The time a patient was shot – Dr. Olufadeji’s Story

8 Minute Read

“OYA! BABY GIVE ME LOVE OOOOOOOOO…” Ayobami sang loudly along with the tunes spewing from his car speakers, bobbing his head up and down. It made him happy to listen to Afrobeat music while he drove. He continued to hum as he pulled into the hospital parking lot. 

Ayobami was a brand new attending physician in Emergency Medicine. Having graduated residency only 6 weeks earlier, he often had to remind himself that he was now the boss.  After 4 years of college, 4 years of medical school, 1 year for his MBA, and 3 years of residency training, he had finally made it. Yet and still, he was surprised at how underwhelmed he felt after all of his accomplishments. While his former co-residents seemed to be excited for the future of their careers, Ayobami simply felt tired. Tired of the hustle, tired of the self-sacrifice, tired of missing out on birthdays, and vacations, and love, and life.

In his free time he enjoyed making Nigerian dishes with a western spin. Cooking was his thing; it invigorated him. The ability to create a culinary masterpiece from the simplest of ingredients, coupled with the good vibes he could curate by inviting friends to congregate around one of his meals, brought him immeasurable joy. Unfortunately, and as life would have it, he rarely had free time to cook because of work. 

Although he loved medicine, he often walked home after a shift feeling heavy… as though boulders were pinning his feet to the ground, and it took everything within him to manage each step. He had convinced himself that he wasn’t burned out, knowing that the day he admitted that would likely be the day he quit. He knew something was wrong; he just didn’t know how to fix it. Nevertheless, he was a doctor, and his job for today was to fix his patients. So he stepped out of his car donning freshly washed scrubs that were the color of the clear afternoon sky above him, and sauntered towards the emergency department (ED) documentation room. “Give me looooooooveeeee, give me love oooooooo,” he sang, more quietly now. An almost unintelligible humming quality filled the air, the kind of energy that people only realized in hindsight was heralding impending excitement.

A co-worker, Kevin, greeted him with a high-five. “HEY EY-YO!” Though Kevin had completely butchered the pronunciation of his name, Ayobami didn’t even flinch as he returned the gesture. Having moved to the US from Nigeria 12 years ago, he was used to this by now. In the past he would correct people each time they mispronounced his name, but he had finally given up. 

Just as he was getting settled and ready to log into the computer, he heard the overhead speaker announce: “TRAUMA RED IN TRIAGE.” This meant that someone who had been severely injured needed immediate assistance. “Sounds like someone needs dodo,” Ayobami joked. Kevin laughed aloud as the two of them ran towards the direction of the growing commotion; Ayobami often recommended dodo (a Nigerian term for fried plantain) as the quick-fix for all life’s problems.

The patient was a slender teenage boy, with skin the color of cocoa beans, and a sleeve of ornate tattoos over his left arm. His face was scrunched into a grimace as he clutched his right side with both hands. His right arm was covered in blood, still flowing from underneath a ragged piece of fabric that someone must have ripped from a shirt and tied around his arm in an attempt at stopping the bleeding.

“What do we have here?” Ayobami asked, ripping a set of gloves from the box on the wall, and putting them on as quickly as he could. Two nurses worked quickly to attach the patient to the cardiac monitor, who groaned in pain with each sudden movement. 

“Sixteen-year-old previously healthy male with gun-shot wound to the right arm, Doc. No head trauma,  airway is intact,” someone replied. “Name’s Matthew Bannon.”

OK he’s conscious, his airway is good… breathing is good… his circulation is… Glancing quickly at the patient’s bleeding arm, Ayobami called out, “Can someone get some blood in here?!!” He then turned back to the patient. “Hey, Matthew, I’m Dr. Olufadeji. Can you tell me what happened?” He untied the fabric around his arm to better assess the entrance wound.

As Ayobami examined him, Matthew told his story. He had been walking to the corner store to pick up some soda and candy after school, when another kid approached him asking for his phone. “When I reached into my pocket to grab my phone,” he said,  sweating profusely as he inhaled sharply in pain. “The kid… he shot me in my shoulder,” his voice became weaker and his breathing more shallow. “And then ran…away…”.

Matthew’s brown face suddenly turned an ashen shade of gray as his eyes rolled back into his head and he lost consciousness. Ayobami suspected what had gone wrong, but he didn’t want to believe it. I can’t find an exit wound, he thought to himself, palpating the patient’s chest and abdomen. “Somebody grab me the ultrasound machine! And let’s get ready to intubate!”

Ayobami grabbed the ultrasound probe and placed it on the patient’s right abdomen and then chest, confirming his suspicions. The bullet had traveled into the patient’s shoulder and through a portion of his lung. The patient’s chest cavity was now filling with blood, causing his lung to collapse. 

