Hand and Heart

"Grab a pair of gloves and get in there."

Following my resident's instructions, I put on a pair of blue gloves and pushed my way through the sea of nurses and doctors, to stand in line ready to perform chest compressions on a patient who had coded in the ICU.

Like everyone else crowded into the small patient room, I tried to ignore the blaring sound of the heart monitor and seemingly lifeless body of the elderly patient, all of which confirmed the sinking feeling I had in my stomach. This was bad, and all I could think about was how much I did not want to watch another patient die in the ICU.

Standing beside the patient's bedside, I looked down and saw her hand reflexively reach out. Instinctively, I grabbed it. And while another medical student rhythmically pumped on the patient's chest, I firmly held the old, wrinkled hand and began to softly stroke it with my thumb. I let go when I got the nod from the nurse running the code to begin my compressions. I carefully placed my hands on the center of the patient's chest, amidst the EKG tabs and wires. I pushed down one time and, miraculously, felt a heart beat.

In amazement I shouted that I felt her heart beat. Almost simultaneously the nurse checking the femoral pulse shouted that he had a pulse, too. I looked up at the heart monitor to see a weak, irregular, but definitely present heart tracing. I backed up as the critical care doctor began examining the patient and giving more orders.

I know the science. I know the physiology. I know that it was the electrical conversions and the magnesium and the brilliance of seasoned attendings perfectly managing a critically ill and dying old woman that caused her heart to start beating again.

But I also know that there is power in compassion and hoping, against all odds, that maybe this one time, for this one patient, a code won't end in defeat.

And walking out of the ICU this afternoon I realized something else, too. I have yet to feel something more beautiful than a still heart begin to beat again.