The Rain in Spain

good food.
good times.
good company.
what more could a girl ask for?

bearing witness.

This week I performed chest compressions on a patient who was coding.
This week the patient passed away.
This week has been hard.

Mr. R was only 36 years old. He came into Grady with severe abdominal pain and distention. During his work-up, our team newly diagnosed end-stage liver cancer that had metastasized to his spine and bones. The final pathology report was still pending but his prognosis was not good. The goal of this admission was to control his pain and to have him follow-up with oncology as an outpatient.

But on day # 6 of his stay, he coded. As I pumped on his chest - ironically to the rate of the Bee Gees' song "Stayin' Alive" - I thought of his 9 year old daughter. She had lost her mother when she was 2 years old; she had died suddenly in the home while pregnant, likely secondary to preeclampsia complications. The body was found a few days later with the small child alone in the home. With each pump, I thought to myself, "That little girl is not going to become an orphan today, not today."

Mr. R was resuscitated, but before being transferred to the medical ICU, he looked directly into my eyes and asked, "Am I dead?" I answered, "No sir, you're going to be okay. Hang in there. We're going to take care of you," as I stroked his hand.
After a family meeting, his code status was changed to DNR/DNI: do not resuscitate/do not intubate. The following morning, he coded again and passed away at around 7am. His little girl, only 9 years old, was now an orphan.

My friend Howie once challenged me to write more uplifting blogs. But it's hard. I don't feel the need to write as much when I'm full of cheer and glee. But when something causes the emotional equivalent of a punch to the gut, I'm more likely to put my scattered thoughts into words. I debated on a public blog vs a private journal entry. But I opted for the more public option: as a means of bearing witness to this man's life, as a way to remember that we were a part of this man's care at the end of his life, as a way to document one of those defining moments of my fledgling medical career.

I had helped keep this man alive by literally keeping his heart pumping. And less than 24 hours later, he was gone.

I cried in my car as I drove away from Grady that afternoon. And then I went about my business: a haircut followed by dinner at a Thai restaurant. It was surreal to be going through the motions of everyday life - small talk with the stylist, ordering a beer at dinner, reading an article on acute chest syndrome - while waves of raw emotion intermittently drowned me. I tried to talk to my mother and that didn't help. I tried to talk to my sister and that didn't help. I tried to talk to classmates and that didn't help.

I wanted to cry and scream but instead, I packaged my emotions into a neat little box ... and moved on.