First Code

You were fine this morning.

No crackles in your lungs, no new murmurs in your heart, no grimace as I press into your abdomen, no redness around the catheter line protruding from beneath your clavicle. Nothing new to remark on as I pound away at the computer keys five minutes before I join my team for rounds. Alert and oriented times three, sleepy but able to be aroused.

I am in another room one floor down from yours, awkwardly swaddled in a contact precaution gown, when my resident’s phone beeps. She listens for a moment and then is tearing off her gown and heading for the door; she has to see you immediately. I rush after her, untangling myself from blue plastic sleeves and sweaty gloves.

I only realize I’m on the wrong floor when I see signs for the pediatric unit–not the one I’m looking for.  Turning, I scramble up the stairs.

The code blue is repeated overhead just as I round the corner, breaking into a half-run. People are already swarming around your room, spilling out of your open doorway and into the hall.  I squeeze past them, feeling like a minnow in the ocean.

You lie with your eyes closed, salt and pepper hair spilling over the pearlescent earrings you haven’t removed since you came here over a week ago. A doctor’s voice projects over the noise as he calls out his role as code leader. An anesthesiologist is already at the head of your bed, fitting you with a mask to feed you air.  The crash cart is already at bedside.

The names of medications are called out over the noise, approved, administered.

I squeeze your toes, pinching hard enough to feel your joints beneath my fingers, but you do not pull away like you should. Your skin is cool to my touch, and that chills me.

Move your legs. Move your legs, show me you can move. Squeeze my fingers. Can you hear me? Can you hear me?

Your heart rate is too slow.  We are pacing it, the muscles in your chest and abdomen jerking in rhythm as invisible tendrils of electricity seek out your heart, trying to capture its beat.

Open your eyes. Can you hear me?

Someone is asking for your pulse again, and I press my fingers into the crease where your leg joins your hip, seeking out the beat in your femoral artery.  No time to waste hunting for the smaller arteries I routinely check on pre-rounds.

Your heart is still pumping, tracing out peaks in fluorescent green on the monitor.  I can feel it and confirm it.

Another IV line. The needle slides beneath the skin over your wrist, the same wrist I took your pulse in this morning.  That all seems so long ago, that quiet time when I woke you up to ask you how you were feeling and to press my stethoscope to your skin.

I am in free-fall with no time to contemplate if I can fly.

The ICU will take over from here.  Everyone is unplugging monitors and switching cords and unlocking the bed’s brakes so they can roll you out of the doorway, oxygen tank and IV line in tow.  You are surrounded by a halo of monitors as the beeping bustling fades down the hall away from me.

My team and I regroup for rounds; we still have several patients to see.  The next one is mine, and I need to discuss the mass in his gastrointestinal tract.

I am fine, I tell myself.

I am fine.


I am not fine.


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