2:19 AM, Rm 6018, HR: 120bpm
6018 is sliding. He’s dropped 25 bpm in the last couple of hours. Not good. The math doesn’t work. He may not make it to daylight. I can’t think about that right now. Lunch was a chicken sandwich and 30-minute nap.
Why do they call it lunch? It’s the middle of the frigging night. Right now the world is asleep, not eating
lunch. Lunch will be tomorrow, with sunlight, not here, in the deep of night,
watching the sputtering electricity of frail hearts. Except for you, 6018. Your
heart is not frail. Just what is your name anyway? You have a name don’t you?
I clicked on his screen block, causing it to expand. His first name was Samuel. I rolled the name around in my head
for a few soundless moments. About then is when all hell broke loose.
It always starts with an alarm, a wicked annoying bonging. Room 6204, just
across the hall, had an 8-beat run of Ventricular-tach. Not a good thing. It’s a heart in panic mode. It gives me an adrenaline jump. But just as quickly, it
returns to a gasping normal rhythm. I cut off the alarm, start printing the
strip and paging the nurse. Bullet dodged. Then it bongs again. This time it’s V-fib, and it’s not stopping. This is a heart that’s just quivering, not beating. If this goes on long enough, the next rhythm is a
straight line. I’m yelling. Nurses begin to emerge from everywhere. Carol overheads the code.
White coats rush down the hall with sleepy, frenetic faces. Someone’s yelling for the crash cart. I let the paper strip run constant. It’s protocol. I’m standing, pointing, shouting across to the room “Still in V-fib.” The proximity is a luxury. You can’t do this when they’re on another floor. A code is always a combination of cool heads and chaos, an
intuitive, spontaneous, unspoken assignment of roles. My part is already cast,
but for the nurses and docs, it’s often a fumbling assimilation of what character to play. Who calls out drugs,
who grabs the cart, who does compressions, who charges the paddles. The room
crowds up, frenzied voices, frantic words, commands are flying everywhere.
Finally, above all the noise and thunder someone yells “clear.” Then it happens. The symmetrical beat of a normal rhythm returns. Everyone
holds their collective breath, waiting, watching. Nothing changes. Still a
normal rhythm. Silent looks of confirmation are exchanged, body language
relaxes, the room exhales a group sigh. A few more commands are called out. But
slowly, methodically, the players begin to drift away, retreating to their own
small stage of responsibilities. It’s over. Fortunately this drama was short, one act instead of three. And as
always, the real hero was ol’ sparky, the defibrillator.
I get everything together, all the strips and histories, waiting for the
onslaught of residents who want to play 20 questions. It’s the job. Being a monitor tech is like taking off, flying, and landing an
airplane; moments of sheer terror followed by long hours of boredom.
