Melody was nodding off when all the pagers in the room went off simultaneously, jolting her awake. Raj, her senior let out a huge sigh and looked at her with tired eyes. “Seriously?” he mumbled. In two short minutes they would be off the clock after working all night, but at 6:58 AM, they were being summoned to the other side of the hospital.
It didn’t take long to figure out where exactly the emergency was. On the cardiac unit, the crash cart, nurses, and physicians were huddled outside a hospital room. Melody and Raj entered a gruesome scene. On the bed was a man, very thin, and completely uncovered. The primary team had already started chest compressions. Over his mouth was a bag mask underneath which blood streamed from his mouth, down his neck, and onto the bed.
The resident at the bedside quickly explained the situation to the code team. The patient was a 42-year-old man with a history of severe cocaine use, which had caused perforation of his hard palate and nasal septum. He was admitted two nights ago with a myocardial infarction. He had been improving, but suddenly a few minutes ago his heart stopped.
“Take over the chest compressions,” Raj instructed. As Melody approached the bed, her own heart drummed loudly in her ears. She leaned forward and used all her weight to push down on his chest. He was so thin that the pressure cracked his rib cage and with each compression she felt as if she was squeezing his heart. A lot of people moved around her- inserting IV’s, hanging blood, giving instructions, but none of this interfered with the trance Melody seemed to enter. She pushed rhythmically on the patient’s chest, only stopping to see if his heart would re-start and switching off with another team member. All she could see was this man’s face, his eyes staring blankly back at hers. Sweat beads lined Melody’s forehead as she used all her might to keep this person alive. Raj’s words cut through the air and broke her concentration, “I don’t think we’re going to get him back. Let’s call time of death. Melody, call it.” Melody gulped, not realizing how dry her throat had become. “Time of death 7:48 AM”
She followed Raj robotically out of the room. As an intern in July this was one of her first codes and she had not realized until that moment that being a doctor sometimes literally means having a life in your hands.
When Melody arrived home that morning after her long overnight shift, she felt numb. So much had happened, but she could barely process it. She showered, ate, and crashed into bed, falling into a deep slumber and entered a vivid dream.
In the dream, she saw a young version of the patient she tried to resuscitate. His name was Terrence. She knew everything about him and could feel all his feelings. He looked happy as he held hands with a girl he loved very much. Terrence and his lover were swept up in a euphoric storm and carried high above the ground, floating up towards the sky. The happier they grew, the higher they went until suddenly the girl disappeared and Terrence fell, crashing at a great speed back to Earth. A deep fear and loneliness engulfed him because he knew his lover was dead. Then, Terrence was in a room by himself, doing lines of cocaine, trying his best to numb the pain. But the pain only grew until the feeling of a million bricks squeezed his heart. Then, he was in the hospital bed and Melody above him, screaming, telling him to wake up.
Melody woke with a start, her alarm ringing, telling her it was time for her next overnight shift. She sat in her bed and began to cry. It seemed so horrible to her, everything she had been through. She felt terribly lonely and exhausted from being an overnight intern. She was working days on end with barely any time to register her feelings, missing fun summer days, and dealing daily with the gravity of life and death. She felt that something grotesque had been revealed to her about life, about its decay and brevity, and that it was something peers her age could not understand or relate to. Her soft tears turned to sobs and her heart felt heavy. She was not sure anyone else could understand where she was coming from or if she had the words to explain it. She dressed in a clean pair of scrubs and began to get ready for her next shift.
A few nights later, Melody was in the hospital cafeteria eating dinner when she felt a light tap on her shoulder. “Hey! You’re the intern that was in that awful code the other morning right?” A tall and slender young man with dark brown hair asked her. “Ah.. yeah that was me”
“Nice to meet you, I’m Ted. I was one of the interns on the primary team. I don’t think you saw me during the code, but man. I can’t stop thinking about it. Ok if I sit here?”
As their conversation continued, Melody felt grateful that someone else shared parts of her experience. She began to feel a comfort in the camaraderie between interns that starts in July across hospitals in the United States. She felt herself at the beginning of the metamorphosis from student to doctor as she continued her journey into the world of medicine.