Several decades ago, my elderly patient, Mr. Waverly, had a cardiac arrest in the intensive care unit. Dr. Schiller, myself, and three other nurses tried feverishly to resuscitate him. Unfortunately, without success.
Fond memories flashed by of the patient I nicknamed, “My easiest patient with the sickest heart.” He struggled with uncomfortable abnormal heart rhythms and fainting spells, yet he never complained. While he confided in me about his fear of dying, he also made me laugh with funny stories about cows on his dairy farm.
Minutes ago, Mr. Waverly and I had been chatting about his newest grandchild. Now, he was gone, and I was holding his hand. Looking down at his lifeless body and feeling the coolness of his skin, I mentally let go of my favorite patient.
Choking back tears, Dr. Schiller pronounced the time of death. We bowed our heads around the bedside, observing a rare moment of silence in the ICU. The pungent odor of death filled the air as his sphincter relaxed. Clinical death.
Before I could turn off the monitor screens, Dr. Schiller’s partner, Dr. Revell, rushed in, “I just got the page, what’s going . . . ?”
“We lost him,” Dr. Schiller replied softly.
Puzzled, Dr. Revell pointed to the monitor. I saw a stray blip on the screen, then one heart beat every other screen. But no palpable pulse or blood pressure.
“Should we continue?” Dr. Schiller asked us.
With time being critical, we all spoke at once: “We’ve coded him for 40 minutes.” “He’s suffered for too long. Let him go.” ‘It’s his time.” “Won’t help, he’s gone.”
Shaking his head, Dr. Revell countered, “Hell, no. Marilyn, turn the Lidocaine back on.”
I restarted the flow of the anti-arrhythmic and held my breath. No heart activity. “Try the Bretylium.” “OK.” One spike followed by another until normal sinus rhythm returned.
What felt like an hour was only a minute or two. His blood pressure also came back. Mr. Waverly stirred, then opened his eyes.
Despite the breathing tube, he mouthed, “Slept?” And, pointing to his lower side, “Dirty.” Ever the gentleman.
Squeezing his hand, I said, “Glad you’re awake now. We’ll get you cleaned up.”
I had assumed CPR, oxygen and medications brought Mr. Waverly back, but now believe his guardian angel tapped him on the shoulder, “Heaven’s got enough milk and cream. You stay and enjoy your grandchildren.”
12 December 2018