Lassard is offline
Join Date: Jan 2013
Location: California (Bay Area)
I'm new to the community and new to writing. I have started a story which I've pasted below but thought I would post here to get initial feedback (as opposed to writing the whole thing and then getting feedback that the whole thing is worthy of being flushed down the toilet).
I'll put a key on top when/if I ultimately post the story, something like:
Resident = a physician in training
Intern = a first year resident
Attending = a fully trained physician
Ok here it is - much appreciate any comments.
(Spacing may be off in the copy paste process)
The ribs cracked under his weight like they always do. Harrison spoke with a determined but calm voice as nurses and patient care techs ran frantically back and forth. “I’ll be the code leader. Maris, you focus on getting the pads on his chest. Linda, this looks like it’s PEA so draw up the epi – one milligram.” Both Maris and Linda started on their respective tasks with a nod. Harrison craned his neck around to look behind him as he continued chest compressions, and saw his intern staring wide eyed at the scene before him. “Tara! Get your finger inbetween his legs on his femoral pulse – how are we going to know if we have return of circulation?!” Tara stared at Harrison for a moment, as if processing his words, and then lurched forward and did as he asked. Maris finished placing the pads on this fifty five year old man who yesterday was playing golf and now was trying to die on Harrison’s watch in the intensive care unit after suffering a heart attack. Linda, the charge nurse on the unit, drew up the epinephrine and had it ready by the man’s intravenous access on his right arm. Another man, younger, stood by the door of the room with a clipboard and recorded every event that took place during the “code blue”. Three more bodies hurried into the room – a middle aged anesthesiologist, a respiratory technician and a young nurse. “Dr Blum, we have a fifty five year old male who came in with an anterior wall myocardial infarction yesterday, is status post PCI this morning and just went into PEA.” Dr Blum nodded and casually moved to the head of the bed, squeezing himself in between the wall and patient’s head. The respiratory technician placed his intubation box on a small table next to him and started taking out the tube that Dr Blum would soon place down the man’s throat to secure his airway and help him breath. Dr Blum undid his cufflinks quite methodically. Harrison was now getting tired. Having been doing chest compressions now for about five minutes, putting his whole upper body into each thrust, he looked around for relief and saw a nurse standing in the corner, her arms folded across her chest, on her face a look of concern, looking around the room for a way to help her fellow RN’s.
“Dr Lassard should I push the epi?” Linda asked urgently.
“Yes, please do. And in fact, I think I need a break. I should be leading the code anyway, not doing compressions,” Harrison responded. “Excuse me, nurse – sorry I don’t know your name,” he called out to the new nurse in the corner, who immediately looksed at him and started in his direction.
“Angelie,” she said as she stood behind Harrison, ready to take his position.
“Ok, nice to meet you Angelie, on three?”
“One… two… THREE!”
Several things then happened:
Harrison stepped back away from the chest of the fifty five year old golfer.
Angelie stepped up and as was about to place her hands on his chest when Linda yelled, “He’s flat-lining!”
A monotone sound emanated from the machine.
Angelie stared at the flat line on the monitor and did no chest compressions.
An older man in a shirt and bow tie, donning a white lab coat and thick-rimmed glasses stepped into the room, took one look at Angelie, and yelled, “What the hell do you think you’re doing!? Chest compressions!”
Angelie realized that the attending was talking about her and started her chest compressions. Harrison broke out into a sweat. As a third year resident he had lead a dozen codes and felt very in control of the situation - until Dr. Rinslow stepped in. The head of the Pulmonary/Critical Care Department, Dr Bernard Rinslow, was known both for his genius and his poor manners. He was a walking encyclopedia, and he was almost always right. He also had donated massive amounts to the hospital, which meant that between his clinical acumen and his financial prowess he could be as rude as he wanted, and no one could do anything about it.
"Jesus Christ you call those chest compressions? Why don't I get someone to come in here and fart on him, that might provide more force than your facebook pokes?" Harrison swore he saw some spittle fall from his mouth as barked, 'pokes'. He looked at Angelie, whose face had turned red, and whose eyes were clearly filling with tears as she doubled her efforts. Rinslow turned to him. "Lassard. How's that nose picking coming along?" His voice was a bit more controlled.
Harrison surmised that Rinslow actually had a bit of respect for him. When the announcement that he had been selected for chief resident for next year had been made, Rinslow had patted him on the back with a, "Guess you weren't as useless as I thought," which was pretty much the pinacle of positivity for the man.
"Sir, we're about to give him his first dose of epi. I was doing chest compressions until now."
"His airway is secure," Dr Blum said as he walked by Rinslow and out of the room.
"Thanks Jim," Dr Rinslow responded, "Fine. Give the epi. He will then be risen." Rinslow raised his arms and chin up into the air with his eyes closed, his mouth parted slightly. Maris, a devout Christian, pursed her lips and shot him a death glare, then swallowed her comment.
Unfortunately however, the fifty five year old golfer did not rise at all. His flat line continued.
