Speaking in Code.

She wasn't a young woman, but she seemed strong enough. She wasn't thrilled to be here, but nobody ever comes willingly. We joked in the afternoon, and then her pressures seemed to spiral down. Docs weren't thrilled, so in went the lines. We went to CT with a sense of impending doom. We'd just got her pressures above 100, and we ripped her from the relatively safe confines of her room. This. Was not. Going to be good.

First round of pictures went fairly well, she was still not happy to be here, and even less happy to be on that board. We reassured her, and we started to get the second set of pictures. She was really upset with us- wanted badly to go back to her room, she begged us to take her back. We couldn't, we needed to figure out what was wrong with her.

We got the last pictures, and took her out of the machine. She was quiet. Her eyes lost their focus, even though she was looking right at me.

Shit.

She's not responding.

SHITshitshitshitshit!

She's not responding, and now she's puking all over my watch. Shit. Where's the ambu bag? Where's the O2? Call it! Call it!

I turned her as best I could as they started compressions, and kept her over as they bagged her. Within seconds, the room was full of people. I suctioned her mouth, and got out of the way, her emesis all over my hands.

V-fib. Shock. V-tach. Shock. No pulses. No respers. Drugs. Compressions. ET tube. Organized chaos. Yelling. Running. Hold it!

Nothing.

Called it.

And as quickly as they came, the room was empty again.

We were left to pick up the pieces and put her back in bed. Here's the chaplain, who's telling the family? How much time do I have to make her look better?

We get her back upstairs, clean her as best we can, cover her with a warm blanket, and give her back a little of the dignity she lost earlier. I want this damn ET tube out, and the NG too, but they say "no", in case they need an autopsy. I want dignity for her and for her family. Her face is mottled, her tongue is not cooperating. I try the art of towel propping to make her face a look little more normal, but the damn tube...

We're finished at last, the pastor comes in, then family arrives. Their once-jovial faces now streaked with tears. I ask myself "what more could I have done?" I don't have any answers for them, or myself.