“Push another 0.25 mg of epi and resume chest compressions.” Annie wiped the sweat from her forehead and sighed. “Do we know what he was doing before he went down? Has anyone checked his blood glucose level?” A nurse stepped toward the bed with a glucometer and pricked the little boy’s finger.
“99,” said solemnly.
“Okay, so he’s not hypoglycemic. Hold CPR.” She stared at the heart monitor screen and watched the artificial rhythm created by the chest compressions fall back into a flat line. “Damn it! Resume compressions and give 20 units of vasopressin.” She heard a sob behind her and turned to see the boy’s mother collapse into her husband’s arms and scream. “Get them out of here!” Annie barked, pointing a finger hastily towards the door. A nurse gently led them out and she turned her attention back to the patient lying lifelessly in front of her. “Give another round of epinephrine and check for a rhythm.” Her own heart fluttered in her chest as the line on the monitor jumped and jiggled harshly. “V Fib! That’s a shockable rhythm!” She reached for the paddles and held them to his tiny chest. “Charge to 200. Clear!” The little boy’s body jerked unnaturally off the bed and she looked back to the heart monitor, praying for a stable rhythm. A slow, unsteady rhythm pulsed across the screen and she placed the pads of two fingers against his neck to feel for his carotid artery. Nothing. “Let’s see if we can get a pressure.”
A nurse brought a blood pressure cuff over to the little boy’s arm and slipped in on gently. “I can’t really get anything, Dr. Morgan,” she lamented.
Annie could feel the familiar beginnings of tears pricking at her eyes and blinked rapidly in an attempt to keep them at bay. “Let’s um....start a dopamine drip and resume compressions.” She watched helplessly as the pharmacist mixed the fluid and a nurse hung the bag. “Give another round of epi,” she rasped.
Brad slipped into the room silently and pulled the door shut behind him. “How long has he been down, Ann?”
She looked up at the clock on the wall. The seconds ticked by unnaturally slowly. She felt like she’d been there all day. “About 25 minutes. Now check for a rhythm,” she instructed her team. The young man doing compressions halted and all eyes turned to the monitor. A flat line ran across the screen, and the only sound that could be heard was the whoosh of air breathing for the little boy through the ventilator. “Is it time for another epi?”
“It’s only been a minute and a half, Dr. Morgan,” a nurse answered her softly.
“Okay.” Annie nodded slowly and gulped. It felt like daggers were shooting down her dry throat. “Let’s try 1 gram of magnesium, followed by bicarb. Turn the fluids wide open and resume compressions.” She looked down at the little boy and stroked his curly blonde hair with her gloved hands. “It’s up to you and God now, sweetie,” she whispered softly. It felt like the temperature of the room raised by twenty degrees and her heart slammed in her chest. Harsh pounding echoed in her ears and her stomach flopped wildly. She fought the wave of dizziness that swept over her and turned her attention back to the heart monitor. “Give another round of epi and check for a pulse, then somebody needs to go check on his family and tell them we’re doing everything we can.”
“Ann......” Brad pushed his way over to her and laid a hand on her arm. “It’s been half an hour,” he said gently. “We need to think about letting him go.”
“What if he was mine?!” she snapped. “Would you be stopping if this was Drew on the table? Now, push another epi!” Brad closed his eyes and nodded at the nurse, who stood poised with a syringe in her hand. They went on for another twenty minutes, and when two entire code boxes of meds had been exhausted, five people had taken their turn giving chest compressions, and Annie had sent up countless desperate, pleading prayers, it was Brad who called it.
“Time of death 16:54.”
Annie removed her gloves and put a bare hand to the three year old little boy’s cold cheek. “Fly to Jesus, sweet baby,” she soothed. Then, she let the tears fall.
“Annie, I can go tell his parents if you want.”
She looked up at Brad, sniffled, and wiped at the streams cascading down her cheeks with the backs of her hands. “No. He was my patient first. I’ll do it.... but can you come with me?”
He nodded. “Get the room cleaned up and make him look presentable,” he instructed the staff. “They’ll probably want to see him. Annie.” He held out to her and she took it. “Put your white coat on. There’s blood on your scrubs from when you started the central line, and I know you won’t take the time to change.”
Annie looked down at the red spatters on her baby blue scrub top and grabbed her white coat from a nearby hook. After they’d spoken to the little boy’s grief-stricken parents, she left the waiting room and ran down the hall towards the double doors leading outside and into the rain, where she immediately pulled her dark auburn locks back from her face and vomited violently onto the wet grass. “You okay, Annie?” She turned to find Brad standing under the awning.
“Yeah,” she lied, straightening up and smoothing her scrub top down haphazardly. “Just needed some fresh air.”
“You look like a drowned rat.”
“Oh, thanks.” Annie started back inside, but Brad grabbed her arm and turned her towards him.
“Tell me again how much you like your job,” he demanded.
“You know I hate it.”
“Thank you. I love working with you, Annie. You’re an amazing doctor, but you’re miserable. You think you can save every patient, and when you can’t you fall apart agonize over it for days. You can’t do that in this profession. I’m not saying you’re not supposed to care, because you are, but you can’t keep going on like this. Now are you going to think more about Brian’s proposal from yesterday?”
Annie bit her lip nervously. “I think I’ll talk to Andrew about it tomorrow,” she said softly.
“You’re going to talk to Andew. Really?”
“Yeah, Brad, really.” She knew he thought she was a lunatic, but she didn’t care.
“Well, uh...okay then. Go change and get out of here. Your shift ends in half an hour anyway.”
Chapter End Notes:
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