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The hands
The kwnai
of Emergency Medrane, Vol 5 pp 151-l 52. 1987
PrInted r the USA
??
CopyrIght z 1987 Pergamon Jow~~ls Ltd
THE HANDS The Emergency Department is usually quiet early Saturday mornings. Things that hurt too badly have caused the owners of such pain to come in earlier- and the accidents haven’t as yet had time to happen. But the early morning is a favorite time for the elephant-on-the-chest discomfort of a heart attack: it may come on during the rapid eye movement portion of sleep, that part of sleep associated with dreaming. With a thumping dream, good or bad, the eyes roll under the lids like marbles in oil. It can be as though you’re running while lying down, your body tense, heart pumping wildly to no purpose, blood pressure up. Perhaps that’s when it happened to him. What we know is that he sat up on the side of the bed, still, as when he went to sleep, 39 years old. And complained of pain. An ambulance was called and got to him quickly: no question what he had or what must be done. Lying there, hurtling there under the siren, he stopped breathing. Resuscitation was begun: pump, breathe, pump, breathe. Two minutes from the hospital. Radio the Emergency Department: Roger. Man with chest pain.
Just arrested. ETA doors open.
I minute.
a flurry
Drugs,
They’re on the ramp. 39, I keep thinking.
with permission
bicarb. Hurry. Keep pumping! The Resident is sweating heavily and is relieved when someone offers to take over for him. Nothing works. No drug is helping. Try another. Try calcium. I swear his hand moved-no, his arm moved. Both arms are moving! His heart still dead, but he’s moving his arms! God.
Never Saw That Happen Before. The hands come up on his chest to the hands of the pumping Resident and push them away. He’s making a sound around the tube in his mouth.
Check the ECG. Stop pumping. Check it. Nothing. The hands Pump.
Get the
from &warning
Damn!
As the ECG machine is hooked up, the tube for breathing pure oxygen is put down. He’s pinker. Keep pumping on the chest. Nothing on the ECG. Not a thing, just the mechanical jumps of the needle as the Resident pumps a perfect 60 times a minute. Nothing to shock. Flat line. Drugs-that’s what we need: epinephrine,
Pump!
Galvanized is the word for what happens then in the Emergency Department: Reprinted
of white coats, hands, legs, linen. ECG ready. The whip of the siren.
Nothing. own.
fall
down
lifeless
again.
Try some more epinephrine. Straight
line.
Nothing
on
his
Get me a pacemaker.
the
The hands come up away the doctor’s hands.
Streets by John Stone, Louisiana State University Press, 1985, pp IO-I I.
again,
0736-4679/87 151
pushing
-__ $3.00 + .OO
152
Stop pumping so I can see the ECG. Nothing. The man’s hands fall down again as the pumping is interrupted momentarily. We’re keeping him alive but he won’t let us.
Here’s the pacemaker. Keep pumping. Check the blood gases. The pacemaker doesn’t help. He has no pump left. His heart muscle is gone. We keep trying, pumping. The hands come up and fall back down. Death is fighting off life and the living. We work for hours. The hands are weaker; they do not rise as often; they do not rise at all; they do not move. We have
JohnStone
lost in spite of everything. The something that waits inside us all for the first falter and stumble of the heart has won. I hope his wife is a strong spirit. I’d like to tell her about the hands. About how he struggled. How we hurt with him in that purgatory until we were all rendered innocent of everything we might have been guilty of, then and tomorrow.
John Stone,
MD
Emory University School of Medicine A tlan la, Georgia
of Emergency Medrane, Vol 5 pp 151-l 52. 1987
PrInted r the USA
??
CopyrIght z 1987 Pergamon Jow~~ls Ltd
THE HANDS The Emergency Department is usually quiet early Saturday mornings. Things that hurt too badly have caused the owners of such pain to come in earlier- and the accidents haven’t as yet had time to happen. But the early morning is a favorite time for the elephant-on-the-chest discomfort of a heart attack: it may come on during the rapid eye movement portion of sleep, that part of sleep associated with dreaming. With a thumping dream, good or bad, the eyes roll under the lids like marbles in oil. It can be as though you’re running while lying down, your body tense, heart pumping wildly to no purpose, blood pressure up. Perhaps that’s when it happened to him. What we know is that he sat up on the side of the bed, still, as when he went to sleep, 39 years old. And complained of pain. An ambulance was called and got to him quickly: no question what he had or what must be done. Lying there, hurtling there under the siren, he stopped breathing. Resuscitation was begun: pump, breathe, pump, breathe. Two minutes from the hospital. Radio the Emergency Department: Roger. Man with chest pain.
Just arrested. ETA doors open.
I minute.
a flurry
Drugs,
They’re on the ramp. 39, I keep thinking.
with permission
bicarb. Hurry. Keep pumping! The Resident is sweating heavily and is relieved when someone offers to take over for him. Nothing works. No drug is helping. Try another. Try calcium. I swear his hand moved-no, his arm moved. Both arms are moving! His heart still dead, but he’s moving his arms! God.
Never Saw That Happen Before. The hands come up on his chest to the hands of the pumping Resident and push them away. He’s making a sound around the tube in his mouth.
Check the ECG. Stop pumping. Check it. Nothing. The hands Pump.
Get the
from &warning
Damn!
As the ECG machine is hooked up, the tube for breathing pure oxygen is put down. He’s pinker. Keep pumping on the chest. Nothing on the ECG. Not a thing, just the mechanical jumps of the needle as the Resident pumps a perfect 60 times a minute. Nothing to shock. Flat line. Drugs-that’s what we need: epinephrine,
Pump!
Galvanized is the word for what happens then in the Emergency Department: Reprinted
of white coats, hands, legs, linen. ECG ready. The whip of the siren.
Nothing. own.
fall
down
lifeless
again.
Try some more epinephrine. Straight
line.
Nothing
on
his
Get me a pacemaker.
the
The hands come up away the doctor’s hands.
Streets by John Stone, Louisiana State University Press, 1985, pp IO-I I.
again,
0736-4679/87 151
pushing
-__ $3.00 + .OO
152
Stop pumping so I can see the ECG. Nothing. The man’s hands fall down again as the pumping is interrupted momentarily. We’re keeping him alive but he won’t let us.
Here’s the pacemaker. Keep pumping. Check the blood gases. The pacemaker doesn’t help. He has no pump left. His heart muscle is gone. We keep trying, pumping. The hands come up and fall back down. Death is fighting off life and the living. We work for hours. The hands are weaker; they do not rise as often; they do not rise at all; they do not move. We have
JohnStone
lost in spite of everything. The something that waits inside us all for the first falter and stumble of the heart has won. I hope his wife is a strong spirit. I’d like to tell her about the hands. About how he struggled. How we hurt with him in that purgatory until we were all rendered innocent of everything we might have been guilty of, then and tomorrow.
John Stone,
MD
Emory University School of Medicine A tlan la, Georgia