It was 2 a.m. I was in the emergency ward when a patient was admitted, a relatively young guy—he’d had a drug overdose. My sense was that he was unemployed, maybe homeless. He was mumbling and groggy. We were watching him to make sure he didn’t stop breathing or go into withdrawal, but he seemed stable. Then his monitor went off—he flatlined.
We immediately called a code, which goes out over the loudspeakers, and the whole team comes. We were able to start CPR right away, because we were right there by the bedside. The sooner you start CPR, the better; if it’s been more than ten or fifteen minutes, it’s probably not going to work. I felt this pit in my stomach—it was the first time I was going to be in charge of running the code, the first time I would have the whole responsibility for saving this guy’s life or not.
First, we brought over the crash cart, which has a defibrillator and an Ambu bag, which is used to pump oxygen into someone who isn’t breathing. As soon as we rushed over, we checked his heart rhythm with the defibrillator’s electrodes, and found that his heart rhythm was abnormal. Then we knew we were going to have to shock him to try to restart the normal rhythm. The risk with using the defibrillator to shock is that either you’ll start the rhythm in an erratic way or it just won’t work at all. I had to administer the shocks. I grabbed the paddles.
I’m petite—five foot two—and he was a pretty big guy, so I had to stand on something so I could reach high enough to place the paddles on his chest. I yelled “Clear,” to make sure no one was touching the patient’s bed, so they wouldn’t get shocked too, and I stuck the paddles to the patient’s chest. Then I attached two electrodes to the paddles and pushed the button that delivers the shock, which, at 200 joules, is very strong. The first shock didn’t work. You wait a couple of minutes between jolts, and then you try again, upping the level. Meanwhile, other people on the team were still doing CPR, with someone giving chest compressions and someone else administering breaths with the Ambu bag.
When you give a shock, you see the patient jump a little. Each time you administer the shock, you’re thinking, “Oh my God, I really hope this works.” We shocked the patient again, and that second he just sat up. Somehow, he must have had a memory of what had happened, because he sat upright and punched out his arm, hitting me right in the chest. It hurt a little, but mostly I was stunned. Normally, people don’t wake up after defibrillation. Their hearts go back to normal rhythm, but they’re still unconscious. In this case, there was no warning. I got hit square in the chest. I remember thinking, What’s happening? Is this some weird reaction to the electricity? But then I saw that his eyes were open, and I saw that he was awake, and I was relieved. The woman at my side—my friend, and a co-resident—yelled at the patient: “Hey, she just saved your life, stop it!” That broke the tension, and we all started laughing. We were so elated that we’d been able to save him.
I don’t think any of us slept that night. So many people go into medicine because they want to save people’s lives, and then you go into a hospital and you see how much of medicine is about what you can’t help. This case was a good jolt of positivity.