writing. May your fountain of inspiration never go dry!

    🙂

    Reply
  7. A Global Citizen, welcome to my blog 🙂 I’m glad that my humble talent has acquired your liking. And I’ll keep writing as long as someone’s reading

    Reply
  8. Sugar, dont be a tease. I’m hooked. It was playing out like a terrific medical drama, what is the young doctor’s background? what are his likes, dislikes? what was going through the heads of the nurses? Dude. You cant STOP

    Reply
  9. Lily, my whole writing style is based on the tease element! I’m glad you’re hooked. Don’t rush lol you’ll get to know the doctor more as we go on with the story

    Reply
  10. She has passed away!!!
    I have already started picturing what wou;ld be next with Hope 😦

    Amazing story Bassem.

    PLZ, get that sweet inspiration of yours and continue till it becomes a wondeful story 🙂

    Reply
  11. Ohhhhh…what a tragic first chapter….
    as usual, the display of your awesome imagination….
    …i felt the pressure…i love every single detail of your story…
    …it may not be the same as Layla bro but i believe it will be as intricately woven into a wonderful piece of art…….
    Im excited……..

    Reply
  12. his sweetheart, lol because I guess most of my writings are romantic, a lot of people have drifted away in their imaginations of what will happen between them ! thanks
    inshallah it will

    Berno, i’m happy I made you feel the pressure. And as usual, I’m into details!
    This is very much different from Layla even the writing style as you will see. Hope you’ll like it as much

    Reply
  13. mashallah, very talented !

    Biltawfeej nshallah =)

    I hate that G scale, it always takes me more than it should to figure it out !

    Reply
  14. Thanks 🙂
    Oh, a medical student too! the scale isn’t that hard but when you’re in such a situation faj2a all the information disappear and you go blank!

    Reply
  15. LOVE IT LOVE IT LOVE IT…

    it shows clearly that who wrote this is a doctor…u write amazingly with the smallest details and thats gr8 so we can really imagine ourselves in that situation…mmm i felt sad 4 the girl who died from the 1st chapter lol lessa bengool ya hadi…keda ur gonna exaust our feelings but it really made my eyes roll from line to line…!!!

    Reply
  16. I care a lot about the details because it gives a better picture in the reader’s mind.
    lol the first chapter should always leave an impression. Kida include a strong event that makes you want to keep on reading…

    Glad you liked it 🙂

    Reply
  17. You really grasped me with this, I felt like I was living through the events as they took place…

    Love the vocabulary, the description; everything!!

    Don’t ever stop.

    Reply

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