
- Vol 42, Issue 3
The Killer...
Key Takeaways
- A sub-intern misdiagnosed a patient with heart failure instead of pneumonia, leading to a fatal pulmonary embolism.
- The intern's error was corrected, but the patient developed a clot that caused her death, evoking feelings of guilt.
"I guessed heart failure. The answer was pneumonia."
The poem is a capsule where we wrap up our punishable secrets
-William Carlos Williams
She was old and fragile
and I was a just a sub-intern
charged with guiding her care,
her seeing-eye dog in a city hospital.
When I saw a pulse in her jugular vein
I pressed my stethoscope to her chest—
she inhaled and I heard crackles,
like static on a trooper’s radio.
I guessed heart failure.
The answer was pneumonia.
Oh the Chief caught my error the next morning,
dripped in fluids and ampicillin,
but she’d been in bed one day too long,
the clot in her calf broken apart
and trapped in the lattice of her lungs.
I stood by her side, stunned
when her breathing stopped,
and I called the Code,
standing like a killer
cornered on a dead-end street,
cops and canines closing in,
thinking confession, still holding my gun.
Dr Berlin has been writing a poem about his experience of being a doctor every month for the past 27 years in Psychiatric Times in a column called “Poetry of the Times.” He is instructor in psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts. His latest book is Tender Fences.
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