Why was Esther dying? Well, if you ever needed proof that perforated appendicitis is a different disease than regular appendicitis, Esther is your proof.
As I waited for the staff to ready the operating theatre, I thought back to the last patient I had who developed sepsis from perforated appendicitis. He was half dead by the time he got to the hospital, and over the next two days he completed the process. Now the seconds ticked by interminably, and with each passing minute I had a stronger and stronger feeling this case would be a tough one. Little did I know how right I would be . . . sort of. Well, not really. Kind of. Ok, the case itself wasn't hard, it was just that, well . . .
We finally got Esther into the room and placed her on the operating table right at midnight (since appendicitis always happens in the middle of the night, apparently). After putting on the appropriate monitoring equipment, the anaesthesiologist was supposed to quickly put the patient to sleep, put a breathing tube in, and let me get to work. But that's not precisely what happened. Ok, that's putting it mildly - it's not even remotely what happened. Instead, this is exactly what I heard, word-for-word, as Dr. C (not her real name) tried putting the tube in:
Nurse: "Do you see something?"
She tried to put the breathing tube in five times, and five times she managed to get it into the oesophagus rather than the trachea. WRONG, WRONG, WRONG. After nearly an hour of trying, she called a second anaesthesiologist, who had to drive in from home, to assist. While she was waiting, she tried putting in an radial arterial line so she could monitor her blood pressure directly. True to form, she couldn't get that in either.
GOD. DAMN. IT. Back to square one.