Just Here Trying to Save a Few Lives: Tales of Life and Death from the ER Read Online Free PDF Page A

CPR. The respiratory tech takes over the Ambu bag. Julie climbs up to replace Jack for chest compressions. “This is so stupid,” she observes once more.
    You look down at the patient and then close your eyes tight. Full code! you wonder to yourself. How could anyone think this patient should be full code? There is barely anything human left to her. She couldn't have weighed more than sixty pounds, each bird-like limb bent, arms to chest, knees to belly—the fetal position except she's been fossilized there. The paramedics had a hard time just doing CPR because they can't get her to lie flat on her back. As you lean over her you smell that distinct odor, the odor of old age and of nursing homes, that curdled milk and rotting blood smell with overtones of decayed feces. You know the rest too, without even looking. The peg tube in the stomach, maybe a colostomy, an indwelling Foley catheter draining silt, and, always, massive decubitus ulcers. (Decubitus: from the Latin
decumbo,
to lie down.) These are pressure sores, great potholes eroded through the skin—sometimes even down to bone. They occur when someone lies in one position in a urine-soaked bed for months or years. As this woman probably has.
    From the Latin…actually, from the Greek. It was Eos, you think, Goddess of Dawn, that fell in love with a mortal. She went to Zeus to ask for eternal life for her lover but forgot to ask for eternal youth. Eos realized what she had done when her lover's hair turned gray. She left him and he went on alone to age and age and age into all eternity. Eventually he shriveled up and became so small he turned into a grasshopper.
    You shrug at the thought. Your fate as well, perhaps.
    Pam must be thinking of the same thing. “Just kill me when I get like this,” she tells you.
    “What'd she get?” you ask Jack, meaning drugwise.
    “She got three of epi and three of atropine.”
    “Hold CPR,” you say, hand up. The patient is now connected to your monitor and you want to see the rhythm.
    Flat line. Zippo.
    “I feel like I'm not doing CPR,” Julie says, “I feel like I'm beating a dead horse.” She folds her arms, glaring at you, daring you to have her restart CPR.
    You glance back down at the patient and the glance confirms your first impression: it's criminal to go on.
    You raise a hand. “Anyone object to terminating this code relatively early?”
    Julie glares around the room. No one else moves.
    You check your watch. 5:38 A.M. In the hour of the wolf.
    Code called 5:38.
    The nurses are drifting out of the room when Father Minke, the priest on call in the ER this month, peeks in. “Am I too late?” he asks.
    “Well, Father.” You are peeling off your gloves. “I guess it depends. She's been declared dead, if that makes any difference.”
    “Okay,” he says, paging through his prayer book. You look at him again, quizzically. You didn't call him for this death.
    “Father, what are you doing up this late?”
    He
hmmms,
distracted.
    “Father?”
    He looks up at you. “I was watching TV,” he says, as if that explains everything. He goes to the foot of the bed, opens up his prayer book and begins, in an almost imperceptible whisper, his bedside prayer for the dying and the dead.
    Everyone gets this, regardless of creed, if Father Menke is in the mood.
    You stump away, back into the ER. Your job is the secular side of death.
    Step 1: When someone dies: fill out the paperwork. In this case, the eponymous “death pack.” These are supposed to be in the drawer by the door. You poke around there until you finally unearth one. The envelope contains a set of forms and a conveniently provided toe tag. You must fill out the forms with information about the deceased (but you may give the toe tag to the tech so that
he
can put it on the body—that's why you went to medical school).
    You open the pack and pull out the first form. Name, age, social security number. Cause of death? You think for a moment. What you usually