In this post, I’ll be talking about one of the goriest cases I’ve seen in residency so far, why it’s important to breath, and why it’s even more important to want to succeed in order to be successful.

On a normal Sunday afternoon, the ICU is quiet. My attending gets a call, mutters a few words, and puts the phone down. He stands up, looks at me, and gestures with a nod to come follow him. As we rush down the hallway, the double doors burst open. This 60+ year  old man was being wheeled in a bed with nurses and respiratory therapists at his side holding the monitors and bagging him. He was profusely bleeding out of his mouth.

As with most emergencies, you need to first establish your hemodynamic stability. We quickly established intravenous access and pumped the guy with fluids. We started blood transfusions and the appropriate medications, but the patient still had uncontrollable bleeding from his mouth. We needed to stop it before he chokes on the blood or loses too much and dies.

We clinically diagnosed bleeding esophageal varices and the next step was to stop the bleeding. Since this was an enormous amount of blood loss, we didn’t have time to send the patient to surgery. So my attending placed a “Blakemore Tube” (Balloon Tamponade) to stop the bleeding. After 1-2 hours of bleeding, blood transfusions, and balloon tamponade, we stabilized the patient and the gastroenterologist went in and clipped the bleeding vessels by endoscopy.

Balloon tamponade used to stop the bleeding (Courtesy of 5-minute consult)

So what does bleeding from the mouth have to do with success? There was a young man who wanted a lot of money. So he went to a guru and asked him for help. The guru told him to meet him the next day at the beach at 4am. The young man went to the beach and saw the guru, waist deep in the ocean. The young man joined the guru in the ocean, thinking “how am I going to make money by standing here in the ocean?” The guru asked the young man if he really wanted to be successful. The young man said yes and the guru nudged him to come closer. Then, the guru submerged the young man’s head in the ocean, against his will. The young man was gasping, drowning, and fighting for air. And just about when the young man was about to pass out, the guru raised the young man’s head out of the water. The young man was panting, choking on sea water, and staring at the guru in bewilderment. The guru tells the young man,

“When you want to succeed as bad as you want to breathe, then you will be successful.”

Unfortunately, the patient passed away during his short ICU stay. What stuck with me most, was that scene of him gasping for air due to his own blood. First and foremost, I was grateful for my ability to breath. When things settled down, I connected my patient with the story of the guru. If breathing is something you do everyday because you need to do it to live, why don’t you treat your goals the same way?

Here are FOUR action steps for you to take right now!

1. Find out the one thing that you’ve always wanted to do. (Write a book, travel to Europe, own a business, etc.)
2. Take a huge breath and hold it in. (Don’t pass out now! Although I’d love to meet you all, I don’t want to meet you in the hospital.) Now think of that thing you’ve always wanted to do; it should feel more important than your need to take another breath.
3. Exhale and breathe normally.
4. Use that motivation and go out and do your life-sustaining thing!

Life is made for living, so find your purpose and live. Leave a comment of your experience below!