life and death

the other morning a teenager came into the ER in the early hours with a horrible stab wound. she had already been coded three times en route, transfused with multiple blood products, and basically came into the ER and lost all signs of life. we took her to the OR to try to stop the bleeding but after about forty-five minutes of exploring the wound we finally got it to stop bleeding. at that point, it was about 1.5 hours of coding her and she had no signs of life. in retrospect i'm not sure that there was anything we could have done surgically to save her when she arrived in the ER without a pulse.

i had to sit down in a room and tell her family that she died. her 11 year-old brother freaked out and ran out of the room and we had to go and chase him down and find where he ran off too. eventually i tried to get the family members to focus on helping their other family member (also stabbed but survived) get through the hospitalization.

night float is like one of those experiences like when they take astronauts or pilots up to high altitudes and take away some of the oxygen. you start to have trouble thinking - the sheer horror and urgency of some of our situations in the setting of anti-physiological sleep patterns (awake at night and sleeping by day) tends to make feeling emotions an abstract concept. and then sometimes i have an experience like the one that i describe above and i didn't even have time to process it. i had to run up to the icu and do an emergency procedure right after telling that girl's family about her death.