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Read an Excerpt from The Broken Code
Code Blue
Alisha:
A code blue announcement rang through the Emergency room (ER). I was busy reviewing an intubated patient when the ER nurse called for help. I rushed from the ICU. When I entered the ER, I saw Miguel leaning over a stretcher stained in blood. The ER staff moved him aside. I froze at the sight.
“Dr. Alisha we need you. It is difficult to intubate the patient.”
The shout from the ER doctor shook me out of the mental paralysis. There was blood all over the mouth. I sprang into action. We cleared the throat and intubated Nick. The nurses had already started IV lines. The ER staff assessed what in medical terms is the ABC (airway, breathing, circulation).
I reviewed all the medical information, running over every single checklist I trained on. My mind was racing against time. I saw the uneven movement of Nick’s chest. Oh, no this is a pneumothorax. When I put the stethoscope on his chest, it confirmed my fears. Something must have punctured the pleura (a thin layer that covers and protects the lungs), causing air to rush into the chest leading to the collapse of the lung.
My medical alarms kicked in. I asked the ER staff to prepare for the decompression procedure.
The monitors did not paint a good picture. Nick’s vitals were not looking good. He was sinking and showing signs of respiratory distress. Bleeding continued. The staff performed repeated suctions to clear the airway. They programmed the ventilator, but it was difficult to maintain oxygen levels and pressures. There was imminent danger of cardiac arrest.
I proceeded with the chest tube insertion. After inserting the tube in between the ribs, I connected it to a device. The air flowed outward. I kept a close watch thereafter monitoring Nick's chest for lung expansion.
If the lung did not re-expand, he would need suction. If that didn’t work, surgery was the only option. Within the next one hour, some sanity returned to Nick’s vitals. They moved him to the ICU.
In the meantime, I called up Dr. Lawrence, the only person whom I trusted more than myself. For Nick, I needed the best and someone who could take over from me. The mental strain hit me. I would collapse any moment. My voice was desperate, and I kept repeating Nick’s name on the phone.
“Who is Nick, Alisha?” The question from Dr. Lawrence made me realize my emotional state.
"He is the patient. Can you please come? Please."
Dr. Lawrence was a good cardio-thoracic surgeon. We were great friends and Dr. Lawrence respected my judgment. Therefore, when I asked for him to come, he agreed.
"Alisha are you all right? What is disturbing you so much?"
"Please come fast."
Dr. Lawrence came within the hour, examined Nick and reviewed all the medical management and made changes.
He looked at the drainage and assessed the gunshot wound on the chest. The bullet had just grazed the chest wall. Its impact must have chipped a rib puncturing the lung. He stitched it up. Dr. Lawrence asked the staff to arrange for 2 units blood transfusion as soon as possible.
"I will check him tomorrow and decide if we need surgery."
I walked Dr. Lawrence towards the door.
"Now tell me what is bothering you. What is upsetting you?"
"I am tired."
"Get some fresh air. ICU can stifle your senses sometimes."
When I came out, I found Joel & Miguel waiting outside the ICU for news.
I collapsed on the bench just outside the door. Miguel and Joel walked up.
“Can I get you something, Dr. Alisha?”
Tears welled up in my eyes again. Miguel sat beside me taking my hand to comfort me. I clutched his hand tight.
“How did this happen, Miguel? Were you there with him?”
Miguel gave a brief description of what had happened. "Tell me he will be all right. I can't bear something happen to him on my watch."
“He is not looking good. You better inform Laura,”
Unsure of my emotions, I needed to hide myself. Why am I concerned about Nick? He is the reason for all my suffering.
In the changing room I washed my face. The cold water did nothing to stop the burning feeling. “God, I need him to stay alive. At least give me a chance to tell Anmol.”
Later in the day, Jenny caught up with me. She was off duty but came to the hospital as soon as she got the text message.
She had brought coffee and doughnuts. I was in no mood to drink or eat.
“Girl you will need all your mental and physical strength.” Jenny took me by the arm to her room. Once in the room, I was inconsolable. I hugged Jenny and let my emotions flow.
Jenny tried to comfort. “Don’t worry, he will be all right. You and Dr. Lawrence have done the best you could.”
“This is unfamiliar territory for me Jenny. Why do I have feelings for Nick? What if something bad happens? What will I tell Anmol? I have hidden the truth from him. Anmol will never forgive me. He is so fond of Nick. Why am I presented with difficult choices? I don’t want to live my life filled with regret.”
Jenny listened, letting me express my deepest thoughts all the while holding my hand.
"Never consider life’s decisions with regret. You are doing the best you can in the circumstance’s life has presented to you. The problem with us doctors is that we train our minds to only consider logic. Evidence and experiences dictate our choices. When we project these to the future, we can only make assumptions. There is no certainty.
We override the heart. I think of logical reasoning as the salt of life. The heart is the one that adds all the other flavors. When we let only logic dictate our lives, all we get is a salty life to live. Alisha, during this what if moment listen to your heart’s voice! Your heart is telling you something. Embrace the feelings and express them. You need to look to the future."
My mind was not ready to admit my feelings for Nick, even in this moment. The heart had to wait.
About the Author:
Ashish started his career as a physician over two decades ago. For the past ten years, clinical research has been his labor of love. He has managed projects all over India and has travelled widely in the country and abroad. Ashish has a keen interest in healthcare technology. He founded CTQuest that is working with teams developing medical devices and applications.
Creative by nature, Ashish writes poetry, short stories and paints in his leisure time. He is an avid reader and was always a member of the editorial team in his school and college.
The Broken Code is Ashish's first published novel. His healthcare experience has given him an insight into current and future technological advances in this field. Ashish brings his multifaceted experience into the narration of this story. Highlighting for us the challenges that await amidst the technological advances.
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