Every Minute

I woke to a bright light above me, which I realized quickly was just the light from outside my bedroom window. My chest was sore, probably from the drinking last night. I had heartburn from hell, and a wicked headache.  

“Note to self, never drink that hard again.” I muttered to myself as I raised from the dead to go and find something to ease this hangover. As I wandered through the halls, my feet felt heavier than normal with every step and I can hear this buzzing inside my head, it sounds like voices and I can almost make out what they’re saying. 

“Let’s......... one more........ don’t.........” I shake my head to clear my thoughts but all that does is make me dizzy. I sit down at the kitchen table and wait until the feeling subsides, then I start making a pot of coffee, the one thing that’ll wake me up and bring me back to reality. 

The smell is heavenly as it’s brewing and when it’s done, I fix myself my usual, black with a touch of sugar. Just as I’m about to take that first sip, there's a knock at the door. I curse under my breath and whisper to my cup that I’ll be back in just a minute to finish what we started. 

To my surprise, it’s my sister on my doorstep looking very concerned. When she sees me, she jumps into my arms and starts sobbing. 

“I got so worried when I didn’t hear anything from you last night after we got out of the bar. I thought maybe the worst had happened. God, I’m so happy to see you right now!” I stare at her bewildered, and when she calms down, I invite her inside for a cup of coffee. 

When we sit down, I ask her what happened last night because I don’t remember it at all. 

“You don’t remember anything? We went out and had a few drinks, you got very loose and wanted to drive home. I tried to convince you for half an hour not to drive yourself home. I told you I had to use the bathroom and when I came back you were gone. I didn’t see your car when I checked outside, and I started to worry about you, especially when you didn’t answer your phone when I called. I tried you five times last night and sent I don’t even know how many text messages.” 

I went back into the bedroom and grabbed my phone, when I powered it up all her messages came flooding through. I didn’t remember shutting my phone off, but apparently, I had. I didn’t remember driving myself home either, so I went to the garage to see if my car had made it home with me. When I found the garage empty, I wandered back to the kitchen table.  

“My car isn’t here, and I don’t remember driving myself home last night, so I must’ve gotten a ride from someone or taken a cab. You can stop worrying about me, I'm right here and I’m fine.” I said and I wrapped her in a tight hug.  

A sharp pain shot through my chest when I hugged her and it made me jump, hard. 

“Are you ok?!” my sister asked 

“yeah, I think so. I don’t know what that was, but it hurt like hell.” I said. 

My chest was a little numb after that, and we sat down to drink our coffee and catch up from the night before. It was great to see her smiling again now that she knew I was just fine. It made me nostalgic, took me back to when we were growing up, laughing and smiling as we chased each other around the backyard, and watched cartoons together.  

“You’re going to miss that smile” I thought. I immediately wondered where that thought came from, considering she was sitting right in front of me. 

I tried to dismiss the thought, and as I took another sip of my coffee, I got another shooting pain through my chest. God, when was this heartburn going to get any better? I tried to hide the pain from my sister, but she saw right through me like she always did and even though she didn’t ask she did give me a concerned look and sighed heavily. 

“well, I’m glad that you’re doing well. I should probably get going. You look like you need your rest to get through this hangover.” She laughed and winked at me as she raised from her seat. 

“Don’t let her leave!” the voice in my head screamed at me. I don’t know where it came from, but I knew that it was right. For some reason, I had to keep her from leaving, she needed to stay here with me. 

“Are you sure you have to get going? How about another cup of coffee?” I could tell she sensed the edge of desperation in my voice because she gave me a strange look. I tried my best to smile at her and play it off. 

“No, I’ve had enough caffeine. If I keep going, I get headaches, then I’ll be in the same boat as you. Plus, I wanted to check in on mom today and see how she is. She was just as worried about you as I was.” She grabbed her purse from the table and started to back towards the hallway. 

“Why can’t you just call her? I’ll call her if you want, I’ll call her and ease her mind. We can hang out for a while today; I feel like I haven't seen you in forever.” I started to panic as she got closer to the door, and I honestly had no idea why. 

“You know, having you call her might not be such a bad idea. I’m sure she’d love to talk to you. I still told her that I would come and see her today, and I have to go to work after I see her anyways. I can’t stay.” She had her hand on the doorknob when I caught up to her in the hallway. I panicked hard and reached for her, grabbing her shoulder. 

“Please don’t leave. I don’t know why, but I really need you to stay with me. I feel like something is wrong and you need to stay to make it alright again.” I said. She gave me another of her famous smiles and hugged me. 

“It’s ok, I know you're alright now. Nothing bad is going to happen, you always used to get so anxious when we were growing up. Just remember to breathe, and it’ll be alright. Breathe. Breathe. Breathe! BREATHE!” Another jolt went through my chest that knocked me to my knees and when I looked up, my sister was gone. Laying there on the floor, I realized that I really was going to miss her smile. I was going to miss her laugh. I was going to miss her, no, that wasn’t quite right. She was going to miss me. I could feel myself fade, growing weaker and weaker. My vision started to close in around me, and that too, started to fade away with the rest of me. 

“What do we have coming in?” I asked the ED Dr. As the incoming trauma paged overhead. 

“MVA, mid 20’s, John Doe. Bystander saw him come from the bar.” he said. 

The gurney rolled in about two minutes later, he was rough. He’d arrested in the ambulance on the way to us and there was a paramedic on the gurney with him doing compressions as they rolled in. He hopped off as they landed in the trauma bay and helped slide him over to our bed. The trauma Dr. came in and started directing our staff for different roles. One RN took over compressions, another got the ambu bag out and started giving breaths until we could intubate him, one broke open the crash cart, attached the pads to his chest and hooked him up while another got IV access and started organizing the meds from the cart. Our documenter noted the time the patient came in and waited for the Dr. to start directing us on medications.  

The crash cart beeped to let us know that it was analyzing the patient's heart rhythm. It detected a shockable rhythm and advised us to clear the patient. With the first shock administered there was no change, so we go back to doing compressions. After another three to four minutes, we get another prompt for a shock and we clear the patient again. Still no luck, we continue compressions, the documenter calls out the minutes since the last dose of epinephrine was administered. We continue. 

Half an hour later we are still having little luck, the family has made it into the waiting room and wants us to continue trying everything that we can. They look to be his sister and mother; I always hate seeing families in such a hard situation, there's nothing you can say to make the pain go away. 

“Let’s try one more time. Don’t slow those compressions.” I hear the Dr. Say as I walk back to see how things are progressing. The Dr. is trying for an intubation to open his airway and is having trouble, the irritation from multiple attempts is starting to make his throat swell. I takes one more try but he finally gets access, and we move on with the Code. 

Three more shocks later and we bring the sister back to explain the situation to her, the mother is completely inconsolable, and ask if they want us to continue trying. We’re getting nowhere with CPR, defibrillation, and meds. All of us are exhausted, but we keep going as long as we can because it’s our job to fight for every minute we can.  

Through tears she decides to let us stop, she doesn’t want his pain to continue any longer. As we take stock of everything that we’ve done and slowly disperse into the ER hallway to give the family time to say their goodbyes and get their affairs in order, I can hear the sister pleading into her brother's ear. “Come on, breathe. Please breathe. Breathe! BREATHE!” 

This job takes a toll on all of us. We try so hard to save every person that we come across, but sometimes there's nothing we can do. Sometimes they’ve just done too much damage to themselves. Is it accidental? Is it intentional? It’s not our judgement to make, we just do our best to give them every minute we can give.