I'm barely awakened from my 10:30am nap when an EMT student taps my shoulder.
"Um, Sam," he says quietly, "I think you need to get up; there's a call, and I think it's a code."
Up like a shot, I grab my boots and head towards the rig.
"78 year old male, unconscious, not breathing. Sam, I need you to unhook the monitor, grab the drug box and the IV box and put them all on the stretcher. Can you do this while I drive?"
"Yep," I say regrettably as I hit the wall, "not a problem."
"Sam, if this is a real working code, you will either be bagging or doing compressions. Are you up for this?"
"Yep," I say once more, wondering if I really am.
As we scream down the main street, I take off my sweatshirt and tie my hair back. I'm ready for this call, I think to myself, remembering my first code. As we arrive, I grab the backboard and clumsily take out a bush as I try to carry both the board and the strap bag into the house. The hallway could not be any narrower, but I manage to slide into the living room relatively quickly, without destroying any walls, furniture or artwork along the way.
"Sam, get down here and bag."
I make my way towards the man's head and take over for the paramedic.
"Every five seconds, okay? Christ, the guy's in PEA, 40 bpm. Somebody get a line in!" The paramedic doing compressions looks flustered, but I keep my eyes on the mask.
Breathe. beat. beat. beat. beat. beat. Breathe.
I see the man's glassy eyes looking into my own, but I keep on bagging, trying to push all thoughts from my mind.
"Sam, when I say 'go', I want you to move out of the way, and I'll intubate. Then you're going to take off the mask part and put it back on the tube as we secure it. Okay?"
"Got it."
I let him work, and I take a second to breathe. Before I know it, I'm bagging through an ET tube as he listens to lung sounds. Everything sounds good so they secure it in place.
"Sam, do you see how I'm doing compressions?"
"In just a few seconds, we're going to switch because I'm getting tired, okay?"
"Alright, tell me when."
I step over the patient, apologizing silently as I do, and start compressions.
"Sam, a little more to the left. Deep compressions, Sam, deep."
I push harder and feel the furniture shaking. I feel an odd cracking beneath my hands and think back to CPR class; good compressions break bones. I don't have time to marvel at how terrible it feels, so I focus on compressing to a beat. I can't seem to find one, so I start to imagine that I am doing compressions to the beat of a song. I pick the one that best matches the tempo I already have.

If you're listening.
Sing it back.
String from your tether unwinds.

Jimmy Eat World? Are you serious?

Up and outward to bind.
I was spinning free with a little sweet and simple numbing me.
Are you listening?
Sing it back.

Oh my god. I realize I'm singing Jimmy Eat World under my breath, and in my head I apologize to the man whose bones I'm breaking.
"Great compressions, Sam, you're doing a really good job."

So tell me what do I need when the words lose their meaning.
I was spinning free with a little sweet and simple numbing me.

Before I realize it, the paramedic is telling me to stop.
"Guys...guys, look at this. Holy shit, he's converted...80 beats, normal sinus!"
I stop and push the hair out of my eyes with my forearm, managing to slide my glasses back up my nose. They got two rounds of epi and atropine in him while I was busy singing Sweetness, and he's actually converted. I switch back to bagging, and look at the monitor; I can't believe what I'm seeing.
As I go to bag again, I feel a strange pressure. Trying not to think much of it, I try again. Once more, I'm met with resistance. I look down and realize he's actually trying to breathe on his own. I watch him intently and bag when he breathes.
By the time we get to the hospital, I can even see his hands moving, and I feel so encouraged. This guy could actually make it.
After turning over care, I stretch and find it funny how I'm just now realizing how badly I ache. We start to clean up, and I realize just how long this is going to take. About forty minutes later, I hear someone come up behind me as I'm cleaning.
"Hey Sam?"
"Hey Liv, what's up?"
My roommate has been doing clinicals at the hospital all day for her EMT class, and I can tell she's worn out.
"Your code patient died. I'm sorry."
I can see she has tears in her eyes, and all I can manage to say is, "oh."
She leaves, and I'm left alone in the EMS room, a can of half-empty fresca sitting in front of me.
While I make sure no one is looking, I start to cry. I told myself I was stronger than this. Who is this guy to me anyway? He's no one! I've never met him or his family before in my life, but still I can't help but be completely devastated. I put my head on the desk and cry into my shirt.
My mind wanders, and I push thoughts of his empty eyes staring up at me out of my head. I try to finish my soda, but all I can think of is his wife's distressed look as she opened the door.

This sweetness will not be concerned with me.
No the sweetness will not be concerned with me.



Mike said...

I just lost my first code too. We did everything to the best of our ability, and i thought that would be enough. I cried as well. It's kind of comforting to know that someone else felt the same way.

Anonymous said...

You lose most codes... even the ones that you win.

My CPR song is Queen... Another One Bites The Dust. I'm a bit jaded from commercial EMS.

Anniforscia said...



Fyremandoug said...

I do compressons to "she'll be coming round the mountain " Swear to God it works for me

Anonymous said...

Im so sorry Sam- I hate it when they show signs of recovering but they still end up passing. I'm used to codes now, I've had two in one week once.


Chris said...

Ok, so I have been on both your codes so far. You will have more of them in the comming years. It makes them no easier yet your comfort level will increase kiddo! You have done well on the first two. More fun times ahead... Chris

P.s. I have a crazy tendancy to talk to them while doing compressions.