Extremes: Life, Death and the Limits of the Human Body by Fong Kevin

Extremes: Life, Death and the Limits of the Human Body by Fong Kevin

Author:Fong, Kevin
Language: eng
Format: epub, mobi
Publisher: Hodder & Stoughton
Published: 2013-02-21T05:00:00+00:00

We arrive in theatre and shock again before the surgeons begin. The ventilator is running. The patient’s lungs too are now beginning to fail – becoming stiffer and demanding more oxygen. The acidosis in his bloodstream is worsening and his kidneys are deteriorating. We increase the adrenaline and the noradrenaline. The doses are now so high that their side effects are becoming a real problem. The drugs make his heart more irritable, more prone to fatal arrhythmias. We can hold his blood pressure up but we’re having to defibrillate more often now. Each time the ECG flips into a shockable rhythm, the defibrillator spits out an inch-wide strip of paper on which the jagged trace is printed in hard copy, like a seismograph beating out the lines of an earthquake. Several feet of this strip have now collected on the floor. An alarm goes off. I nod at the surgeons. They step back from the table. We fire the defibrillator again.

This is absurd. Sooner or later the rhythm of his heart will degenerate into something we can’t treat, something that electricity can’t reset. Perhaps, realistically, that is all we’re waiting for.

But then the surgeons call out. They’ve found a section of dead bowel, its arcade of vessels blocked by something – a blood clot perhaps. Deftly, the surgeons snip out the gangrenous tissue and join healthy ends of bowel together. Things do not change immediately but with the diseased bowel gone and no longer leaking toxins into the circulation, my patient’s physiology will get better rather than worse. Surviving the next few days will be no mean feat but the surgeons have given us the means to turn the corner. They are the change that we have been hoping for. We are far from out of the woods, but at least the woods are no longer on fire.

Back on the intensive-care unit, in the hours after the operation, the support we need to provide steadily decreases. We still deliver shocks, but they are fewer in number and less frequent. And slowly the patient is weaned off the drugs and the artificial ventilator. Over the next few days we gradually hand control back to the patient, shutting off our machines as his normal physiology reasserts itself. Precisely how his body is able to recover and knit itself back together after such an insult is unclear. But he is young, and the young are remarkably resilient. And less than four weeks later, that eighteen-year-old walks out of the hospital.


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