Playing Doctor




Initial Visit?

Monday, June 13

Paging Doctor Frankenstein

Two weeks ago, you may recall, I told a story of bringing a woman back from the dead.

I want you to see the attending’s comments about my performance during the code. He said that I was ‘outstanding during a difficult, prolonged & successful Code Blue.’ I share this because I want you to understand the difference between what I can do and what I ought to do—the difference between my capacity to thwart death and my fealty to sustain life.

The part of the story that I didn’t tell before—the part that is important to understand now—is that she never made it off the vent.

When she was down—when she was dead—her brain went without oxygen. When she came back she had continual seizure-like activity. Every 10 or 20 seconds, her eyes roll back into her head, her head lolls up and to the right, her arms shake and her feet extend down for about 2 or 3 seconds, then she goes back into her baseline sleeplike state.

That evening, her family decided she’d been put through enough; that we were no longer extending her life, but prolonging her death. They gave us permission to take her off the vent and she expired quite quickly.


This was the result of my outstanding performance during a successful code.

I’m told that 80% of codes on television bring the patients back to life. In reality, only 5% of Code Blue patients survive to hospital discharge.


The morning after the code, before the patient’s family had made their decision, I saw them in her room. I thought about what I had done to them. I wondered if they were pleased that they got to see her before she died or angry that they had to make the decision to pull the tube out and allow God to finish what he had already started.

I confessed my umbrage to the administrative assistant.

‘What would you do if I introduced myself to you as the doctor that brought your mom back to that?’ I asked, gesturing to the family, watching as their mother writhed and then went limp.

‘I’d punch you in the jaw,’ she said.

‘I know,’ I said, looking at my shoes. ‘I’d do the same.’


Sometimes I’ll hear people talk about patients who are on vents and emergent dialysis with cardiac pressors and internal pacers. They’ll actually say, ‘It’s in God’s hands now.’

Let me clarify something for you.

I have done everything possible to take it from God’s hands. If God has issues with shoplifting and sodomy, I cannot imagine his affront to this usurpation.

I am Daedalus offering waxen wings to Icarus desires: I’ll give you your loved one back.

‘Behold, I can restart their heart; I can take over their lungs, their kidneys. Their mind might be gone, but they’ll be warm, they’ll possess the penumbra of life! Come! Feel their hand! It’s still pink, is it not? The blood courses yet! Don't let go! Want to see more? I can give you more. When their gut no longer works, I’ll put their nutrients right into their veins.’

Of course, the real conversation is always the opposite. Me explaining that I have the capacity to do these things, but should not do them. But try explaining this to a family when their mother is dying.

‘We’re hoping for a miracle,’ they’ll plead. ‘We want you to do everything.’

They have no idea what everything entails. No idea at all. And I have no way to really explain to them the horrors that I am capable of, all they will hear is that she will not be dead.

I will sit and look them in the eyes. I do not cry. My voice does not break. I am Prometheus, keeper of fire and not dispensing it, but trying to withhold it with compassion. I hold their hands, and often enough hug them.

‘God’s calling her home.’ I say, in a language that they can understand. ‘If God wants to perform a miracle, he doesn’t need my permission. Or my help. It’s time to let her go.’


2 Comments:

6/13/2005
Blogger jamesdamian writes:

Erik, I'm glad I can call you a friend.

 


6/20/2005
Blogger Brooke writes:

Oh man. My stepdad's an ER doc, and I heard about this sort of thing off and on through junior high and high school.

It convinced me I would never want a job that is so fraught, but I'm glad there are people like you doing it.

 


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