A 100 years old man

It’s my first day in the hospital. It is not busy, only around ten patients with two operations done. But I need to make a difficult decision. There was a 100yrs old man, bed bounded, admitted 3 days ago with infected, gangrene left foot. It is so bad that he needs amputation. I suggest above knee amputation. It carries a very high operative risk but if he does not operate, he will certainly die of the infection. The team decided to interview the relatives. I saw his three sons and some grandchildren. All are pretty old man but they are quite reasonable. They understand quite well on his father’s condition and grave prognosis. They decided to take conservative approach with no operation. I respected their decision. They would like to take their father home and let him die with the family. I agreed. I gave them some antibiotics and pain killers and asked them to come back for medication after using up or any problem arises. They were very grateful. Again it shows that they are kind hearted people with strong family bond. It seems that it is quite characteristic for a tribal type of society. Before we left the hospital at 5pm, we received two emergencies. One was a 5 years old boy knocked down by a car on the left. He complained of left chest and abdominal pain. I tried performing an ultrasonography for him although I am not good at it. Luckily there was no sign of bleeding. He was admitted for observation.