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

write here is: cardiopulmonary arrest. After all, the heart has stopped beating and the body has stopped breathing. Someone, though, probably a pathologist, pointed out once that this was the
definition
of death, not a cause, so you sit there, pen tip tapping against the paper. What am I supposed to write? you think. Cause of death: Old age? Human nature? Cell apoptosis? God's will?
    You write: cardiopulmonary arrest.
    As you finish up the form, Bill, the ER tech of the day, comes in. He has an empty body bag in his hands.
    “I wish someone would think to put this bag on the bed before they put the patient on it,” he grumbles. “Do you know how hard it'll be to put the patient in it now?”
    You hand him the toe tag and walk out. You are on your way to Step 2: Call the coroner.
    When you call you actually talk to the night shift deputy coroner, a Mr. Loredo. You've talked to Mr. Loredo so many times that you recognize his deadpan voice in an instant. Mr. Loredo sounds the way you expect a deputy coroner working night shift to sound. He's not real happy to be there and he's not real happy you called. He has a nasal, monotone voice salted with a bit of country music. He gives you the impression that he has seen everything, and, in fact, Mr. Loredo may be one of the few people in the world that, given the nature of his job, actually
has
seen everything. Once Mr. Loredo asked you for the cause of death and you told him you thought it was secondary to a butcher knife, the blade of which had transected the left ventricle of the heart of the deceased. He said, without a beat, “When was the patient pronounced dead?” and he just went chugging along with his list of questions without pause until he got to the last one: “Any sign of foul play?” And you said, “Well, Mr. Loredo, I'm no detective, but the guy does have a knife sticking out of his chest.”
    Now, at last, he paused. “Okay,” he said after a moment's reluctant reflection, “I guess that means he's a coroner's case.”
    Mr. Loredo's job is to ensure that nothing is a coroner's case. In fact you've heard that the best way to get away with murder in this state is to dump a body somewhere in these city limits and have someone find it when Mr. Loredo is on.
    “Cause of death?” he asks you tonight.
    You wonder for a moment what he would say if you told him, “Rabies.” Then you think, he probably wouldn't say anything at all. He would just ask the next question. So you tell him with a shrug, “Cardiopulmonary arrest,” as you scribble, scribble a note about the code for the closing chapter of this patient's chart. Your mind is already on:
    Step 3: Notify the family. This is the hardest part of the job. Breaking the news. The bad news. As an ER doctor you get to give families the worst news they will ever receive and you get to do this almost every day. It's your job to say, “I'm sorry, but your mother, daughter, brother, husband, >insert name here<, has died.”
    After saying this you always stop and there are a couple of heartbeats while the news sinks in on the other side. Disaster; shipwreck. This is the time when people hate you as a doctor. You have failed, flunked, dropped the ball. You should be sued—you will be sued. You are a quack; if they had gone to the hospital down the street this never would have happened. And a part of you believes all this because no matter how sure thing the death was, some part of you really believes that because you are a doctor, you really can perform miracles. And actually you've seen this happen. Only not today. Today you
didn't
save a life. That nightmare you had during your second year of medical school has come true. You couldn't save a life because you
are
a fake; you are an incompetent fool who never should have been a doctor. Hippocrates would have laughed you out of this profession.
    But it's not Hippocrates that calls you to judgment; it's God. After all, you just went one-on-one with Him and God won.