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A doctor's honest account of losing his first patient.

Dr Izaak Lim has never forgotten the first death he witnessed very early on in his medical career.

“I was stunned. I couldn’t walk anywhere I couldn’t really talk to anyone,” Dr Lim says.

He says he was absolutely floored by the magnitude of the situation and shocked that the hospital continued to buzz around him.

“I thought to myself ‘what an Earth-shattering moment’,” he says.

“I don’t know what I expected but I felt like a bell should have tolled or we should have observed a moment’s silence.

“I just felt that this moment deserved some recognition. A man had just died.”

Dr Lim says he was painfully aware that for that man’s family, the world stopped that day.

But in the emergency department business continued as usual. There was a young woman in the room next door who had a ruptured ectopic pregnancy, which is considered a true surgical emergency. The waiting room was full of people and the ambulances were ramping up outside.

‘I could hear the ribs cracking.’

Dr Lim’s patient that day was a 48-year-old man with no medical history who was sitting at home on the couch watching TV when he clutched his chest and fell to the ground.

Forty-five minutes later he was in hospital and Dr Lim was pounding his chest.

“What they don’t teach you in medical school is the sensory aspect of performing CPR on a real person,” Dr Lim says.

“As I was trying to keep this man alive, by squeezing his heart up against his spine, I could feel the ribs cracking underneath the heel of my hand.

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“I could hear them cracking, and I could smell the vomit that I was pumping from his stomach into his throat.”

He says patients who have heart attacks outside of hospital have a very poor chance of survival and the chances decrease the longer they’re not in hospital.

“This man I was resuscitating was dying. The nurses had cut off all of his clothes down to his underwear and I remember thinking he must be cold in here because the thermostat was low,” he says.

But Dr Lim wasn’t cold, he was sweating from extreme physical and mental exertion.

“CPR is physically exhausting. Your whole body knows it is dealing with an emergency,” he says.

“The adrenaline is coursing through your veins. Every muscle was aching and I was getting out of breath.”

Calling it.

Dr Lim recalls the consultant saying that after the next round of CPR, if there was no improvement, they were calling it.

“‘Calling it’: What does that mean? How could you stop? How could you give up on this guy? He’s so young, he has a family,” he recalls.

“When he woke up this morning he was absolutely fine. I signed up to medical school to save lives, not to give up on them.”

Dr Lim and his team got through the next round of CPR and everybody stood back and looked at the cardiac monitor.

“There must have been 10 people in that room and not one of them was breathing. Thirty seconds. Nothing,” Dr Lim says.

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“The consultant announced the time of death and a sheet was brought up over the body and everyone walked away to deal with the next thing.”

But Dr Lim couldn’t walk away.

“I stood outside of the cubicle. This was the first death I had ever witnessed and I needed some time,” he says.

Acknowledgement of grief.

It was when his patient’s wife arrived shortly after that Dr Lim witnessed the acknowledgment of this man’s humanity that he had been waiting for.

“I watched her being taken behind the curtain to her dead husband and I heard wailing, not a shrieking, hysterical sound but a low pitched gut-wrenching tortured wail,” he says.

“Finally someone was engaging with the tragedy of this man’s death by giving an emotional response.

“I leant against the wall and listened for as long as I needed for in some way to pay my respects to this man by sharing in the grief of his bereaved wife.”

Dr Lim is now some years into his medical career and has a strong view on the role of doctors and the need to have a consciousness of the effects of death and grief.

“If we don’t allow ourselves to feel, we’re at risk of becoming mere technicians of medicine,” he says.

Hear Dr Izaak Lim tell his story on ABC Radio’s new Tall Tales and True podcast. Subscribe on iTunes, the ABC Radio app or your favourite podcasting app.

This post originally appeared on ABC News.


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