The last second miracle at taipei renji hospital

In the heart of Wanhua District in Taipei, Taiwan, on a narrow, wet lane called Guangzhou Street, there stands a very old hospital called Taipei Renji Hospital. From the outside it does not look like a modern hospital at all, its tiles have turned yellow with age, its walls are covered with layers of notices, handwritten signs about visiting hours, about wearing masks, about emergency fees, and every morning from seven o clock people start lining up in front of it. The air smells of rain, fried food from the stalls nearby, and disinfectant. It was in this hospital that a story happened that people in Wanhua still talk about when the crowd gets too much and the nurses get too tired. The main person of this story was a man named Chen A-Gong, he was sixty two years old but looked much older, his back was a little bent from years of lifting scooter engines, his hands were black with grease that never fully washed off, his clothes were old and patched, a faded brown jacket and blue pants that had been stitched many times. He lived alone in a small room near Longshan Temple, just a ten minute walk from the hospital. His wife had passed away five years ago, his son Chen Jia-Hao worked in a factory in Kaohsiung and only called once a month. Every day Chen A-Gong woke up at five in the morning, opened his tiny scooter repair shop, a shop that was not really a shop but just a covered space on the sidewalk with tools hanging on nails, and worked till sunset. He had National Health Insurance, like everyone in Taiwan, but he believed going to the hospital meant losing a whole day's wage, so he avoided it unless he was really dying. For three days he had been feeling a strange pressure in his chest, like someone was sitting on him. On the first day he thought it was gas from eating too fast, on the second day he thought it was tiredness, on the third night it became so bad that he could not breathe properly when he lay down. He sat all night on a small plastic stool under his table fan, wiping sweat, praying. On the fourth morning, he finally decided to go. He took his old rexine bag, put a few coins in it, a single one thousand NT dollar note folded many times, and an old medical report from two years ago that said hypertension. He walked slowly to Taipei Renji Hospital, stopping every few steps to catch his breath, feeling the pain spread from his chest to his left shoulder.

When he reached the hospital, it was already full. It was flu season in Taiwan that month and everyone had a cough, the emergency room was overcrowded, and to make things worse, the hospital's old computer system had crashed at nine in the morning. All the records that were usually digital were now on paper, handwritten, carried by hand from one floor to another. The staff was running, shouting names, and patients were sitting on benches, on the floor, outside under umbrellas because of light rain. Chen A-Gong went to the registration counter, got a number, his number was 8812, and was told to wait outside because there were no chairs left inside. So he sat on his small stool near the entrance, his bag on the ground, his breathing heavy, watching the scooters pass by on the wet road. Inside the hospital, a big mistake was already in motion. A young nurse named Wang Jia-Ling, twenty four years old, who had joined the hospital only three months ago, was told to carry a stack of about thirty to forty patient files from the third floor surgical ward down to the first floor emergency. The files were heavy, the stairs were old and slippery, and as she was hurrying down, her foot slipped and all the files flew into the air and scattered across the corridor. Papers everywhere, yellow sticky notes falling, patients looking. Another senior nurse, Chen Mei-Li, shouted, be careful, but it was too late. In a hurry, they picked up all the files quickly, without checking, and put them back in a pile. In that pile, two files got exchanged. One was Chen A-Gong's file, sixty two year old male, chest pain, history of hypertension, file number 8812, and the other was a woman named Zhang Mei-Ling, forty five year old female, gastric ulcer, with a known allergy to Penicillin, file number 8813. The numbers were next to each other, the papers looked similar. So Chen A-Gong's name now had Zhang Mei-Ling's medical details, and Zhang Mei-Ling's file had Chen A-Gong's details. No one noticed. The pile was taken to the emergency doctor's desk.

