A Medical Record Number

Trigger warning: This story contains themes of suicide, grief, and death of a young patient. Reader discretion is advised.

I was hired as a junior physician in the pediatrics emergency department (ED) at a well-known institution in India. Previously, I had worked in the hospital during my internship, but I had never felt the devastation of losing a patient of my own. In my first month on the job, I grew accustomed to seeing countless parents rushing into the ED carrying a lifeless child, only to be given the most devastating news of their lives.

One day, halfway through a quiet shift, a 15-year-old boy—let’s call him John—was rushed into the ED on a stretcher. Behind it followed his father, mother, and other family members.

I approached the father to elicit a history. Through tear-filled eyes, he recounted the harrowing struggles of the past five days. One evening, he had told his son to finish his homework. A few hours later, he found the boy hanging from the fan, his mother’s sari wound tightly around his neck.

John was still breathing at the time, so they rushed him to a local hospital where he was intubated. A few days later, his condition improved, he was extubated, and discharged. But that morning, they found John struggling to breathe once again. That’s when an ambulance crew intubated him en route and brought him to our hospital.

Upon examination, the boy’s eyes were bulging and hazy, without movement. He was intubated, struggling to breathe through the ventilator. Looking closer, I could clearly see the wound on his neck where the cloth had torn through his skin. We took blood samples and had him shifted to the ICU for close monitoring. Along with the staff, I worked quietly, without emotion or a second thought to what was happening. Just another shift. Another patient. Draw blood. Do paperwork. All business as usual. Nothing difficult, nothing different.

But when I went home that evening, the gravity of what I had witnessed hit me. Though I’d had minimal interaction with the patient and his family, I couldn’t stop thinking about what they must have endured. I thought of my brother, about the same age and what would happen to my own family if we faced the same unimaginable tragedy.

For the next three days, I found myself obsessively checking the electronic medical record for updates on John’s clinical status. I had his medical record number memorized. I would check at the start and end of every shift, once each morning and at night before bed, hoping and praying for some sign of recovery.

I woke up one morning to find his death certificate.

For two days after, I mourned that boy as though he were my own brother. A 15-year-old boy with his entire life ahead of him. An adolescent with so much left to experience in this world. I couldn’t help but wonder what darkness he faced to make such a desperate choice.

It may sound silly to some, but what struck me most was the thought that he probably never even had his first kiss.

I sat with thoughts of his family and the storm they had faced, moving from hospital to hospital, clinging to hope and fighting for his life over something that now seemed so small in comparison; academics. They would have to live with the weight of guilt, carrying the knowledge that their son’s pain had grown too heavy to bear. I also wrestled with darker, more difficult thoughts. Ones I hesitate to admit even now. In those final days, as his family clung to fragile hope, moving from hospital to hospital and watching him suffer, straining their financial resources, I found myself wondering: was this path easing his pain, or prolonging it? Would a quicker end have spared them all the unbearable plight of watching him slip away in such agony?

This small experience had a massive impact on me. I realized that life is so fragile.

Eventually, all of what we are, what we have and what we leave behind will disappear. Truly, all we leave behind is a string of letters and numbers that binds us to history and encompasses our existence from birth to death. A medical record number.

While I don’t know where John’s soul resides, I wish well to his family. He will forever be my first patient death story. His medical record number, forever vivid in my mind, 200xxxF.

-Nikita Egbert