Frenzied attempt to save patient's life

Sarab Sodhi

is a fourth-year medical student at Temple University School of Medicine

The paramedic's bulletin was short and to the point: "40 something-year-old woman. Found down, possibly after a fall. Unresponsive in the field. Bradycardic to the 40s. Protecting her airway initially, but now desatting to the 80s. Barely got an IV."

I stood by my resident's side as she paralyzed the patient and, using a large, curved laryngoscope, pulled open her mouth. Straining with her right hand to pull open the patient's jaw, she grabbed a tube from my hands that went down between the vocal cords. We all released the breath we had subconsciously been holding, and she ordered a medication to raise the woman's heart rate. As she seemed to stabilize, I walked to the door of her room, pulling off my gloves as I went.

But then alarms began to sound. Her heart rate was beginning to drop again. My resident met my eyes and said just one word: "Compressions." I grabbed another pair of gloves and went to my place at the patient's chest. Within seconds, I was at it. My arms were extended, my 6-foot-plus frame leaning over the patient, and my hands linked. I pushed down on her breastbone, hard and fast, and I felt something pop beneath my crossed hands. I was breaking her ribs in this violent, last-ditch attempt to beat her heart for her.

Around me was a blur of motion. The nurses giving med after med. My resident was splashing betadine on the woman right next to my hands. She readied a big needle to get into a big vein in her chest. The IV blew, and suddenly there were people all around me with needles trying to get something in, somewhere, anywhere to keep her alive. And through it all I pumped, humming the song "Stayin' Alive" under my breath. (That's the rate at which you're supposed to do CPR.)

As I hummed, I pushed. Each time I lifted and dropped my shoulders, about 100 times a minute, I felt her chest give a little bit. I saw her chest lift off and drop back onto the bed, her arms lift and fall just a little. Her movements gave her the illusion of life - an illusion I was creating.

The needles were ineffective. The nurses, who almost never miss, were cursing in frustration as they got a line, only to have it blow a second later. My resident and two attending physicians were trying to get central lines, and from their lips, too, came soft curses.

As my arms began to tire, one of the nurses switched with me. Her light, svelte frame was perched precariously on her toes as she began the same cadence and rhythm, trying to beat this woman's heart. I stood watching, but in what seemed like seconds we switched again. As the nurse did her final compressions, I heard the strains of "Stayin' Alive" soft under her breath.

We worked for what seemed an eternity, my arms keeping to the cadence. But 30 minutes after we began, my attending called it: "Time of death, 10:40." I walked out of the room, again pulling off gloves. As I grabbed a chart for the next patient, "Stayin' Alive" was still playing in my mind. Perhaps this one would.