“Again!”I command, my doctor’s voice taking over even as I feel something breaking inside me.“Push an amp of epi and shock him again!”
The paramedic follows my orders without question, injecting the epinephrine into Zach’s IV line.I watch the clear liquid disappear into the tubing, mentally tracking its journey through his veins to his failing heart.Three seconds.Five.The medication should be taking effect.
“Charging to three-sixty,” the paramedic announces, the whine of the defibrillator rising in pitch as the paddles store their life-giving energy.
I force myself to release Zach’s hand, my fingers reluctant to break contact even for these crucial seconds.His skin is cool now, the warmth I’ve come to associate with him, the heat that radiated from his body when he held me at night, fading with each passing moment.
“Clear!”
Everyone backs away.The shock delivers with a dull thump that lifts Zach’s torso off the stretcher before it falls back.I stare at the monitor, willing the flat line to break into peaks and valleys.One second.Two.Three.
Nothing.
“Continue CPR,” I order, my voice steadier than I feel.“And get him inside, now!”
As we rush through the emergency doors, I position myself at Zach’s head, continuing to bark orders that keep my mind focused on medicine rather than the fact that the man I love is dying beneath my hands.The trauma team swarms around.Hands reach for IV lines, for monitors, for the gurney rails.
“GSW to the right flank with significant blood loss,” I report to Dr.Patel as we wheel Zach toward Trauma One.“Cardiac arrest began approximately ninety seconds ago.One round of epi administered, two defibrillation attempts unsuccessful.”
Dr.Patel’s eyes flick to my face, recognition dawning.“Dr.Blane?I thought?—”
“Not now,” I cut her off, the steel in my voice surprising even me.“He needs an OR immediately.”
She nods, professional instincts overriding whatever hospital politics might have been about to surface.“Peterson, call up to surgery and tell them to prep OR Three.Wang, get four more units of O-neg.Miller, ultrasound now, I want to see what we’re dealing with.”
The trauma bay fills with controlled chaos as the team works.I stay at Zach’s head, my hands on either side of his face, thumbs gently stroking his temples as if I could somehow reach into his consciousness and pull him back to me.
“Come on, Zach,” I whisper, my lips close to his ear while the team continues CPR, the rhythmic compressions forcing his heart to beat when it can no longer do so on its own.“Don’t do this.Don’t leave me now.”
The ultrasound wand glides across his abdomen, the screen showing dark pools of fluid where there should be none.Internal bleeding, massive and ongoing.
“There’s a tear in the hepatic artery,” Dr.Patel announces, her voice tight with urgency.“We need to get him upstairs, now.”
“I’m coming with him,” I state, not a request but a declaration.
Dr.Patel hesitates, then nods once.“As far as the OR doors.Then you wait like everyone else.”
I want to argue, to remind her that I’m a doctor too, that my hands are steady and my skills could help save him.But I know the protocol.Know that my emotional involvement disqualifies me from participating in his care.So I nod, grateful for even this small concession.
As we rush toward the elevator, the paramedic continues compressions, his arms rigid with the effort of maintaining perfect form.Each compression forces blood through Zach’s body, delivering oxygen to his brain, buying precious minutes.
“How long has he been down?”Dr.Patel asks, her fingers on Zach’s carotid, feeling for any hint of a natural pulse.
“Three minutes,” I answer, the number burning in my brain like a countdown timer.Three minutes without effective circulation.Three minutes closer to brain damage.To death.
The elevator doors open with a soft chime that seems obscenely cheerful given the circumstances.As we wheel Zach inside, I notice his hand has fallen from the gurney, dangling lifelessly.I gently place it back at his side, my fingers lingering on his wrist, searching for a pulse I know isn’t there.
“Try again,” I say as the doors close, enclosing us in the small space that smells of antiseptic and copper and fear.“One more shock before we get upstairs.”
Dr.Patel nods to the nurse holding the defibrillator.“Charging to three-sixty.”
The paramedic pauses compressions, lifting his hands away from Zach’s chest.The nurse positions the paddles, calls, “Clear!”and delivers the shock.
Zach’s body jerks, then settles.For a moment, nothing changes.The monitor continues its monotonous drone, a single flat line stretching across the screen.Then, just as the paramedic moves to resume compressions, a blip appears.Then another.Small, irregular, but undeniably there.
“We’ve got a rhythm,” the nurse announces, her voice tight with a professional restraint that doesn’t quite mask her relief.
“It’s ventricular, but it’s there,” Dr.Patel confirms, her fingers returning to Zach’s neck.“I’ve got a carotid pulse.Thready but present.”
