codes

i walk on to the ward to see my patient in bed 8. there is a man in 6. he looked terrible. his breathing was real shallow. his skin was grey. it reminded me of patients in gandarra. 'that man looks pretty unwell. somebody should check him out. do a set of obs or something.' the nurses kept on talking. so i kept on walking. a minute later, while i was looking at my patients chart and exchanging pleasantries, chimes sound overhead: 'code blue, ward ***, code blue, ward ***, code blue, ward ***'

shit

there was one bag and masking at the head. one doing cpr. a third fluttering about. 'whats the story? what did he come in with?' the crash cart arrives. i jumped on the bed and take over cpr. the ribs cracked under my hands. there is a rhythm on the monitor but no output. he got a shot of adrenaline and another of atropine. time went by. a few more ribs cracked. we checked for output for a few times. it felt like forever. i got into a zone. pump-pump-pump-pump. and then: 'okay stop thats it.' it's all over. time of death: 0940hrs.

*

'mrs *** has just vomited what looks like coffee grounds. can you please come and review her?' it's 2135hrs. 25 minutes before i knock off. wonderful. i walk into the room: 'can i see the vomit?' it looked faeculent. it smelt faeculent. 'hello *** what's going on? how are you feeling? have you got any pain?' nod shake mumble. abdomen tense. no bowel sounds. bowels day four. 'can someone do a set of obs? and take some blood?' i went back to the desk to read the file. it's 2140hrs. 87 year old woman with septic arthritis transferred from another hospital after they overloaded her. then the team overdiuresed her. a million other medical problems. now she's just plain confused and not responding to antibiotics. not for resuscitation. not for met calls. fan-fucking-tastic. 'doctor we just did her blood pressure and it's 80'. i return to the bedside. no access. no bloods. 'okay we need a fluid bolus of 250mls normal saline, iv pantoprazole 40mg and granisetron 1mg, i'll put int a drip and somebody call in xray.' cannula goes in the right hand. vomiting becomes uncontrollable. 'lie her on her left side and suction. she might aspirate.' i go to call in the surgical reg. 2150hrs. 'ortho patient? call ortho reg. bye.' for fucks sake. 'faeculent vomiting? that sounds bad. do you think it's a bowel obstruction? isn't that a general surgical problem? hmm... okay im coming in.' 'doctor she's just became unconscious.' rush back to her bedside. she's aspirating. flatten the bed and turn her onto her side. did the finger sweep. took out her dentures. suction. 'can someone please call a met call?' 'she's not for met calls.' 'oh that's right.' fuck fuck fuck. 'well can you please get 2.5mg of morphine please? no make that 10mg.' she stops breathing. no pulses. i listen with my stethoscope. no breath sounds. no heart sounds. pupils non-reactive to light. time of death: 2200hrs.

i stand back and flick off my vomit covered gloves. as i walk past the curtains and out the door i run in the ortho reg. 'hi how is she going?' just look at me: im a motherfucking tired flu-ridden black thundercloud.