by Nicole Yordán
“Compassion becomes real when we recognize our shared humanity.”
“We’re here, David! David! We’re here!”
His eyes were looking straight at me in a dream-like trance, as if trying to hold on to reality, as if begging me not to go. I held his head, trembling. I kept telling him to rest, he would need his energy later. I kept pulling his hair back, wondering how long it had been since someone had locked eyes with him, or touched his face, or held his hand. I combed his hair like one would a child, as if by making him feel safe his soul would choose not to leave. I would not have been here, staring down the limits of his humanity, had it not been for the Code Blue that woke us all from our own daily trance. I pulled my hands away from him for a moment and realized I had inadvertently stripped away half of his hair. He was so weak. I felt my heart burrow inside my chest, aching to help him.
I had met David before, briefly. He had been staring at me from his trauma bed, as if waiting for something. I asked if he was ok, which really meant “how can I help?” At some point the surgeons had made an opening through his throat and inserted a tube so he could breathe—now he could barely talk.
“Are you ok? Do you need anything?”
I could make out “iit..huuurts..” in the muffled vocals under his crackled breathing.
“I’ll tell the nurses to give you a little something more for the pain then.”
That was it.
The surgical resident told me his story. “It’s terrible. He was walking home from college when he was assaulted. They cut his throat and stabbed his abdomen. He survived, but he’s been coming and going ever since… He was an athlete before the incident.” Now he’d lost so much weight, he was barely recognizable. Most who told his story quickly followed with: “He didn’t deserve this.”
Does anyone really?
David was moved to the trauma intermediate care unit, and out of my thoughts for a while.
“Code Blue, TICU, 306. Code Blue, TICU, 306. Code Blue, TICU, 306”
That was David.
I rushed to his room as part of the Trauma Team, not really knowing what was going on. I was a third year medical student, and this was the first time I was called to a Code. David’s lips were gray and there was not the slightest hint of red on his cheeks. His pulse was faint and erratic. The multiple sensors attached to his body echoed a desperate SOS. His oxygen saturation’s were low. SOS. His blood pressure kept dropping. SOS. He was cold.
His heart was racing faster and faster. The EKG tracing had a mind of its own. There was blood on his sheets.
SOS. SOS. SOS.
“Normal saline! Someone get the normal saline!”
“Bring the crash cart!”
“We need an artery!”
“David, are you with us?!”
I don’t remember how things happened. Five pairs of hands hovered over David. They worked together to bring him back. They pricked him and stung him in a desperate attempt to find a viable artery. We surrounded him like vultures.
All the while, I spotted his mother outside the door. She wasn’t allowed in at the time. Disheveled, she cried at the social worker, “That’s my son! They’re hurting him! These doctors have no compassion!”
I had been giving him a carotid massage for what seemed an eternity. It had slowed down his pulse, which now beat regularly. He was oxygenating well. He was stable. I held his head and tried to wipe some of the secretions oozing down his neck from the tracheostomy incision, as I would have wanted someone to do for me. We could breathe again, but we were far from done. We had almost lost him. We might lose him still.
Patients’ stories evolve as they make their way from the scene to the ER to the floor. This time, a nurse told us his story. “19-year-old male patient, assaulted six months ago, gang and drug-related. In and out of the hospital since.” She summarized his procedure history as she signed off to the incoming shift. I saw a glimpse of anger in the resident’s face when she heard this version of David’s story. I could tell she was disappointed and I wondered if she would have acted differently had she heard it before. Yet, she kept going, giving orders as surely as before, and I knew it wouldn’t have made a difference.
It didn’t make a difference for me either. As I looked into his eyes I saw my own fear reflected. Breathe in. Breathe out. His freckled, dazed face could have belonged to anyone —a student, a teacher, a beggar, a crook. Stripped from belongings and titles, we are all only human: flawed, fearful, frail.
I held his head, trembling.
“We’re here, David. We’re here.”
*NOTE: David is a not the patient’s real name. His name, as well as other identifying details, has been changed in order to protect his privacy.
Nicole Yordán is a Puerto Rican physician. She completed her M.D. at Recinto de Ciencias Médicas, in Río Piedras, Puerto Rico. Jordán lives in Miami, where she is currently pursuing a residency in General Surgery at Kendal Regional Medical Center. Her work in fiction, as well as in non fiction, has appeared in CienciaPR, The New Physician, and the blog Generación Jípster, among others.