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My Night on Call…Alive or Dead?

Authors: Fatima Rauf, Rawalpindi, Pakistan, @fatimarauf45

From examining abdomens for peritonitis to assessing Glasgow Coma Scale (GCS), I didn’t know at that time, but my transition from general surgery to neurosurgery felt like going into a different world. On my first day in the neurosurgery ward, I was asked to assess the GCS of every patient as the round progressed. I didn’t know about the history of the patient or how they got there. I didn’t know about the lives they spent before lying there in bed either irritable, drowsy or comatose. I was just assessing their GCS as requested by the consultant.

After having assessed a female patient whose GCS was 3/15, I saw tears dropping from her eyes. As I wiped them and tried to assess the GCS one more time, as I thought I might have assessed it wrong previously, my consultant told me that she would be declared brain dead soon as soon as her brain stem reflexes were absent.

I looked at him and then I looked at the patient and my mind went numb. How can someone who just showed me her tears was about to be declared brain dead? Why don’t we count those tears in while making our assessment about the patient.  How can we label a person dead (or near dead) based on a mere score. I saw her tears! I know that she couldn’t open her eyes or move her limbs when given a painful stimulus, but she cried! Isn’t it what we mostly do when we are in the most pain!

We as humans have to give scores to everything, even life and death to wrap things up logically. We need to keep things black and white for reasons sake. As I was standing there torn between logic and emotion, I was asked to move to the next bed. As I moved forward, fighting against my emotions, I could not help but think as to who was more conscious and alive; those lying in beds trying to tell their stories and show their pain or us who, though physically alive, were internally dead and unknowing of the pain of those lying in front of us. Lifeless people declaring others alive or dead based on a mere score! 


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