*I walk briskly down the hallway and enter ER South. I have an annoyed look on my face. Barging into the room I make my way towards the nurses' station, my target in sight.*
"Dr. Wayne." I say firmly as I approach. The young intern abruptly stops conversing with the even younger looking medical student next to him and looks at me. I'm certain he notices the look on my face.
*I stop in front of him*
"So I just went through the charts, and it seems that you're 3 whole days behind in charting. I've got multiple people breathing down my neck about it, and I'd really appreciate it if you got caught up." I say in an annoyed voice.
*There is a brief silence*
"I'm sorry Dr. Grant, I've just been so busy..."
*I cut him off*
"Well, not anymore. I need you to get caught up...and until you do, I don't want to see you in here."
*His bewildered face looks back at me, as if to ask 'are you serious?'*
"There's an empty office in ER administration that you can use...away from the distraction." I say.
*His face shows disappointment with a hint of anger.*
"Okay," he says softly. "Lets go." he tells the medical student.
*I look at the student. He looks confused about what he got caught in the middle of.*
"That won't be necessary." I say. "There's no reason the student needs to suffer for your inability to stay on top of your work..."
*I get a dirty look in return from Dr. Wayne. It doesn't bother me.*
"Come with me." I say to the student as Dr. Wayne turns and walks out of the room.
*I look around and notice the clerk and a couple nurses staring and then immediately returning to work when they notice me look at them. They smile while whispering to themselves about the scene they just witnessed.*
"What's your name?" I ask the medical student as we walk over to trauma. "George Hoff...third year."
"Well, George Hoff, third year, what is it you want to do in medicine?" I say as I approach the trauma nurses' station. I start fumbling on the computer.
"Well...I'm really interested in cancer research. I'm actually an MD/PhD student." he says proudly.
"Cancer research, huh? ...well I got the next best thing for you...a rectal bleed." I say as I see the case on the computer.
"Ever done a rectal exam?" I ask him. He shakes his head.
"Well today...is your lucky day." I say with a smile on my face. The first rectal exam is a rite of passage for any medical student.
*His eyes get wide*
"Dr Grant." A nurse says as she walks into the trauma area. "We have an MI turned full arrest coming in..with an ETA of 1 minute...Trauma 1"
"Well, it looks like you just earned yourself a stay of execution there, Dr. Hoff." I say as we make our way to trauma 1.
"What's the first drug given for a patient in ventricular fibrillation" I ask the student as I get ready for the patient.
He pauses...thinks for a moment..."Oxygen?"
"1mg Epinephrine IV Push with a repeat every 3-5 minutes...what's the second drug?" I ask.
"Oxygen." He says confidently.
"Amiodarone 300mg IV push with a 150mg repeat every 3-5 minutes " I say. "When he comes in, I want you to do compressions."
He gives me a look of fear.
"Relax....hands in the center of the chest...and you push....and once you've finished pushing...you push again." I say as I start to organize the team.
The patient comes in, paramedics are bagging him. No tube in place. The patient is a large heavy-set man in his 50s. He has ECG patches and defibrillator pads on him. IV is in place but no tube. The paramedics explain that the patient had a confirmed MI on the 12-lead ECG. Further, they explained that he lost his pulse during transport, but quickly got it back with defibrillation.
The patient is moved to the trauma bed, and we begin our assessment. The paramedic's monitor immediately starts to alarm as his heart rhythm goes back into VFib. The paramedic starts compressions again as a tech transfer's the patient to the hospital defibrillator and monitor. The patient is blue around his lips, but appears to be muttering something. Dr. Hoff, the medical student, leans in to hear what the man is saying.
"I love you Abbey...I love you Abbey.." he whispers before he goes unconscious.
"Lets charge to 200. I say." The defibrillator charges. "What did he say?" I ask student doctor Hoff.
"I think he said...'I love you Abbey'." he replies.
"Everyone stand clear." I say as the patient gets shocked.
"Dr. Hoff, get on those compressions."
He hesitates, but after some coaching starts doing compressions well.
After a 20 minute resuscitation, we fail to get the patient's heart rhythm back. I make the call. Time of death 13:31.
"Is there any family in the waiting area?" I ask.
"Yeah. There's a whole crew out there. They're in the first family waiting room" a nurse says.
Dr. Hoff looks disheveled. His tie is loosened, the top button undone on his button up shirt, his hair is a mess, his short white student coat on the counter in the corner.
"Well, Dr. Hoff. Now we get to do my least favorite part of the job....Delivering bad news. Let's go." I say to him.
As we walk down the long hall to the private family waiting room, he tries his best to fix up his appearance.
*We arrive at our destination. I knock on the door and we both enter. The room fairly full. It looks like there are a lot of family/friends in here waiting.*
A woman comes forward, a man holding her. She looks distraught already.
"Are you the Benitez family?" I ask. The woman fighting back her tears replies that she is the patient's wife, and that the man holding her is her brother. I look around. There are about 12 people in the room in total.
"I'm Dr. Grant, the attending physician who saw your husband when he came in earlier....I'm sorry to say that your husband had a massive heart attack.."
*The patient's wife begins to cry, he brother holds her tightly.*
"..and despite our best efforts, the damage to his heart was too much and we were unable to save him. I'm so sorry to say that he is dead....I'm sorry for your loss."
*The patient's wife loses it and buries herself into her brother. Everyone else in the room begins hugging and looking sad. Sniffles start to fill the room.
Suddenly, Dr. Hoff says something to the patient's wife:
"I just want you to know...that your husband was thinking of you in his final moments." he tells her.
The patient's wife composes herself enough to ask Dr. Hoff a question in reply.
"What...what did he say?" she says struggling to put a smile on her face.
Somberly, Dr Hoff replies: "He said...I love you Abbey."
The patient's wife's looks back confused.
"...but my name is Michelle.." she says confused by this statement. "Abbey is Johnny's wife" she says as she looks to the back of the room. Everyone in the room looks at a larger woman in the very back. Her eyes grow wide.
*Complete silence falls upon the room for a moment. Suddenly there are a few gasps. *
"THAT BASTARD!" the wife lets out in anger. She begins to yell incredibly angry things.
*I perform a partial facepalm and transition into giving an incredibly dirty look to Dr. Hoff for making this mess of a situation.*