My First Code
Originally published April 8, 2017
The radio call comes in: “thirty-something male, cardiac arrest, compressions in progress, five minutes out.”
My adrenaline starts pumping. This new patient will be my first time running a code. I can’t help but be excited.
I claim my place at the head of the bed and start setting up my airway equipment. My brain is methodically running through the ACLS algorithms I have memorized.
When the patient rolls in he is blue and mottled, eyes bulging slightly with each of the one hundred compressions per minute performed on his chest. I go to work: IV, O2, monitor. ABCs. Intubate.
My attending lets me stumble through the code, offering guidance and hints when needed. Based on his appearance at arrival, we all know where this code is heading, but he’s young. He’s my age.
Rounds of Epi, amio, mag, phos, bicarb and lidocaine go in. Compressions continue. No improvement. Every pulse check is some variation of being dead: first v fib, then PEA, then asystole.
After forty minutes everyone is so worn out that I do the last round of compressions myself, pounding away at his lifeless heart, mentally willing it to start. Final pulse check: no cardiac motion on ultrasound.
The patient’s thirty-something wife arrives. My attending breaks the news. The wife whispers, “No, this isn’t happening.” She starts repeating the phrase over and over. Sometimes the words are stated factually, sometimes as a yell and sometimes as a pained cry between sobs.
I can’t help but picture myself in her place, as I am also a newly married thirty-something. I feel the tears welling up in me. I look down and take a few deep breaths.
The freshly minted widow must be physically supported as she is walked to her husband’s room. I walk two steps behind them, unable to hold back the tears any longer.
I turn down a side hall and sneak into the break room. Overwhelmed and heartbroken for this woman, I let the tears pour freely. Not five minutes later I quietly slip into the restroom so I can wash my face and dry my red eyes. Once my breath is steady I go back to work. I have more patients to see.