today was yet another reminder of the unpredictability of life, and how as doctors, our job is to treat and not to heal.

a 57 year old guy was brought in by ambulance for shortness of breath, some pain in the shoulder but no ecg changes. was put in the p2 area until a very sharp nurse noticed some st elevations, and he was pushed to the p1 area. a while later his bp started dropping, and he went into ventricular fibrillation. repeated attempts were made to cardiovert him but he kept going into vt/vf. meanwhile the cardio reg was called, and we medical students took turns to either bag or administer cpr. he was rushed to the cath lab where the cardiologists tried to restore blood flow and get his heart beating again. several times his heart would come to life in a valiant effort to hang on, but it eventually stopped, two hours after full resus measures were begun.

the group of us were there with him, from the time he was wheeled into p1 all the way to the cath lab. initially, other than the pain, he was alert and oriented, until his bp started to drop. our job was to prepare the adrenaline for the doctors, and we must have used up tons of vials in the process. by the time we were in the cath lab we had run out of the small vials, and had to break open the bigger ones. it was crazy, but it was sad too, especially when we could see on the screen that his heart had stopped beating. for some time there was some nearly imperceptable movement, but that too later stopped.

this was certainly an exprience for us. we were giving cpr, bagging the patient and syringing the drugs. and we must have been quite a sight when we wheeled him out of the ed and out onto the corridor. most of us were trailing behind, trying to run and fill the syringes at the same time. it was exactly like how you see it on tv, where the patient is pushed down an infinitely long corridor and the nurses yell, "coming through!" only this time, it was real, and there was to be no happy ending.