He's Still Alive!

Just as an exhausting on-call day is ending, with only enough energy to ponder the slumber that lies ahead, I hear the beeper go off. It is an outside line; the doctor from the intensive care unit answers.

“His pressure has been dropping all afternoon,” he explains, “and on maximum vasopressors, I don't expect him to live through the night. You might want to come in now”.

I am a bit shaken but not surprised, and, having prepared for this news, I race for the door, purging my mind of the day's events in anticipation of what is to come. In the taxi ride uptown I try to imagine what is happening at the hospital and prepare myself for any scenario. Is he dead already or is he still alive? I chide myself for not having predicted more precisely when things would change for the worse and regret not taking the entire day off to be there and provide support.

I arrive, expecting the worst, and run up the stairs to the unit. A small mob of family is huddled around his bed. In extreme circumstances, the two-visitor-at-a-time rule is mercifully overlooked. He's still alive! Fortunately, I am not too late. Glancing up at the monochrome screen, I see the green tracings of the cardiogram, arterial blood pressure, central venous pressure, pulmonary artery pressure, and respirations that testify to the presence of life in the motionless boy. Motionless except for the chest rising at a mechanically precise rate of 20 times per minute.

His heart rate is 160 beats per minute, his systolic pressure is about 55; at least it will not be long now. Looking around at the family, my family, I sense a collective sigh of relief. The doctor is here. The doctor to whom the entire family …