God Don't Play Dice

Fair is an unusual concept in life, and yet one that we return to all too often.

For all the people we see in the ED who have stubbed their toes, who have a bit of a sore throat, who used a lump hammer to smash stuff and wonder why their shoulder aches, for all of the 'worried well', there are a dying breed who don't like to make a fuss; who feel that they are 'bothering' us at work.

Geoff was just such a man. Yesterday evening, while lugging heavy bags of compost about, he developed a pain in his chest. He described it as like having someone pull your tongue out by the root. It shot from his chest to his belly, and wa accompanied by explosive diarrhoea. He remarked on the pain to his wife, but didn't want to trouble anyone.

He took himself off to bed, where the pain got worse and worse; he became sweaty, and had trouble breathing, so much so that he got himself out of bed at 3 a.m. and spent the night in his chair. This morning he thought he ought to talk to his own doctor about it, but got worse through the day, and eventually called an ambulance.

The Ambos thought he looked a bit grey, and belted him to the ED; the Admitting Nurse also thought he looked a bit grey, and flagged him to me. He told me he wasn't too bad, tho he later admitted to pain of 8/10 severity, and marked shortness of breath.

I thought he looked a bit grey, and his ECG told us why - he was having an acute myocardial infarction.

We rushed about him, trying to explain, but he didn't quite fathom the detail of what we were trying to explain. He understood he was unwell, and that we were trying to help. He trusted us to do what was right, even if he didn't understand the anatomy of what that was.

His faith was almost repaid.

He tried to do the right thing; We tried to do what was right.

And he still died.