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As an Orange County plastic surgeon, I feel fortunate to like what I do and be in a surgical field where majority of my patients do feel and look better after surgery.

However, I never forget what happened one night when I was a second year general surgery resident rotating at the intensive care unit (ICU).  One evening, I received news about an 18 year old female who was pregnant with her first child.  During or after delivery and the details were not clear, she stopped breathing and sustained several minutes of oxygen deprivation to the brain.  She was subsequently intubated and transferred to the ICU.  Fortunately the child was healthy.  Over the next two days, due to the unknown time of oxygen deprivation and since the patient did not respond appropriately to external stimuli, multiple studies were performed to asses her brain function.   All studies came to the same conclusion:   brain death.

In the evening, when the last set of test results was noted, I approached the family regarding organ donation.  I explained to them her brain damage was severe and irreversible and she will never be able to function or breathe on her own.  The family deliberated for 30 minutes in a private room and decided against organ donation.  They asked me to disconnect her from the breathing machine.

While they were in the room, I hoped the family chose organ donation, since I did not want to face her death.  She was so young!  It also would have benefited another patient who desperately was in need of an organ donor.

With the family in the room, holding hands and with their heads down in prayer mode, I disconnected her from the breathing machine.  It was eight or nine o’clock at night and the ICU was quiet.  This time it was eerily silent.  Although I could have left the room, I did not.  Here was a family I hardly knew, a patient I had known for two days.  After tonight, I probably would never see any of them again.  Yet, I couldn’t leave.  It didn’t feel right for me to leave.

Here I was, a second year surgical resident, helpless.  Neither surgery nor medical technology could save this patient now.  I watched the monitor showing her heart beat gradually slowing down….3 beats per minute…2 beats per minute…one beat per minute…flat line.

No words were spoken to me, but I knew the family appreciated my presence.  I left the room and went to the bathroom and started crying.

I realized something no medical school book or teacher could have taught me.  I was given the privilege and power not only to save lives, but to take life away.  I better not mess up and I better take my responsibilities seriously!

I often think of this patient, just to make sure I don’t forget what it means to be a physician.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon in Santa Ana and a member of American Society of Plastic Surgeons.  His office is located in central Orange County.  If you like to schedule a complimentary consultation, please call (714) 834-0101.

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