Privileged #4 - Thankful

On ICU call, sometimes it can get pretty awful, and this night was terrible. It was 3 AM, and I had just finished admitting a patient to the ICU who has gone into respiratory failure, when a code was called overhead. It was a bad scene. The patient was roughly 300 lbs, lying face down on the floor. He had apparently tried to go to the bathroom and never made it. Usually the nurses would be in the midst of CPR by the time I arrived, but they couldn't even roll him over because of his size.

It took 4 guys to muscle the patient onto his back so we could finally check for a rhythm. Of course: pulseless electrical activity. PEA is a really painful code, not because it is difficult or complicated, but because it is so frustrating. Everything on the monitor looks right, except that your patient is dead.

We ran the code on the floor, since we didn't have the strength to get him to a bed. After 20 minutes of futility, I called the code and paged the patient's attending. As I waited for the call back, one of the floor nurses grabbed me. The patient's wife was here.

At the nurses station sat a willowy, elderly lady. She was wearing an overcoat, a light blue lace nightgown, and pink house slippers. The nurses gave her a cup of that terrible coffee ubiquitous to every hospital unit, but she could barely hold onto it. It was singularly the most pathetic sight I had ever seen in the hospital to that point in my life.

I took her to the conference room and sat her with a couple nurses. They held her hand while I explained what happened. Her husband got up in the middle of the night and had a sudden heart attack, likely (hopefully) dying instantly. We made every effort to bring him back, using shocks and chemicals and CPR, but nothing worked, and we declared him dead (As an aside, when you tell someone that their loved one is dead, you must be tragically blunt sometimes. Denial is a powerful thing).

Tears were already pouring down her face. I told her the nurses were getting her husband cleaned up, and she could visit with him shortly. She had no questions, no accusations, just tears. I sat with her for a few minutes, and then excused myself to leave. The nurses had her well in hand, offering tissues and hugs. Before I could leave, she stopped me to say one thing: "Dr. Ifinding, I know that you didn't know my husband at all, but I just wanted to thank you for doing all that you could to save him. He's a good man and would've appreciated it."

I stopped by later that night to finish some charting. She was still there, weeping at her husband's bedside, holding his cold hand, whispering softly to him.

This code hurt for so long. It hurt because I had failed this patient and failed his wife, and then to have her thank me, it was salt on a wound. As a resident, the sight of her sitting next to his body was painfully seared into my mind. But when I think back on this now, I am so touched by this whole event. It must've taken so much courage for her to thank me, when she had so little to be thankful for. And it was such a beautiful thing to see, a wife crying over her dead husband. It was a display of love that far outshone the most joyous wedding. Words cannot convey how utterly heartbreaking a sight this was, but at the same time, how grateful I am to have seen it.


J said...

What a heartfelt, touching moment. Thank you for sharing this. It is so rare to see this. An amazing reminder of the compassion that can exist in Medicine!

Vyvilyn said...

THank you for this passage. It was beautifully stated and by far my favorite from you. Please continue to indulge us with your experiences!

A said...

I've found this blog while staying up late, horribly disheartened over my lackluster MCAT score returned. Please continue writing, even if you write to no one but yourself. I'd like you to know that you are an inspiration to me.

Pranab Chatterjee said...

Isn't PEA a non shockable rhythm?

Anonymous said...

Thanks Dr. Ifinding. I'm a senior in high school who wants to become a pediatrician someday, and I truly enjoy reading your blog. I learn so many valuable lessons! Thanks, again. This passage really touched my heart.

incidental findings said...

Pranab: What you start with in a code and how you end up at minute 20 can be night and day.

Pranab said...

That is absolutely true. I misconstrued it, then. Apologies... Anyways. Great reading your blog. :-)