It was 5 AM. Shrill, incessant beeps echoing throughout the trauma/surgical ICU awoke us from our notetaking-induced stupor. My pager informed me of a “Code Blue” – cardiac arrest – that had just begun in another wing of the hospital. I asked the resident if I could go with him, and we were soon sprinting through the empty hallways, skipping down the staircases two steps at a time, and twisting from one intersection to the next. When we finally turned the last corner, we knew we had found the right place; the room was filled to the brim with a dozen providers, swarming around the man who lay unresponsive on his bed. The patient had developed a non-shockable heart rhythm, which meant that defibrillators would not be of any use.
The resident and I stood just outside the doorway, observing the organization of chaos. “See her chest compressions?” he said softly in my ear, indicating the nurse who was currently on top of the patient. I nodded, and he added, “They’re too slow. Why don’t you go in?”
I dropped my white coat onto the cabinet behind me and sidled through the crowd inside the room. When it was time to switch places, I stepped onto the stool beside the bed, locked my elbows, laced my fingers together, and thrust my entire weight into this man’s chest.
The deafening whirlwind of activity continued around me (“More epinephrine! Another minute!”) but I noticed only my ID badge bouncing in a steady rhythm against my scrub top. My hands and arms dived into the sternum over and over again, in synchrony with my own racing pulse. I had practiced on mannequins many times before, but those experiences were laughable in comparison. At this snapshot in time, I was the patient’s heart.
Once two minutes had passed, I was ordered to step down so that the patient’s pulses could be checked. The room went silent for several seconds as the doctor pressed her fingers against the patient’s femoral artery.
“Pulse,” I repeated underneath my breath, my chest still heaving. I blinked several times. My resident was gesturing at me from the doorway. I inched around the crowd unnoticed, threw my white coat over my shoulders, and followed the resident back through the three-dimensional labyrinth of the hospital.
“How was the code?” another resident asked as the two of us returned to the ICU.
“Good,” said the first resident, grinning proudly in my direction. “She saved the patient!”
I knew that he was half-joking – countless other providers had been in the room with the patient, adjusting ventilator settings and calculating doses of fluids and pressors to inject intravenously – but I decided to savor the moment of triumph for what it was.
I never knew the patient’s name, his room number, what medical conditions brought him to the hospital, or even if he survived. I only knew that he had regained his pulse, that it was my first Code Blue, and that for the first time in my memory, I looked in the mirror and congratulated a hero.