Tag Archives: Internal medicine

Shubham Shan is a medical student in the Class of 2019 at the University of Toronto

 

She arrived on an inclined stretcher, grasping her Venturi mask like a child holding on to her favourite toy. Flanked on both sides by paramedics, her eyes were splinted wide open by shock and her chest heaved up and down rapidly. She was a queer shade of purple — like spoilt red wine diluted with water — and her gaze flitted around the emergency department as if looking for someone familiar. The paramedics passed her off to the doctor then left, shaking their heads. I remember watching the doctor take the patient’s puffers. The patient swore loudly and snatched them from his hands; first the orange, then the blue. She cocked the puffers like guns, inserted them into her mouth, shot the mist deep, and inhaled. She coughed for what seemed like an eternity. She was what we called a “blue bloater.”

When I saw her again, she was lying on a tattered mattress with bright blue sheets in a freshly bleached acute care room in the emergency department. Her condition had gotten much worse. Her abdomen caved in paradoxically whenever she breathed in. Her eyes were bloodshot. Every time she exhaled, it sounded like an infant's rattle. ...continue reading

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Ray Schachter is a lawyer in Vancouver. He is on the Executive Committee of the Global Sepsis Alliance and Canadian Sepsis Foundation

 

In March 1996, I was a healthy, fit 50-year-old man enjoying life with a young family.  A month later, I was in an induced coma fighting for my life against acute septic shock accompanied by severe adult respiratory distress syndrome (ARDS) and multi-joint and -organ dysfunction which frequently accompanies sepsis.  My sepsis was brought on by Group A Streptococcus (Strep A) in my bloodstream which compromised almost all my joints.

My trajectory which led to acute sepsis is not unusual.  On Day 1, I had a very severe, but short-lived, bout of extremely high fever (40.5 degrees Celsius), followed by excruciating hip pain the following day.

By Day 3, the hip pain had become unbearable.  That evening, we called my family doctor’s on-call service and a doctor came to the house at midnight.  The physician felt my condition was osteoarthritis and prescribed anti-inflammatories.

On Day 4, my wife became so concerned that she called a doctor who was a family friend.  ...continue reading