By Michael Morse
The guys from Engine 10 were doing CPR when we arrived.
“Asystole,” said Kraz, looking up from the monitor.
The patient lay on the floor next to a hospital bed in the front room of an ordinary house on an ordinary street in Providence. The diaper he wore was clean, and the inflated plastic bags that were wrapped around his hands were new. I’ve seen those bags before. They are used when a person has lost his sense of self and injures himself with excessive scratching.
“Who found him?” I asked. Three or four family members stood outside the room, afraid.
“He was awake 10 minutes ago,” said a 20-year-old woman.
“Is there any paperwork or records?”
“What do you mean?” She was nervous, shaking as she watched the firefighters behind me move her grandfather onto a backboard and continue pumping his chest and breathe for him.
“Did he have any wishes should something like this happen?” The guys had him ready to go.
The family looked at me as if I were mad.
“No bracelets or necklace,” said Bill.
“I know things are a little hectic,” I said to the girl, “but I could really use some information. Is there a folder or something from the hospital?”
She handed me a thick folder from the visiting nurse company that visited every day. No advance directive. I scanned the room, looking for the DNR orders that would allow me to let this man die in peace. Nothing. A picture on a wall showed my patient in 1967, dressed in a South Vietnamese military uniform, smiling, holding a rifle. His name and date of birth were written below. On a dresser were some medications. I put them in a bag, copied the information from the wall, and left the home.
Inside the rescue we worked the code. An IV was established, Epi and Atropine administered, CPR continued when a rhythm didn’t materialize. We had the defibrillator pads attached. I looked at the flat line on the monitor after each drug was pushed, hoping it stayed flat. It didn’t seem fair; he had fought enough.
My intubation attempt was unsuccessful; we rolled toward the ER, doing CPR all the way. Although I thought the effort was doomed from the start, my training took over. We did all we could.
The medical team had assembled prior to our arrival. Ten or so people waited for us to move him onto their stretcher so they could take over. I gave the report.
“Seventy-six-year-old male, conscious at 11:15, found by family not breathing at 11:30. CPR started at 11:35. 20 Gauge IV in left AC at 1140, Epi at 1141, Atropine at 1143, remained pulseless and asystolic. History of stroke five years ago and Alzheimer’s.”
The hospital team took over. We backed out. Another round of Epi and Atropine, then other meds. Five minutes later, I heard the attending,
“I’ve got a pulse.”
I was disappointed. Then, I was shocked by my reaction. They got him back. All of our work was not in vain. A man was alive who should heave been dead, and I was disappointed. I helped save and prolong a life, and for that I should be anything but disappointed. Sometimes I wonder if this job takes more than it gives.
Ten minutes later, he was breathing on his own, his blood pressure rising.
An hour later, he was still with us. Ten hours later, he was still with us.
Regardless of our beliefs or feelings, we have a job to do. Once resuscitation efforts are started, training and experience take over, everybody gives their best effort, and a power higher than us decides the outcome.
His son and granddaughter stayed by his side. Everybody was at peace.
Well, not everybody ….
Michael Morse, a Providence (RI) Fire Department member for 22 years, writes about his experiences as a firefighter on Engine Co. 2, 7, and 9 and Ladder Co. 7 and 4, as well as his time on Rescue Co. 1 as a lieutenant and Rescue Co. 5, where he is currently captain. He lives with his wife Cheryl seven minutes from his station, which, fortunately for him, is “worlds away.”