Monday, March 19, 2012

Why I look up and smile during a code

Heard the most amazing story over the weekend from a patient- and it was her story.  She was 17 years old and it was the early 80s and she wasn't feeling right. She had a lump that wouldn't go away and was treated for DVT in the leg and was admitted to the hospital and put on coumadin.  Even after a month long course of treatment, the lump remained and she just wasn't feeling right. So one Dr. suggested that they amputate. She was horrified at that prospect (understandably), so she sought another opinion and the Dr. agreed to do a biopsy.  They found cancer. Luckily, she had a Dr. who studied at Sloane Kettering and he told her to get there NOW for treatment.  She spent the next year at SK receiving chemotherapy before they had PICC lines (at least not for chemo.  I'm not up on the history of this type of thing but she showed me all the damage to her veins and even an old chemo burn where a site infiltrated).   She studied for her HS diploma during that year and finished treatment and then traveled abroad with her family for a few weeks.  While she was there, she wasn't feeling well at all, got home, and they found more cancer on her scans.  Started her on chemo AGAIN, then she presented with this weird rash and shortness of breath and her Dr. at SK told her to get back there immediately.  Her mother wanted to take her to a local hospital, but the Dr. was insistent that she return to SK because they knew all the specifics of her case.  It turns out, she was bleeding internally from the chemo and needed blood transfusions. SO, started receiving her blood and after a few minutes she said to her mother "mom. I can't.. " she didn't even get the word breathe out.  She arrested. Her mother ran out into the pediatric unit at SK screaming "SOMEONE HELP! PLEASE!"  CPR started and they asked her mother to step aside.  Her mother saw the defibrillator paddles jolt her daughter and she passed out in a chair at the foot of the bed. A nurse grabbed smelling salts and helped bring her mother to consciousness.
The next morning, the young girl woke up to her mother sitting on the side of the bed sobbing and holding her hand. She said, "Mom?  I had this horrible dream.  I was hanging by the ceiling in my room and there were Drs. and nurses all around me and they were all working on me and I saw you pass out in a chair and a nurse run to help you..."
How would she have seen all of that with a team of Docs and nurses around her? (if you've ever been in a code, you know what it's like.  It's a controlled chaos full of people.) She clearly described an out of body experience. She said "I didn't see the pearly gates, I didn't see a light..I saw my mom pass out.. then I remember a feeling of being pulled back.."
It's a pretty common thing to hear people say they vividly recall seeing their environment from above when they "die" and come back. But hearing the account first hand from someone who lived through it and seeing that spark of spiritual knowledge that comes along with it is truly something to behold. That said, I always have the image in the back of my mind of a person hovering over their body during a code situation and I always make it a point to look up during one and smile at them.  To me, it's the ultimate way to comfort someone and let them know that everything will be alright, even in the face of death.  How I know that for sure, I really don't know.  I've just always had a confidence that no matter what, no matter how horrible something seems, the smoke will clear, tears will dry, and the joy will return.  And that's why I always look up and smile at least once during a code.

2 comments:

  1. I have to say that having witnessed a lot of horrible codes, I really hope the patients have no awareness of what goes on in them. I can't imagine a more horrible way to leave the Earth. Although perhaps a smile from a kind nurse would help.

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  2. A code is such a trauma I think it's akin to an MVA and most people black those out.. at least that's what I hope for them, too. I have heard conflicting first hand reports from patients who have lived through a code. Some of them can recount everything in great detail (usually only up to intubation, though), some of them don't remember a thing. One woman told me the first and last name of the nurse who initiated CPR on her 12 years ago and the patient swings by her department with doughnuts every few months. Stuff like that is what makes healthcare so addictive. I can't think of a better way to make a positive difference in a person's life. :)

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