Sometimes in this work, things are timed perfectly. Too often people wait too long to call. I can't blame them, no one really wants to see us. Also too often, people call too early. I mean, they probably shouldn't call at all, but that's a different post.
Recently I had a perfectly timed call. I arrived after the ambulance and peeked in the door, I was advised to set up in the truck while they got the patient out of the house. Sweet. As I was pulling cords out of the monitor and opening an IV start kit, I saw someone running out of the corner of my eye. The back doors were suddenly flung open and they pushed the now unconscious patient right in front of me.
"He just went unconscious when we got outside." the EMT hurriedly told me. Well, shit. But how convenient to go unconscious just as you are being loaded into an ambulance where a paramedic is standing with EKG cables in her hand.
So, I threw him on the monitor and he was v-fib (a lethal but treatable heart rhythm). Sweet, light him up! Or, give him some 'edison medicine' as my medical director puts it.
So, we shocked him, and he got a pulse back and it was high fives all around. But within minutes, he was back at it, so we shocked him again, and again, and this happened six times before I had time to get an IV in him to give him some medicine. I hadn't shocked someone that much in a very long time. And I've never had someone all but come back to total life after a shock. This poor guy would come back enough to groan and confuse us, as I guess his heart couldn't decide what to do. At one point, I thought we'd lit him on fire. I'm sure it was a good feeling to look up after being violently dragged back from the bright light in a post-shock haze and hear your paramedic say "Is something on fire?!" (Nothing was on fire, of course, but a few singed hairs never hurt anyone.) His heart finally submitted to working thanks to the amiodarone.
The patient was talking (but not too chatty) by the time we got to the hospital and was swiftly transferred out and then it really was high fives all around.
I'd never had a patient actually come back from a cardiac arrest and to be honest it really was a really amazing feeling. He's the one patient who mattered in a sea of recent mediocre calls. A bright spot in my day, my month, my year, my career. Most importantly, he is a reminder of why I do this strange job, and of just how strange it is. He is all of these wonderful things to me, and yet, a stranger. I wouldn't recognize him if he fell down dead in front of me (again). And weirdly, that's okay. I don't need a better ending than the one I already have.