15 July 2018

A Dinner Party

With every breath my patient was choking !

A distressed patient. A dinner party.  Investigations that seemed to take ages. I was waiting for the reports for documentation, although clinically sure of diagnosis. Finally the reports arrived. Meanwhile, the patient had been shifted to the operation theater, ready for surgery. I made a small incision on his chest wall on his left side, inserted my finger and cut open the outer layer covering his lung. Hiss. . . I pushed a tube connected to an under-water seal and bubbles of air escapeed as he coughed. Now he could breathe easily.


His lung was damaged due to years of smoking, and had ruptured partially. The escaped air was trapped between the lung and the chest wall and due to one-way leak the volume of air was expanding and compressing the lungs, leading to his distress. As he inhaled, more air leaked and squeezed his lung. He was choking with every breath!  Now that I had released the air the lungs expanded fully and he could breathe comfortably.
 I looked at the the watch. . . 10:30 p.m. I was hungry and had missed the party.
  I returned home and explained the situation to my wife. She understood. I heated the leftover food from lunch, sat and ate. It was simple and meager, but I was satisfied.
I took a deep breath. Now I could sleep peacefully, sure that my patient could too.

(second image is X-ray before surgery. Note the dark air on ur right side.  The lungs and heart pushed to opposite side. First X-ray, note how the lungs have expanded and heart is back to its normal position.)