I had a few days off last week, and when I went back to work the other day, I was shocked to find out that a teenager I had admitted a few nights before had died suddenly on the floor. She'd had heart and lung problems her entire life and had been leading a relatively normal life when she started coughing up blood. When I saw her, she was completely stable, and she got admitted for more formal testing. Everything was done correctly-- specialists were called in early and responded quickly, and I don't think that there was anything that we could have done differently.
While death and bad outcomes aren't all that uncommon, I guess I just have high expectations for stable patients that get admitted. Emergency medicine is high-pressure, but generally you can lump patients into just a few categories: those that go home, those that get admitted and then go home, and those that you just can't fix. I think that I have been brooding about this case because we all thought that this child would do so well. I had to really push the parents to allow her to even stay to get evaluated.