The emergency doctor on duty that morning was Dr. Chen Jian-Hong, thirty two years old, a graduate of National Taiwan University Hospital, but he chose to work in this old community hospital because he wanted to help poor people. He was already exhausted, he had been on duty since last night, he had seen a scooter accident case, two fever cases, and his eyes were tired. When he looked at the file that said Chen A-Gong on top, he read gastric ulcer, Penicillin allergy, forty five year old female details but the age on top said sixty two, he thought maybe it was a typo, but he thought this is not a cardiac case, this is just a stomach pain case, give him antacid and do ECG after two hours, first see the accident patient. So he told the nurse, let the old man wait outside, his stomach is paining, give him some time, we have more urgent cases. Outside, Chen A-Gong waited for two hours. He told a nurse passing by, sister, my pain is increasing, it is going to my shoulder, but the nurse, looking at the wrong file information in her hand, said, uncle, your gastric pain will take some time, doctor is busy, you will get medicine soon. Chen A-Gong went back to his stool, he closed his eyes, he held his bag tight, he thought of his son, he thought maybe this is his last day. The light rain continued, his jacket got wet, his sweat mixed with rain water, his face became pale, his lips turned a little blue. Inside, another nurse, Lin Xiao-Hui, thirty five years old, with ten years of experience in emergency, noticed something. She had seen many heart attack patients, she knows the look. She saw an old man sitting outside since morning, his color now completely pale, his head falling down. She ran outside, touched his hand, his hand was cold and clammy. She shouted loudly, Dr. Chen Jian-Hong, come fast, this man is collapsing. They put him on a stretcher and rushed him into the emergency room, the emergency room had a sign in Chinese that said Emergency Room and Please Keep Quiet, Rescue in Progress. They connected the monitor, the numbers were terrifying. Heart rate thirty eight, oxygen saturation seventy eight percent, blood pressure very low. The ECG line was almost flat, the heart was about to stop. Dr. Chen looked again at the file that said gastric ulcer and felt confused, this is not gastric, this is heart. At that moment, Chen A-Gong's old rexine bag fell from the stretcher, and from it fell that old crumpled, slightly wet report from two years ago, the one that said hypertension, high blood pressure. Dr. Chen picked it up, saw it, and his mind clicked. He shouted, this file is wrong, check all papers on the floor. Nurse Lin quickly searched through the scattered files on the floor near the corridor and found the real file, file number 8812, sixty two year old male, chest pain, hypertension, no allergy. That meant the allergy warning was false for him, and the ulcer diagnosis was false too. If they had given him the medicine for ulcer, it would have done nothing, and if they had avoided the life saving injection because of the false Penicillin allergy, he would have died. There was no time left. Chen A-Gong's eyes were closing, his breath was breaking, the monitor was beeping slowly, then a long beep.

Dr. Chen started CPR immediately, he put both his hands on the chest and started pressing, one, two, three, four, sweat dripping from his forehead onto his glasses, his white coat shaking. Nurse Lin put the oxygen mask, prepared the correct injection, the one that was not Penicillin based but actually could be given now that they knew there was no allergy, but also the blood thinner and other cardiac drugs. The room was silent except for the monitor and the sound of chest compression and the rain outside. Outside the emergency room, a few patients were peeping, praying. Two minutes passed, no change on monitor. Four minutes passed, Nurse Lin's eyes filled with tears, she thought they lost him. Six minutes passed, Dr. Chen was exhausted, his arms were paining, but he shouted, A-Gong, wake up, you cannot go now, who will take care of your scooter shop, your son is still in Kaohsiung, wake up. And like a miracle, the monitor gave a small beep. Then another. Heart rate went from thirty eight to forty two, then to fifty eight, then to seventy six. Oxygen saturation went from seventy eight to eighty five, then to ninety two. Chen A-Gong opened his eyes slightly under the oxygen mask, he tried to say something. Dr. Chen sat down on a stool, completely tired, his breathing fast, he said, he is saved, we saved him at the last second, he was gone and came back. They shifted him to the ICU, started the real treatment, blood thinners, preparation for shifting to a larger hospital for blockage removal. When Chen A-Gong gained full consciousness, it was seven in the evening, the rain had stopped, the lights of Wanhua's night market could be seen from the small window, the smell of stinky tofu coming from outside. He saw Nurse Lin standing near him, he asked in a weak voice, am I alive. Nurse Lin nodded with a smile and said, A-Gong, your file was exchanged, but God saved you. A tear came from Chen A-Gong's eye, he looked at his bag that still had some coins, he said, I have no money to pay the doctor. At that time Dr. Chen came in, he said, don't worry about money, NHI will cover most, and I will take care of the rest, you just rest. The next day, the hospital director called a meeting, after this incident they removed the old paper file system and installed a new barcode system, and put a notice that no file will be carried by hand anymore. Nurse Wang Jia-Ling was not scolded, instead she was given proper training. After a week, when Chen A-Gong was discharged, he had a small bag with medicines, and Nurse Lin had bought him a new blue raincoat with her own money. He went back to his small scooter repair space, sat on his stool again, but now whenever a customer came with chest pain or talked about gas, he would tell them, brother, don't think chest pain is gas, go to hospital immediately, and check your own file, make sure your name and disease match. In that small Renji Hospital in Wanhua, Taipei, the small mix up that happened due to hurry and old system almost took the life of a poor man, but the alertness of one experienced nurse and the hard work of a young doctor brought him back from the edge of death. Even today, people in Wanhua remember that case when the hospital gets crowded, they say, remember Chen A-Gong's case, check the file carefully. It became a lesson that a small negligence can become very big, and a decision taken at the right time can bring someone back from death itself.