At Peace

The guys from Engine 10 were doing CPR when we arrived.

“Asystole,” said Kraz.

He lay on the floor next to a hospital bed in the front room of an ordinary house on an ordinary street in Providence. The daiper he wore was clean. The inflated plastic bags that were wrapped around his hands new.

“Who found him?” I asked. Three or four family members stood outside the room, afraid.

“He was awake ten minutes ago,” said a twenty year old woman.

“Is there any paperwork or records?”

“What do you mean?” She was nervous, shaking as she watched the firefighters behind me move her grandfather onto a backboard and continue pumping his chest and breath for him.

“Did he have any wishes should something like this happen.” The guys had him ready to go.

“No bracelets or necklace,” said Bill.

“I know things are a little hectic,” I said to the girl, “but I could really use some information. Is there a folder or something from the hospital?”

She handed me a thick folder from the visiting nurse company that visited every day. No advance directive. I scanned the room, looking for anything that would allow me to let this man die in peace. Nothing. A picture on a wall showed my patient in 1967, dressed in a South Vietnamese military uniform, smiling, holding a rifle. His name and date of birth were written below. On a dresser were some medications. I put them in a bag, copied the information from the wall and left the home.

Inside the rescue we worked the code. An IV was established, Epi and Atropine administered, CPR continued when a rhythm didn’t materialize. We had the defibrillator pads attached. I looked at the flat line on the monitor after each drug was pushed, hoping it stayed flat. It didn’t seem fair, he had fought enough.

My intubation attempt was unsuccessful, we rolled toward the ER, CPR all the way. Though I thought the effort doomed from the start my training took over. We did all we could.

The Medical team had assembled prior to our arrival. Ten or so people waited for us to move him onto their stretcher so they could take over. I gave the report.

“Seventy-six year old male, conscious at 11:15, found by family not breathing at 11:30. CPR started at 11:35. 20 Gauge IV in left AC at 1140, Epi at 1141, Atropine at 1143, remained pulseless and asystolic. History of stroke five years ago and Alzhimers.”

The hospital team took over, we backed out. Another round of Epi and atropine, then other meds, five minutes later I heard the attending,

“I’ve got a pulse.”

Ten minutes later he was breathing on his own, blood pressure rising.

An hour later he was still with us. It’s ten hours later and he is still with us.

Regardless of our beliefs or feelings we have a job to do. Once recessitation efforts are started, training and experience takes over, everybody gives their best effort and a power higher than us decides the outcome.

His son and granddaughter were at his side last time I looked. Everybody was at peace.