The code

Recently, I've been working on the MICU service. This is a team of interns, residents and attending physicians who take care of all patients in the intensive care unit. Physiologically, the science is the same. But the patients are sicker. And everyone's about to die.

One of our responsibilities is to respond to any "code blues" around the hospital. That means that any time a patient is found down, or without a pulse, or not breathing, a "code blue" is called and our team rushes to the bedside to implement a series of actions designed to revive a patient from death/near-death.

On Monday, a "code blue" was called and we all sprinted three flights of stairs to reach the patient's bedside. From report, we were told that she was recovering from surgery and all of a sudden, collapsed and stopped breathing. After the code was called, 15-20 physicians, nurses and respiratory therapists ran to the bedside. The commotion was palpable and tensions ran high. In the end, it was decided that the patient would have to be intubated. Intubation involves carefully placing a small tube down the patient's trachea so that we can hook her up to a ventilator.

All in all, it was a success and the patient was revived. This actually isn't a very rare occurrence except for one detail: she was awake, but paralyzed for the whole thing.

Apparently, somehow, the paralytic from the surgery had some secondary action and acted a second time. She wasn't sedated and she could consciously perceive that she couldn't breathe and couldn't move. She heard the "code blue" over the intercom, saw people run into the room and waited, helplessly, while a tube was put into her throat.

The hospital is a scary place.