Months ago, on a friday- I had the pleasure of checking in a patient that I really “clicked” with. Sometimes a patient comes in and right off the bat, you get a fun banter started, and inside jokes are established that set a playful precedence for the whole visit.
This particular time, the patient was checking in with chest pain. He had a history of cardiac disease, and had previous heart surgeries. I hook him up to the monitor, do an EKG and help get him settled in. Even though he’s in some pain- he keeps good humor and we crack jokes back and forth. I get the pleasure of being part of his care for the morning- and then he’s taken upstairs to a room.
I don’t remember if I had the weekend off or not- really it’s not important- I know it was a busy monday. The emergency room was full of patients- and as usual when it’s busy…the level of chaos was high. I was dealing with a psych patient who had started out being very friendly with me- by the end of the day he was flat out cursing me and threatening me- until we tied his butt to the gurney. All in all, it was a challenge of a day.
It was about lunch time- I think I had just eaten when I hear a code called over the intercom, “code blue, cath lab.” Code blue is our hospital code for pulseless arrest and the cath lab is an area where patients go for vascular studies and cardiac intervention.Surgeons have the capability to put a wire into the system of vessels that leads to the heart, pump some x-ray visible dye in, and see plainly- where blockages are in the heart or surrounding vessels. On top of being able to see the blockage, they can place stints, use clot busting agents and a number of other interventions.
Even though I’ve already done CPR twice before lunch (yeah, it was a crazy one) I run to the code. I gown up and relieve the nurse doing CPR. To my dismay, I look down at the patient I had checked in on friday. This sucks. Usually it’s fairly easy to separate yourself mentally and stay in a “medical mindset.” When you have a personally history, it makes the whole ride a little more traumatic. We worked and worked and this patient, trying everything that the docs on scene could think of.
The surgeon kept muttering, “Damn, this is one of my favorite patients.” I could tell that this guy was well loved and it made it hard to seperate mentally when all was said and done. Soaked in the sweat of defeat, I bagged up our supplies and headed back to the ER.
As I sat, being cursed, threatened and insulted- post CPR- it made me realize something. The things we do- really can have a lasting impact on someone. I’m sure I would have remembered the coding patient had he been kind, rude, quiet or otherwise. My medical response would have been no different, but my heart would have been in a different place.
You never know when you’ll take that last step, that final breath, or speak for the last time. I want to be remembered as someone who loves- I want people to feel like I blessed them with the way that I treated them. Easier said than done, it’s true- but a worthy goal to strive for.