the inevitable

The day before my first ER shadowing experience as a part of EMIG (Emergency Medicine Interest Group) I went to ask my friend Meena, who had already had a couple experiences, what it was like. She honestly looked a little rattled. It had been the first time anybody in the EMIG had been asked to perform chest compressions, and the patient had passed away.

*speechless*

My visit that night was relatively uneventful. But my second visit, not so much so.

It started out quite calmly - the usual patient history, chief comlaint, labs, discussion with a million people on what it could be or how to treat it, staring at radiology images and frantically speaking with radiologists about masses and unexpected perfusions. We even had a young patient who was horrified by the prospect of her first visit to the ER so much so that she had severe tachycardia (elevated heart rate). I was also sent into a patients room all alone to determine a diagnosis all by myself, and I succeeded...it was jaundice. *hah* Not easy to miss. But my resident was proud of me. :) Not long after, the docs, residents, and I sat joking about an exam the residents had earlier that day.

My resident was supposed to switch shifts. I "handed myself over" to the next resident who would guide me with infallible efficiency throughout my last case of the night. A patient was wheeled in with chest pain (I can't share more details). I just stood in a corner watching information transferring from the EMT's to the attending physician. He was alert, and able to speak, except I noticed his head was very VERY pale. All of a sudden he lost consciousness. That did it for me.

I still remember saying to myself "OH my god! He's going to die! I'm not ready for this! Oh my god what if he dies right in front of me?! I've never seen ANYONE die before! He's dying!" I also still remember my body saying to itself "You need to leave this room, and go outside and sit down. You're light headed and the last thing the emergency team needs is a fainted first year medical student beside a dying patient. Hold onto the bench! Hold on to the bench! And don't lock your knees!"

Within the 5 minutes of flurry to regain balance, the patient had been stabilized, and surprisingly so did my mind..... for about ten minutes, after which CPR was begun. And I was called to do it. And I did. At 120 I got dizzy. He was a big man, and I was a little girl, watching the ECG reading blip up and down with each pump of his chest. There was nothing apart from that. Within 30 minutes of when his chest pain began, he had passed away.

I cried. I cried because I didn't feel anything. If anything, I felt inhuman. Was it the lack of personal contact? That it happened so fast? I will never know.

I said a little prayer as I left the room.