“Do you want to eat here or head back to the station?”
I ponder him for a brief moment. He’s already holding our
neatly packed Chinese food in a to-go bag. I glance between him and our
ambulance parked neatly out front. “Let’s eat here,” I finally say after some
deliberation. It’s well after 4 in the afternoon and I haven’t eaten since
breakfast before I came on shift. The 10-minute drive back to the station seems
like a relentless eternity for my growling stomach. We plop down at a sunny table
near the door and descend upon our food like vultures who have found their
first meal in days.
“I took us out of service since you need to leave at 5,” my
partner tells me in between bites of his chow mein.
Perfect. Eat. Finish my report quick. And be home in time
for our family’s plans for the evening. It almost seemed too easy…and it was.
16:39…our pagers interrupt the calm quiet of the restaurant
and startle the few patrons that are milling about at this hour. Cardiac arrest…at
the grocery store only slightly more than a block away.
It has only been a little more than a week since my “Christmas
Code” and my heart does a strange flip-flop. It’s a mix of excitement and fear.
The grocery store. I hate codes in public. So many eyes. So much judgement. And
what if she doesn’t live?
But we’re a block away and even though I’m supposed to be
off in 21 minutes, we cannot pawn this call on the next available crew. We bolt
from the restaurant, my partner abandoning his half-eaten curry that he had
been savoring, and dash through traffic in the parking lot. Within seconds we’re
in our ambulance. I flip on the lights but opt not to key up the siren. Neither
will save us time in the gathering afternoon traffic but the lights at least
let people know we’re on “official business” as I make the quarter-mile dash to
the grocery store and swiftly park in the fire lane directly in front of the
main entrance. One minute. It’s been one minute since our pagers so rudely
interrupted our much-anticipated lunch.
Bystander CPR is in progress. 92-year-old female down in the
pharmacy. That’s what dispatch had told us.
“I bet it’s a seizure,” my partner has repeated more than
once in our brief journey.
But my gut says it’s not.
As we drag our equipment-laden cot past check-out stands
full of horrified customers, we hash out who’s running the call.
“I’ve got it,” I firmly tell my partner more than once.
“You’re supposed to be off soon,” he argues.
“I’m next in the rotation.”
“You’re sure?”
“It’s my forte. I’m not passing this up,” I reassure him.
And then we’re there. Just past the partition of the
pharmacy. CPR is indeed being done on an elderly female by someone wearing a
puffy winter jacket and a large stocking hat. The woman’s eyes are open yet
unseeing and her mouth is moving in a fashion that makes it appear that she is
trying to talk. But no words are coming out. My partner and I deftly grab our
equipment and fall into place beside the person who is feverishly doing chest
compressions. They are weak and too fast and for a full moment I wonder if the
woman even needs them at all. Then man doing chest compressions briefly glances
up at me…and I recognize him.
“Hi, Amber,” the emergency physician offers me a half-smile
then quickly turns his attention back to the female lying helplessly on the
floor. This is the same ER physician who assumed care of my “Christmas code”.
Equipment is being flung about in what appears to be some
haphazard garage sale in the middle of the pharmacy. I slap defibrillation
patches on the patient’s chest and briefly glance at the rhythm that dances its
way erratically across the screen. Ventricular fibrillation. I charge my
monitor and deliver a jolting dose of 200 joules. The ER physician immediately
resumes his hurried chest compressions.
My notebook is in hand. The timer has started. I have 2
minutes before I need to recheck my monitor. I grab an intraosseous needle and
quickly drill it into the bone below her left knee. From somewhere the
pharmacist has appeared and is trying to hold the patient’s hand. I need her
out of our way so, trying not to be rude, I hand her the IV bag of fluid and
ask her to keep squeezing it. She graciously complies and assumes a position
near our patient’s feet.
Our 2 minutes is up. Re-check the monitor. As all of our
eyes catch a glimpse of the regular, yet oddly misshapen complexes racing their
way across the screen, the physician reaches down and checks for a pulse. “I’ve
got one,” he says, as the fire department rounds the corner into the space that
seems to be growing smaller by the minute.
“Let’s do a 12-lead,” the doctor orders and all oblige his
request while he thrusts a bag of medication at me to attach to the line I have
running into her leg. The picture of her heart shows nothing incredibly out of
the ordinary.
We pick her up and load her onto our cot while one of the
firefighters takes over the job of helping the patient with her breathing using
a manual bag-type mask that represents what an average person would probably
constitute as a torture device. Once again whisk our cot past horrified
customers in the check-out lanes. It’s been just over 10 minutes since our call
came in. As we quickly load our patient in the ambulance, a firefighter makes
his way to the driver’s seat and almost immediately activates the siren as he
bounces us down the snow crusted roads toward the hospital. My partner inserts
another IV into her arm while I notify the hospital that we will be there
shortly. All the while, our patient is becoming more and more coherent and
eventually tries to push at the mask that is being held over her face…a good
sign. My partner is asking her questions but none of us can make out the
garbled words that she is muttering.
After what seems like an eternity of being jostled in the
back of the ambulance under the scrutiny of the ER physician, we finally arrive
at the emergency room where a large team has assembled…our “welcoming committee”.
But unlike other occasions where I’m called upon to make a report to the
receiving physician, I get to stand back on this one and let the other ER
doctor do all the talking. It is an odd dynamic, one probably never to be
repeated. So, I curiously watch their interaction, and, when the time is
appropriate, I duck out of the room to start my report…and make the call home
that I’m not going to be off at 5. I’m already 17 minutes late.
Generally, I don’t relish staying late at work. Family time
is important to me and I’ve always been a person to follow through on what I
say I’ll do. I feel a twinge of guilt as I make the phone call still. But when
I see my patient’s son holding his mother’s hand when I left the ER, it made
things feel right with the world.
When we finally get back to the station, our story spreads
like wildfire. A fellow medic takes it upon himself to wrangle everyone who
comes through the door even before we can to tell them our unbelievable
adventure.
What made us stay to eat lunch at the
restaurant? What are the odds that our ER physician happened to be grocery
shopping there at just the right time? How in the world does a 92-year-old
woman survive a cardiac arrest? I’ve mulled over all of these questions in the
last several days. And all I can tell you is that there are things out there
that we will never fully understand…other than we all just happened to be in
the right place at the right time
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