21 minutes

today i found myself in the middle of a code.

i had admitted this patient several weeks ago. he was in his 60s. he had a cardiac history, not unlike my father's. and his wife was kind. they walked the halls together hand in hand. and sure enough, not surprisingly, part way into his chemotherapy, his heart started to act up. i hadn't seen much of him since he was transferred to our intensive care. i don't tend to spend much time back there - on purpose! but compared to other ICU patients, this patient was doing decently. he was not yet intubated. his lungs had not failed him yet. infection wasn't yet riddling his body. it was just his heart. it continued to beat erratically and uncontrolled, despite medication. and this morning, his blood pressure dropped to dangerous levels. i can't really discuss the complexities of his care because i was uninvolved.

but at 10:26, when a code blue was called on my unit, i found myself in the midst. i was planning to go back to the room, check to see if things were under control. sometimes nurses need more supplies. sometimes i can run and get the code cart. most of the time though, i hang out in the halls with the family - with distraught loved ones. i get chairs and boxes of kleenex. i explain that the nurses and doctors are doing all that they can do and once things are more stable, someone will come out to give them an update. i ask if i can make calls, to relatives, friends, whomever. but typically, i stay OUT OF THE ROOM.

today was different. i've been on my unit for more than 5 years. i'm more than capable of helping out. and so, when the charge nurse asked if i would come in and record, i did. the recorder actually has a significant role. as vital signs are taken, i document them. as shocks are given, i write the time and the number of joules. when pharmacy delivers medications, i note the amounts and the times given. at different intervals throughout the code, all eyes are on me to list the names, amounts, and times certain medications were administered. epinephrine. calcium gluconate. atropine. sodium bicarbonate. lidocaine. paralytics. vasopressin.

people did chest compressions for two minute intervals. an airway was introduced and the respiratory therapists breathed for the patient. doctors discussed likely causes for sudden death. ALL CLEAR was yelled before the paddles delivered the unsuccessful shock. several rounds of epinephrine were given, in an attempt to restart the heart. but all of it was futile. at 10:47, the pulmonary fellow pronounced it. "time of death 10:47." just like on TV. within seconds, the room cleared. the 20 people who gathered to assist took off their rubber gloves and gowns and dispersed within the hospital. in less than 1 minute, i was left in the room with just the patient's nurse, the charge nurse, and a deceased man.

i often think my job is strange. i find myself in strange situations. but today, i couldn't help but feel extra weird. for 21 minutes, i witnessed medicine in action. for 21 minutes, heroic measures were attempted to bring a dead patient back to life. for 21 minutes, dozens of people worked harmoniously on the same "project," for the same purpose. and after 21 minutes of hard work and intense efforts, a human being died. it's so strange that in just 21 minutes so many things can change. our unit had one less patient. one nurse no longer had a person to care for. and one wife no longer has a husband.