Is There a Med Student in the Room?

My last long call at the hospital was eventful. When you are on long call, your team has the code pagers. So if any code is called, your team is responsible for responding to the codes. The code pager has gone off on a few of my previous call days, but they have always been false alarms. So I was 5 weeks into my internal medicine rotation and I still had not seen a code.

We had finished rounding on our patients and had eaten lunch. All my work was done so I was studying while I was waiting for a patient to be admitted. I was in the medical student room when I thought I heard a "Dr. Blue" overhead. The room does not have a speaker in it so I ran to the hallway and listened again to see if I was correct. (Normally if I was with my residents they have the code pagers which go off and you just start running.) Then it was announced again, "Dr. Blue, heart hospital room #___" So I took off running. I was a couple buildings away so by the time I ran to the heart hospital and up to the 5th floor I could barely breath (plus I was sick.)

I ran to the room and saw a ton of people surrounding the room. I knew right away this was a real code. I walked into the room and saw a patient lying on the ground. There was a physician doing chest compressions, anesthesia was trying to intubate, and others were trying to get IV access. I just tried to stay out of the way but of course wanted to watch. I was standing behind a physician when he turns around and says, "Is there a medical student in the room?" I of course timidly pointed out that I was a med student. He asked if I had ever done CPR before. I replied that I had not. Well, he told me, get some gloves on we need you to do chest compressions. Right away my awesome resident looks at me and encouragingly reminds me to keep my compressions firm and at a rate of 100 per minute.

Of course my heart immediately started pounding and my hands were shaking. Fortunately I grabbed a pair of large gloves because I don't know if I would have been able to get my shaking hands into anything smaller. As soon as I was gloved up I kneeled down next to the patient. I had never done this before on a real person, only on the CPR models. Many thoughts went pouring through my mind: would I feel his ribs crack?, will I do this right?, am I going to look like a fool?, Oh my gosh this is a real person!, etc. But I tried to look like a calm, confident med student on the outside. As soon as the other guy stopped the chest compressions I jumped right in and started doing them just as I had learned in my CPR courses. Nobody was calling me an idiot or yelling at me so I must have been doing them correctly. The entire time I just focused on doing the compressions correctly and thinking I was pumping blood for this guy right now because his heart wasn't.

As I was doing the compressions, everyone kept asking me if I was getting tired. I didn't feel tired because the adrenaline was pumping through my body but I alternated with a nurse who was sitting on the other side of the patient from me. When I wasn't doing chest compressions I was helping with the epi and saline flushes. It was surreal sitting next to this patient and actually doing things that were trying to resuscitate him.

Unfortunately after 20 + minutes, the code was called and he was pronounced dead. It was awful. On TV, they always bring their patients back. . . real life sucks. I was a little overwhelmed. I did not know this patient before I walked into his room that day, but I was sad. I listened to his physician call his family and give them the news of their father and spouse passing away. I was grateful at that time that I wasn't making that phone call. I would not have been able to make it without crying. I know I am not too far away from being in a position to make that phone call, but fortunately I have a little more time.

I have so many thoughts and mixed emotions about this experience. This was one of the coolest things I have done in medical school. What a rush trying to save this gentleman's life. But on the other hand, we were not successful and it was very sad. I just wanted to rush home and give John a hug. I don't ever want to receive that phone call. I can't even imagine what that would feel like. This was a great learning experience and one that I will NEVER forget. . . nobody forgets the first time they do chest compressions.