Our dangerous dance

Update: the patient we tried so hard to save quickly died after arriving at Baghdad hospital. He's in a much better place than we are, to be sure.

This brings me to this post's topic: Resource Management. The team has spent a lot of time talking about how to manage trauma over the past few weeks. Taking care of patients in this austere environment is much different than treating the same patient in the United States....supply is always a consideration, but out here supplies become downright precious.

Besides dealing with trauma and loss, the next hardest thing we have to face out here is the judicious management of resources.....

We just want to do the right thing: we are trained to save the life....and giving up is the last thing to cross our mind--ever. But we have had some heavy debates over the past few days, and had to set some unfortunate boundaries and limits. When we activate the walking blood bank, we are taking potential future donors out of the picture for two months....activating it twice in one day for the same patient is unheard of. One false move on our part, and a future blast or gunshot victim with very treatable injuries may die weeks from now because of a futile decision we make today.

Deciding who gets the resources and who doesn't forces choices on us that quite frankly we just don't want to make......it has deep and lasting ramifications for a trauma team that just wants to "do good", but especially for the patients and their families and friends back home.......the fact that every decision we make out here has consequences one way or the other is constantly on our thoughts.