Harrison looked at Dr Rinslow for a cue.
"What are you gawking at me for Lassard, manage it!" He was clearly upset. How dare the vicissitudes of life and death contradict his will, Harrison thought sarcastically as he gave the order for another milligram of epi. Angelie's chest compressions were going pretty well now, even though Harrison could see that she looked terribly hurt and embarrassed. She seemed to be covering it all up with a mock look of determination on her face. As the code continued, Harrison found himself watching Angelie. Her straight auburn hair and hazel eyes, her slim figure in tight emerald green scrubs. She wasn't a very busty girl, but that didn't matter. She was very attractive. Eventually she too needed relieving, and so Harrison had another volunteer step up to replace her. Forty minutes into it, with no change from flat line, Harrison was about to call it. Suddenly there was a pause in the permanent tone that had been filling the room for the past forty minutes. A blip, blip, blip, came on the monitor, with formed electrical complexes.
"He's back! Is he back? Check his pulse Tara!" Tara fumbled around in the man's groin and nodded.
"Yes. Yes, he does." There were yelps of joy in the room. Harrison let out a big sigh of relief as he motioned for the chest compressions to stop. And just as he did, the man flat-lined again. They worked on him for another twenty minutes, before finally calling it.
"One forty two A. M." Harrison stated blandly. His contacts were dry, his voice cracked, his body aching from compressions and the tension of trying to save someone's life. He tried to keep things together for the sake of everyone else though, and patted everyone on their backs, saying things like, "Good job," and "We all did our best." Unfortunately, Dr Rinslow, who had stepped out after his initial appearance, stormed back into the room.
"So who was responsible for this man's death?" His words created a palpable nausea in the air. Harrison, who had been walking away from the room, stopped in his tracks, astonished at Rinslow's cruelty and immediately thought of Angelie. It wasn't her fault by any measure, but he turned around wide-eyed and caught sight of her in the corner of the room, her eyes cast down. "Was it little miss facebook poke over here who doesn't know how to do basic American Heart Association high quality chest compressions and has no business being in the ICU?" Angelie ran out of the room sobbing. Bumping into Dr Rinslow, who barely seemed to notice as he started examining the dead body, and then past Harrison, she ran off to somewhere in the back of the ICU. For a moment Harrison met the shocked faces around him with the same look, and then broke out after her without thinking.
He found her in the break room sitting at the table. Her face in her hands, her hair creating a private curtain, crying. Having a fiance himself, he had practice. Pulling up a chair he said next to her, put his arm around her, and remained quiet.
Angelie had just graduated from nursing school. She had worked as a patient care tech throughout, attending classes at night. Her mother had been a nurse, and had taken care of her father, who had died a long, painful death at the hands of lung cancer several years ago. Seeing how her mother's love and compassion had been channeled through nursing her father, she had no doubt she wanted to be the same. After years of hard work, sleepless nights, tireless clinicals, she had finished and had started in the Intensive Care Unit of Ravenwood Hospital a week ago. It was her first ICU night shift. It was her first ICU night shift, and she had killed her first patient. The horror of a career, within the first week of it. And now, to make things worse and more confusing and more guilty, the resident who had his arm around her was terribly cute, and she felt disgusting for even feeling such a thing at a moment like this. Eventually her sobs settled into silence.
"Angelie, I want you to listen to me very carefully," Harrison spoke slowly and deliberately. He slid over a tissue box from the far end of the table. Angelie mumbled thank you, managed a very weak smile and took one. "You were not responsible for that man's death. I have been in many code blues, and I'm speaking from experience." Angelie felt what Harrison was saying was true. At least she wanted it to be. "Angelie," Harrison moved some of her hair aide so he could see her. Her eyes were a deep hazel, and her skin was not quite white. The whites of her eyes were blood shot however, with all her crying. "Do you know what Dr. Rinslow told me on my first day of inter year?" Angelie looked down at the table and then up at Harrison. He felt butterflies in his chest - the type he felt when he had first met his fiance - he immediately put the feeling away. It was dangerous. Angelie felt it too, but she was drowning herself in the feeling. Harrison's tenderness and care was melting her away, and she was becoming lost in his deep brown eyes. "He told me I was responsible for one patient's septic shock, another's pneumothorax, and a third's loss of his leg - all in one day." Harrison smiled, trying to show Angelie how absurd it all was. She chuckled and then looked away. Then back at Harrison.
"I know... I know he's just like that. I've heard."
"I did my best."
"I know you did, and everyone takes a little time to learn how to do compressions - it's all part of learning. No one starts out perfect."
"I know, you're right. I know." She let out a sigh, smiled at Harrison and leaned forward and gave him a peck on the cheek. Harrison swallowed awkwardly but managed a smile. "Thank you Dr Lassard. You are a very kind man." And with that she got up quickly and left the break room.
"You're welcome," Harrison said to the empty room as his hand touched his cheek. And at that moment he made a determined intention, to avoid Angelie as much as possible.