“Clear.” As he brought the paddles once again to the man’s chest, Pesh muttered, “Come on, come on, beat, dammit,” under his breath. It didn’t matter how young or how old, he hated to lose a patient. Although the body shuddered and jerked in reaction to the electricity, the heart remained frozen. Although it was a losing battle, he called, “Clear!” once again.
When the man’s vital signs didn’t change, Pesh shook his head. “We need to open him up to massage the heart. Get me the rib spreader and the chest saw and page one of the residents,” he ordered. He took a face mask from another nurse and slid it on.
After making a quick incision in the man’s chest, Pesh took the saw from one of the nurses. Once he had sawed through the sternum, he shifted to the side to allow a nurse to move closer to work the crank on the rib spreader. Pushing aside the hard bone of the sternum, he gently took the man’s still heart in his hands. No matter how many times he’d had to do it before, there was still something so humbling as holding the most important muscle in the human body in the palm of your hand. Squeezing it over and over, Pesh mimed the usual pumping the organ did.
Seconds ticked agonizingly by as they waited to see if the damaged heart would restart. When it remained still, Pesh sighed and closed his eyes for a moment. He eased back from the man. Glancing up at the clock on the wall, he said with regret, “Calling time of death: nine forty-seven a.m.”
“Want me to handle the family?” the resident asked.
Pesh shook his head. “No. You get him closed back up. I’m sure they’ll want to see him.” He took off his bloody gloves and tossed them dejectedly into the hazardous materials trash can and then removed his mask. He walked over to the glass doors of the trauma area where a paramedic stood surveying the scene. “Do we have a name on him?”
The paramedic flashed the guy’s driver’s license. “Aaron Chapman.”
“Thank you.”
He walked down the long hallway before pushing open the button on the mechanical door that led out of the emergency area. In a room to the side of the waiting room, the man’s wife and two teenage sons sat in hushed silence. As he opened the door, he said a silent prayer for strength. This was the most difficult aspect of his job. While he relished in the long hours of saving lives and diagnosing illnesses, this part drained him both emotionally and physically.
“Mrs. Chapman?”
The woman, who appeared to be in her late thirties or early forties, rose from the chair she was sitting in. “Yes?”
He held out his hand for her to shake. “I’m Dr. Nadeen. I was assigned your husband’s case.”
She bobbed her head and took a step forward. “How is he?”
“Your husband experienced a severe myocardial infarction.” At her blank look, he replied, “A heart attack.”
“Oh my God, I can’t believe it. He’s had some high cholesterol, but he’s been running every day. I was only ten minutes from here dropping the boys off at school, and I told them I bet their dad had fallen and broken his ankle or something. Of course, I wondered why he wouldn’t call instead of the hospital…” Realizing she was rambling, her voice cut off. Her hand hovered over her throat. “But he’s okay now?”
Pesh shook his head. “I’m very sorry, but the heart attack caused too much damage to the heart. We were never able to revive him after he was brought in.”
The woman’s eyes widened to the size of dinner plates. “No, no, NO! Surely there is something you can do!”
“I’m so very sorry. We did everything we could to save him, including multiple attempts of resuscitation past what the paramedics originally did, but he did not respond to our attempts.”
The woman’s wail pierced through to Pesh’s soul. She collapsed back against her sons, who now had tears in their eyes. Stoic on the outside, Pesh stood by her side as she sobbed uncontrollably. Most doctors when playing the Grim Reaper would deliver the bad news and then retreat. Pesh believed that part of a patient’s care also meant the care of their family. That’s why he ignored his pager going off in his pocket. It was only when his name was paged over the intercom that he took a step forward. He placed a hand on the widow’s shoulder. “If you would like to be with him until the funeral home arrives, you can follow me.”
“Y-Yes, please,” she murmured.
With her sons flanking her, she followed Pesh out of the room and behind the mechanized doors. When they got to the exam room where her husband’s body was, Pesh turned and once again touched her shoulder. “I’m so very sorry for your loss.”
“Thank you,” her son mumbled when his mother was unable to speak. Instead, she rushed forward to bury her head against her husband’s chest. Her body shook with her sobs.
Pesh nodded and then finally turned away. With determined steps, he answered his page—some sort of consult on a diagnosis. After his input, this patient would pull through. It was the true embodiment of the dichotomy of his job.
Once he finished, Pesh went over to the office area of the emergency room. He eased down onto a stool, placing his head in his hands. As he rubbed his eyes, he swore they were moist from overuse, not from the potential tears welling behind them. If there was one thing he was, it was a professional. Doctors had to be emotionally detached when they were doing their job, or they would lose their minds. But it wasn’t staying detached in the moment that was the issue—it was the aftermath. The agonizing moments when the adrenaline stores depleted, and his sagging body seemed to shoulder the hysteria, the panic, the grief, and the heartbreak of the family.