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Thursday, March 22, 2007

Joules

I walked into the conference room a bit early for the weekly morning conference to find one of the interns standing alone with the lights off, quivering slightly, but grinning foolishly to himself every so often.

Me: What's up?

Intern: Man, I just brought someone back to life! I shocked them. [his gaze starts to drift] ...twice. Man, it was frickin' nuts!

Ah, that explains it. This guy just ran his first successful code. He's going to be wandering around in that gidddy daze of disbelief, relief, and accomplishment all day.

I remember the first time I got called to run a code. I was about 3 weeks fresh out from medical school, and about the only thing I really knew for sure was that I didn't know enough, and I had a lot to learn. As they say, a little bit of knowledge is a dangerous thing... which effectively makes interns one of the most dangerous people in the hospital.

It was about 2 in the morning. I had been answering pages all night, and had just sat down in the lounge to enjoy a bag of chips and do a little channel surfing when I received a page from the nurses on the floor. I was informed that one of the surgical patients had started to seize, and was now in full cardiac arrest. I hung up the phone and immediately started running up the stairs towards the patient's room.

I got to the room lickity-split to a cacophany of noise and activity. A lifeless body's chest was being pummeled by an overzealous nurse. A respiratory therapist was trying to get oxygen to the patient. There were several other nurses surrounding the patient doing something that I couldn't clearly make out. A couple nurses were standing along the wall, ready to jump in and help. It seemed like every monitor and electrical device in the room was emitting an alarm.

As I stood at the doorway trying to make sense of what I was looking at and trying to sort through all the information various nurses were trying to tell me, my brain just froze over and I realized that all knowledge that I had learned about cardiac resuscitation had left my brain during my mad dash to the room.

I looked at the patient, who looked like he was dead. I realized that everybody was staring at me, waiting for my orders, waiting for me to lead the code. I stared back at them like a frightened rabbit. Precious seconds were ticking away. I had no idea what to do. My heart was about to explode out of my chest. I thought I was going to faint.

My Brain: You better do something, or that man's going to die! And it's going to be YOUR FAULT!

My Stomach: Oh man, I feel like I'm gonna throw up!

My Colon: I feel like I'm gonna throw up, too!

My Sphincter: Senor, please hurry! I don't know how much longer I can hold!

(I don't know why my sphincter had a Mexican accent.)

Somehow, magically and guided by the grace of God, that knowledge crept back in my head and I started to run the code. I somehow read the EKG tracing, gave the right medications, and knew when to use the defibrillator to shock the patient. And amazingly, we were able to regain a rhythm and stabilize the patient, who was eventually transferred down the ICU for further monitoring.

And after everybody had cleared out of the room to go about their business for the rest of the night, I stood there alone, much like the intern from this morning, quivering from the residual adrenaline and in disbelief of what had just happened. The relief of successfully getting through that ordeal was, and still is, indescribable.

And all I could do for the next hour was just foolishly grin to myself periodically.