When a code is called in the hospital, it means two things: A caregiver’s day is about to be turned upside-down, and a patient’s world is about to fall to pieces. If you’re a caregiver, when a code is called you look up from your own work and wonder who’ll be sprinting through the halls and whose story is unfolding.
This time, the story was ours.
Mrs. Hernandez is a ninety-two-year-old Spanish-speaking woman, originally from Mexico, with high blood pressure and high cholesterol, who arrived in the emergency department of the hospital where I’m a fourth-year medical student.
Her right arm and leg were weak, the right side of her face drooped; her speech was slurred, and she seemed confused. Her CT scans showed that a blood clot had blocked her middle cerebral artery, in the area of the brain that governs language. Mrs. Hernandez was a stroke victim.
I am a medical student in my third year of studies. For medical students, this is the point at which, after two years of book learning, we rotate through hospital clerkships that give us our first experience of delivering hands-on care to inpatients.
Earlier in the year (it feels like many lifetimes ago), I read that COVID-19 was “just the flu.” We heard from scientific sources and popular media that other maladies were much worse, and that it would be a mistake to overreact to this one. Like many people, I accepted these assurances without too much concern. It all seemed a bit remote to me–the way I imagine issues like food stamps may seem to a politician who’s never needed them.
But now
After finishing my third-year clinical rotations in medical school, I was feeling sleep-deprived and stressed out. The problem, I finally realized, was the ridiculous amount of pressure I’d put on myself to impress my attending physicians and get good grades.
My father is an ophthalmologist and cornea/cataract specialist. After routinely rejecting his career advice throughout my undergraduate years, I’d entered medical school–and, to my father’s delight, found myself increasingly fascinated by his field.
The first thing I notice are the dark circles under Mr. Jones’s eyes.
It’s 4:30 pm on a Wednesday during my third year of medical school. I’m in the fifth week of my family-medicine rotation, and we’re deep into our daily routine: triage, history, physical examination, differential diagnosis, present the case to the attending physician, repeat.
“Deeper compressions! Deeper! Make sure you get that recoil!”
I push harder and lift off higher. I’m starting to sweat. My stethoscope is banging around my neck. I should have taken it off, I think. My hair is flying around my face. I should have tied it up. I’m on tiptoe; my legs are cramping. I should have stood on a step stool.
“All right, she’s getting tired. Next!”
Embarrassing…I only lasted through one round of compressions. Other people (taller, more muscular people) are lasting longer. I really need to lift weights. Doing chest compressions is much more physically demanding than I’d thought.
Zach Reichert ~
In my third year of medical school, I started a rotation at the nearby VA hospital. Walking toward the polished glass doors that morning, I saw my reflection–clean white coat, assured expression to cover up how lost I felt. It was my second clinical rotation ever, and my first time at the VA.
I found my team and soon met a patient I’d be seeing for the next month. His name was Jim. He’d already been hospitalized for a week–and he wasn’t leaving any time soon.
At seventy, Jim had no muscle or fat on his body. His gray skin hung like a sheet over the ridges of his skeleton, and his bony arms were
I walked into the room of a dying man. This phrase might conjure up the image of a frail, white-haired patient peacefully nearing the end of life. Alex, however, was thirty–just two years older than me.
I was a third-year medical student doing a rotation in the ICU. This first encounter was sadly inglorious: As my team entered Alex’s room, the police officer who’d been guarding him walked out, leaving Alex handcuffed to the bed.
Alex looked like a ghost, his cheeks sunken and lifeless. A heart infection caused by his IV drug use was spewing dangerous bacteria through his bloodstream, infecting his lungs and spine. When not sedated, he was delirious, eyes staring wildly between wasted temples.
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