5 AM, the morning after the Sandy Hook Elementary school shooting, I wake up from my deep slumber of the fire station’s bunk. “Ambulance 3, Engine 3, respond to a cardiac arrest of an eight-year-old female. Note, CPR is in progress”. I jump out of bed and run to the ambulance. Next, I navigate to the the patient’s house, reading dispatch’s notes aloud to my partner as the adrenaline rushes through me. We arrive, and reality begins to set in as I’m about to walk into my first cardiac arrest code. I say a quick prayer and walk into the house.
Her two older siblings stand in front of the bedroom door, both wrapped in a single blanket. We walk into the master bedroom. Her mother stands in the corner of the room, crying, as her father stands above her doing chest compression on the mattress. The firefighters come into the room to move her from the bed and onto the floor for more effective chest compressions, and the father steps back breaking into tears. We reassessed the patient. I inserted the oropharyngeal patent airway and begin ventilations and switch to chest compressions at the end of every cycle. The paramedic applies the pads. Asystole. We couldn’t shock. Arms fatigued, blood rushing through me, the team and I move her onto the backboard and the stretcher. Securing her accordingly, we move her to the ambulance and resume CPR. The paramedic push the drugs, no changes. We arrived to the hospital and transfer the care to the staff. Before I leave, I see the parents running to the double doors, crying.
I’ve been an EMT-B for four years, started straight out of high school at the age of 18. At the time as a novice EMT and an optimistic new college student, I was under the impression that for every ailment or injury, there would always be a successful treatment that I could provide as an EMT with basic life support (BLS) as the first line of treatment. Additionally, as an Allied Health major, I learned of innovative new technology and research breakthroughs that help people live healthier and longer lives. I was fascinated to see how patients improved with treatments and in awe of the science behind it, and wanted to do as an aspiring physician assistant student. Regardless of all the knowledge I’ve gained from the articles and textbook readings or the amount of time I sat in class lectures, the one thing rarely discussed was when we could no longer save and help people. Up until I worked my first code, I associated life with success and naturally, death with failure for the patients; in other words, if the patient was alive and was going to get better, then I successfully did my job. But I never thought what would happen if the patient didn’t get better and passed away. Physically and mentally, I was prepared. Through those two perspectives, I understood how death occurred, how to effectively perform CPR and life-saving techniques. However, emotionally, I wasn’t. I didn’t understand how to cope with death of a patient, much less, the impact it had on me. I struggled to understand the anger and frustrations I felt after the code, how all of the technological advancements we’ve made overtime in medicine and how all the medications synthesized could not save this young girl’s life. And because I didn’t emotionally understand myself and the situation, I questioned whether medicine was truly my calling and whether becoming a physician assistant was career path I wanted to pursue.
After much time, reflection, and talking to other people who have been in similar situations as I, I learned the the biggest and most important knowledge gained from this experience to prepare me in the future is the reminder that death doesn’t equate to failure. As healthcare providers, we go into medicine to help people to the best of our ability and for as long as the patient wants our care. However, no amount of innovative technology nor breakthrough research allows us to help the patients cheat death when the time comes. We are not God, and we do not play God when a patient’s life is teetering between the delicate balance. In the future, when I face similar life-saving situations with patients, I am prepared mentally, physically, and emotionally. In the mental and physical aspects, I know and am competent on how to perform life-saving procedures when the time comes. Emotionally, I am ready for the outcome. Life or death, I know that my team and I did the best of our ability to help the patient, and with that, there’s peace in our hearts. Good or bad, I know pursuing medicine is my calling and becoming a physician assistant is my path.