Martha

Uninformed: Not a romantic interest whatsoever. Drop it. I'm fucking serious.
Storytime: Slow night. Fifty something female with complaints of CP. Cold and clammy. Sheets and gown soaked with sweat. "We need to get her BP back up." An all too familiar stench fills the air.
"I'm sorry."
"Rate your pain ma'am....on a scale of 1 to 10, describe your pain."
"Niiine."
We rolleed her to Kelly's side. Then to mine. Changed her sheets.
"There you go."
"We mixed the epi too early. Here Jon, swirl it....gently."
"The cuff's not getting a reading."
"Try a manual. Get the doppler again."
I run for the doppler searching frantically. Turns out it was behind the EMT student who was just standing there. The husband enters as well as the cardio. Pool tells me to get an ambu bag ready.
"We need to cath her to keep her heart from dying. I'll need you to sign a consent form for the procedure."
Again another foul stench. Nicole, Kelly and I put in a foley.
"Well she showed us which hole to use, just follow the stream."
"Put her on the monitor, we're just waiting on the cath lab to be ready."
I grab a heavy duty defibrillator from the crash cart and attach the three electrodes to her chest. Kelly puts a shock pad on her chest and her back. We hear a loud gasp, then nothing. Then another. Again nothing.
"She's not breathing too good here."
"Should we intubate?"
"Yeah I think so, get Respitory down here."
Pool takes a 7.5 tube and grabs a miller blade.
"Don't you want a stylet?"
No answer. The tube is in. I pump the ambu bag every few seconds. Injections of epinephrine and morphine are being pushed into the blue plugs protruding from her cold blue arms. Pool and the cardio are watching monitors and giving orders. They decide the electrical activity of her heart is too irregular to sustain. The two generals give us troops our marching orders. The RT guy takes the ambu bag. I find the little "V" formed by her ribs and I lock my hands together. Kelly says I should move up an inch or two. Pool listens to her heart beat with the doppler via her femoral. Every couple of mintues they tell me to stop and they listen. The swishing sound from the doppler stops when I stop my compressions. I must be doing something right then. THey tell me to continue pumping. I look around for reassurance that I'm doing everything right. I've unhooked bras more times than I've done CPR, which isn't saying very much.
"Dr. Pool am I doing ok."
"You're fine just keep going."
They ask me if I'm tired, but I that's the furthest thing from my mind. I keep going.
"Hold compressions."
She stabilized. Her heart was beating on her own.
"Ok the cath lab is ready. Let's go."
I disconnect all the unnecessary wires and Kelly, Nicole, the RT guy and me whisk her off to the nearest elevator. I'm so nervous and I'm driving the cart so fast that I almost run over Kelly twice. We get in the elevator.
"What's her rate at?"
"126......112.....84.....dropping."
Elevator door opens. Kelly starts pumping as I drive the cart again too fast and too out of control. The cardio is waiting there for us along with the cath team.
"How's she doing."
"Not good."
They tell me to start chest compressions again. Again it feels like an eternity. The EMT student is there. Someone lets in the husband. As I'm pumping, he's right at my side grasping her hand telling her to keep fighting. I close my eyes, but keep pumping. They decide to shock her. The husband is escorted out. "Clear" and all that jazz. Her body spasms violently.
"Would you like to pump for a while? It'd be good practice."
"Oh, I don't care."
"Jon are you tired?"
"No, I'm good, but if you really want to go for it."
The EMT student takes over. All I can do is pace back and fort. They shock her again. No improvement.
"Can you take over again, I'm getting kinda tired."
I resume my post. I can still hear blood flowing from the doppler when I pump, but I hear nothing when they ask me to stop. The reading on the heart monitor is just a flat line. They shock her a third time. Still nothing. The cardio says I can stop pumping.
"Let's call it."
She is almost completely purple, save for a handprint on her chest where I had been pumping. We wheel her downstairs. Julie and I "pretty her up" so the family can say their goodbyes.
"You need to learn that even if you do everything right, sometimes you'll get a result you won't like. You need to learn your name. I can tell you right now it's not God."
After the family had done their peace, we put her into a body bag. I filled out the toe tag in triplicate and affixed it to it's proper place with a twist tie. Vince the security guard escorted me down to the morgue with her, which was scary on uncountable levels. With a ham handed shove, he moved her body from the ER cart to the morgue gurney and closed the door.
"Well that was a disaster."
"I wouldn't say so. I mean, she died in the cath lab, not in my ER."

I hate my job.