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CPE continues to be CPE. Lots more introspection than can possibly be healthy, too little time with patients. This morning I almost called in sick. I woke up feeling that body ache you get just before the flu. Then I realized...no, that's just a tired ache. It's not the flu; it's five hours of sleep. I also remembered that I was today's on-call chaplain, so I'd better get my bum out of bed or a fellow student would have to fill in and be mighty put-out and distempered with me. This will sound a bit odd, and potentially morbid, but I'm glad I went because I was paged to a Code Blue (cardiac arrest) at which a man died. Let me be clear - I'm not glad the man died. I'm glad that, if it was going to happen, I was present. For one thing, it was my first experience of a Code Blue. For another, I was able to say a prayer at the time of death. I was also able to help some of the staff deal with the incident, which is a deep and awesome privilege. Medical types work very hard to remain stoic in the presence of a lot of pain and death...when they do break down it's a bit frightening. I could tell when I arrived that it was a lost cause - the man was on his gurney, in the hallway of an outpatient clinic (where Codes Blue do not normally happen). A crowd of people in scrubs and lab coats surrounded him. A determined looking young doctor was doing chest compressions, while a number of others (whose titles and duties remain a mystery to me) fussed with tubes and suction and whatnot. A couple of other doctors stood nearby, one of whom appeared to be calling the shots. What struck me was how casual everyone was. There was a job to do, and they all knew their roles, but nobody got all excited like the doctors on ER. No rushing, no cursing at slow nurses or yelling "stat!" at the interns. It was workmanlike...except for the young doctor doing the chest compression, whose face was set in a fierce refusal to allow this man to die. Determination was not enough. Not today. The various gadgets the team was using were all a mystery to me, but even I could tell from the almost forlorn sound of the "beep...ping" that the outlook was not good. Finally, after ten minutes that seemed like ten hours of a desperate struggle, the doctor in charge admitted defeat. The young doctor, so defiant one minute, immediately stepped back. Then a whole different process began, just as efficient. Wires and tubes were either removed or tucked into the covers, machinery was wheeled away, gizmos whisked off to be sterilized or whatever. The crowd, called as I had been by the Code Blue page, dispersed. Their talents and skills and training were no longer needed. Mine were just now called for. I spoke to the young doctor, who seemed determined to bluff it off. I talked to a nurse who looked shaken but capable of coping. Then I saw him...a lab tech, standing in his examining room door, which had been blocked by the dying man's gurney. This poor fellow had been trapped in that room, watching it all happen. Once the gurney moved I stepped into his room. He was visibly shaken; the patient had been with him, getting an EKG test, when it happened. "When I finished the test, he was alive," the man said. Worse still, his own father died not a month ago and his mother two months before that. All that grief, stowed away for his day at work, came flooding to the surface. There was very little to say, so we just stood. I closed the door and handed him Kleenex. He desperately wanted to maintain composure, but on his computer screen were the EKG test results of the now dead man. You could see the squiggly lines flatten as he scrolled across the screen. "How do I close this out?" he asked. "He's dead. How do I close a file on someone who is dead?" "I don't know," I answered, and that was the absolute truth. |
