Is this your first code?
One man in scrubs says to the room with authority, “What is this patient’s name?” No response. The overcrowded bustling of busy bodies accomplishing seemingly nothing continues.
First rotation. First day. First patient encounter. Yes, this is my first code.
Is this your first time performing compressions? Sing “Staying Alive” in your head and get your weight above the patient’s body.
He has no family to notify.
We need another IO! What’s an IO?
A lot of people “do” or seem like they are doing. Some interns and students watch, like me. Unlike me, they watch their supervisors. They observe and learn from the actions of physicians. I cannot do anything but watch him. In this moment, I find I identify more with the person on the table than I do with those rushing around him. It feels urgent that I stay focused on him; that someone doesn’t forget who he is, that I SEE him while he dies.
His name replays in my head over and over. His eyes are open.
I have nothing to keep my hands busy, no tasks to take on, all I can do is watch and think. The first hour goes by. Someone needs to be here for him. I know they’re trying urgently to keep him alive, and that effort is all consuming, but does that excuse their apparent forgetfulness of his identity, his humanity? Can he hear us?
Does everyone agree it would be medically futile to continue compressions if he codes a third time? Yes. A nurse aside, “at this point he will have brain damage if he does wake up.”
Our team was dismissed before they declared him dead. The machine compressing away after the third code. Futile effort, I suppose. Does this still count as the first? The first death I will see?
What about the second? The third? The fiftieth?
Will I still care that no one knew his name? That no one spoke to Mr. Smith while he was dying? Mr. Smith, you have a lot of people taking care of you right now. Mr. Smith, we are here for you.
The first. A big deal. Does the second get to be a big deal? Is it a normal human experience to watch people die, and modern society has removed it from our lives?
Would my superiors understand or only be concerned? Can I handle this?
How was your first day?