Saving a life?

Posted: August 11, 2011 in medicine
Tags: ,

This story begins with me in a rotation in the medical ICU as an intern, which is the first year of residency. I feel more prepared than others because I have experience as an EMT on a 911 ambulance service and I also have had quite a few rotations before this one, including pediatrics, 2 family medicine hospital rotations, and a rotation in the cardiac ICU.

As settle myself in I see the fast paced action going around and I decide in about the second week to tell the senior residents that I want to “run” the next code. Running a code basically means you tell when to give the drugs, when to stop CPR to check the EKG rhythm, and when to stop the “rescue effort” all together. As fate would have it, the next patient who “coded”, aka whose heart stops mechanically pumping, is one of the patients I have been managing.

She is an african american in her 50s who looks like she’s in her 80s because of her severe blood infection (sepsis). I have never interacted with her when she was awake, as all my visits have been while she was in this coma like state. Despite our efforts to save her, including tons of IV fluids, which are making her swell like a marshmallow, and 10 drugs hanging from IV poles, she is still dying. Even though everyone sees what is happening, her health care proxy, her son, wants us to do everything possible.

The blue light begins flashing, “CODE BLUE MICU, CODE BLUE MICU”, indicating a patient in cardiac arrest. I run to my patients room knowing that it is probably her. I am one of the first ones there and begin assuming command of the code. As I am keeping track of time and the drugs that have been given, I am disgusted as I watch the medical staff slip off her chest as they do CPR. Sadly, she is so far into sepsis that any contact with her is literally tearing off her skin. The area where chest compressions are done is just bare raw flesh, even her wrist where the nurse is checking for a pulse has turned into red flesh absent of any skin. The staff put a towel on her chest so their hands stop sliding while doing CPR. We continue the code….5 minutes…10 minutes… I call out “2 more minutes and I am calling the end of the code!” 1 minute passes… Then a nurse yells out “I have a pulse!”, I reply in a monotone voice “Confirm”, which another nurse does.  We end the code and I have “saved” a person. A person who is twice their normal weight from all the fluids that are needed to keep her blood pressure up, a body that’s skin falls off at the slightest of touch, a person who has no interactions with the outside world.

At the end of the code, when everyone else has left , I straightly stand over the “living” person. I stare down at her corpse-like body thinking “What have I done?” Have I really “saved” a person to experience more suffering and hardship? Tears begin forming in my eyes as I am having trouble accepting if I have done as what Hippocrates said, “Do no harm”.

I go off to lunch for about 10 minutes, when I come back a bedsheet is over her body. Her heart stopped again during the short period I was gone and the staff made the son watch the resuscitation process. He last only few minutes before he pleaded for the workers to stop and let his mother go.

Thus ended one of the most horrible experiences I have had when I did what is medically right, but felt so wrong inside.

 

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Comments
  1. Paper Tiger says:

    very moving. i cannot imagine having to be privy to such suffering, or the struggle within and without. how very difficult that must have been.

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