Where years ago he would have panicked, Ayobami was eerily calm, his mind in full alignment with his purpose at that moment. He was in control. No movement was wasted, no word was spoken in vain. The next few minutes were a flurry of activity, and all hands were on deck, listening for him to tell them what to do, where to be, how to help. After the patient was intubated to secure his airway, they placed a central line (basically a large IV) in the patient’s neck. Once fluids and a blood transfusion was underway, Ayobami skillfully cut a hole in the patient’s right chest with a scalpel, and then used his hand to guide a large tube into the chest cavity to drain all the blood from around the lung.

Thirty minutes later, almost 2 liters of blood had drained through the patient’s chest tube. He was hooked up to a ventilator machine, and would take some time to recover, but he was stable. None of his other vital organs had been damaged by the bullet. The patient would be OK. Ayobami had led a team to successfully save this boy’s life. 

He was on cloud nine. Before this moment, he had always felt like he was just going through the motions during an emergency, trying to impersonate other successful doctors that had trained him. But today… he felt like himself. He had proven to himself that he possessed the skills to take charge in the most dire of situations. This was what was missing, what he had been waiting for! He had never before experienced this type of joy throughout his entire medical career. I saved that kid’s life!!!! Thank You, God! Able God!

A few minutes later, Ayobami was off seeing the next patient, a 45 year old woman presenting with four months of mild abdominal pain. His high slowly wore off as he struggled to give her the same energy he had given the boy with the gunshot wound, knowing that if he didn’t, something might fall through the cracks. The shift went on for five more hours, with the remaining patients’ complaints being progressively less urgent: shortness of breath from a known asthma patient, the regular alcoholic that was brought in from the street ever-so-often by the police, chest pain that happened to be reflux. 

Six minutes. He only had six minutes of elation after saving Matthew’s life earlier before he saw his next patient and the feelings dulled. In fact, he was astounded at his precipitous drop from the emotional mountain top, shocked when he ended his shift feeling the same way he felt most days. Tired. Tired of the hustle, tired of the self-sacrifice, tired of missing out on his life. This is no way to live, he thought, as he packed up his things. It didn’t make sense that someone would put in 12 years after highschool, for a 6 minute high. When he had initially decided to go into medicine, he was a young boy that had seen many unnecessary deaths in Nigeria due to a lack of adequate emergency health services. “Maybe you can become a doctor for us,” his mom had said with tears in her eyes after the sudden death of a neighbor. All these years later, he still felt a sense of obligation to the desires and aspirations of his younger self, but wondered if this was the best way. He wondered if he was truly on track to fulfilling the purpose for which he was placed on earth.

Ayobami walked back to his car under the night sky feeling heavy, as he often did. He reminded himself that he loved medicine… but he knew something was wrong. Something was very wrong.

When he arrived home that night, he headed straight for the kitchen. He sliced up the plantains that had been waiting for him, ripe enough that their peels had just started to darken. Connecting his phone to his home speakers, he again played afrobeat music, louder now that he was in his own space. “I AM LUCKY TO HAVE YOU OH BABY, LAYE MI O, LAYE MI O,” he sang at the top of his voice as he boiled rice, fried the plantain, and blended bell peppers, tomatoes and onions for stew. His spirits lifted as he danced around the kitchen, and he found himself on a high for the second time that day. The first, only 6 minutes… but this one: 2 hours and counting. He went to sleep happy, and that was something to note.

Written by Dr. Oye, adapted from an interview with Dr. Ayobami Olufadeji.

PS: For those in medicine (or considering a career in medicine), it is very important that we do whatever it takes to maintain our sense of self as we go through the rigor required to be successful in this field. We are people before we are doctors! We are also writers and amateur chefs and spouses and children and friends. We praise martyrdom in medicine… sometimes we tell ourselves that we have to give up all that we are to be the best doctors we can be. Being chronically fatigued, losing sleep, being forgetful, losing your appetite, feeling sad, aggravated or anxious can all be signs of burnout or depression. It is an honor and a privilege to serve humanity in this profession, but if we don’t take care of ourselves first, we won’t be able to take the best care of our patients. Dr. Olufadeji’s story is a beautiful reminder of these facts, and I hope it touched you the way it touched me.

Until next time, 

Dr. Oye.

Dr. Ayobami Olufadeji is an Emergency Medicine physician practicing in Massachusetts. He has high hopes of changing the landscape of the practice of Emergency Medicine in Nigeria, and sees cooking as his antidote for burnout. Check out his Medium page where he writes articles about healthcare in Nigeria (recently published one about re-opening in the time of COVID-19). And ofcourse, connect with him on Instagram at @0moba , where you can see mouth-watering photos of his culinary masterpieces and let him know that his story resonated with you!

Disclaimer: All names, dates, diseases, or any other identifying details of patients and healthcare providers in my stories have been changed to protect their privacy.

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