By Iris Mónica Vargas
The one question I’ve never been capable of answering properly, or in a completely satisfactory way is, why do I want to become a physician? It probably has the same answer as “why am I a writer?” and I cannot answer that either. I want to be both. Perhaps we do the things we know that we can do well. Or maybe we do what this organism inside us feels it should do even if we still don’t really know, not with absolute certainty, if we can do it.
The other day, though, something happened that offered me a glimpse, perhaps, into the possibility of an answer. The best I can do, then, is tell you the story.
I know there are probably few people in the world who will understand what this means as much, or as clearly, as you will, because you, too, are in the midst of pursuing a dream, chasing something which, many a time, has seemed rather elusive but which you know, your entire organism knows, is held dear within you. If this livens up that fire in you that had dwindled at some point because life’s vicissitudes have taken away its oxygen, then let it. Sometimes we need all the inspiration we can get.
The story begins as most do, with an ending. You see, I am a non-traditional medical student. After passing my first and second year of medical school successfully, I attempted to settle and study for Step 1. That’s exactly when life happened. Illness and death. I took more time than I had anticipated to present my exam. And then, I found Saint James School of Medicine and it allowed me to continue where I had stopped. I passed my board and, the other day, in anticipation of my 3rd-year rotations, I took a trip with my husband and kids (I have two little boys ages 5 and 9) to search for a place to live in Chicago.
This is how it happened.
We have just exited the airport train, and are now on our way to the terminal when a man collapses, half of his body lying inside the passenger car and half over the busy hall brimming with people running to catch their flights.
I don’t know if we have time or not but when I see the man collapsing, I tell my husband about it and we start running back toward the train’s doors. My husband drops his bag right there, and I collect all our belongings and place them next to my children. (Secure the area, my CPR instructor had told us. Verify scene safety. I have just taken the CPR course two weeks prior, as a prerequisite for the 3rd year rotations application.)
“We have to get him out of there!” I tell my husband. He and another traveler grab the man and place him safely in the middle of the wide hall. People accumulate around us. In my field of vision, I see only their feet.
I feel myself trembling. My hands are shaking. “Check the pulse,” I hear myself saying. My husband is checking. “Please call 911 and get a defibrillator, you know, AED, the shocking machine,” I tell a girl next to me. I am extremely nervous. “Get his mask off,” I tell my husband who is nearest to the man’s face. “I want to see his face. It’s important.”
My husband is a physician. Who am I, then, to take the lead here? I begin to think.
I can see the man’s face now. I see what his face is doing. I hear both my husband and another guy who is next to us, wondering whether or not the man is breathing. I start talking to myself. I don’t think self-talk had ever worked before in the way it did this time, but on this day, on this instance, I tell myself there is, most probably, nobody else here who knows what to do more than I do, not even my husband the doctor, because I have just taken this course, two weeks ago. I know what needs to be done, I know what I am witnessing. The man is not breathing. When he first collapsed he had been occasionally gasping, as though he were a fish that had been taken out of water. (Beware of the agonal breaths some people display, the instructor had told us. Agonal breaths can occur in the first moments of a cardiac arrest, as can seizures. Gasping is not normal breathing.)
“Did you find a pulse?” I ask my husband. He says he cannot find it. I know that’s strange because he can always find one. “Can you find a pulse?” I ask the guy next to us. He has become our teammate. I am trying to calculate how much time has already passed since the man collapsed and we began searching for his pulse. (You have five seconds to do that. Not more than ten, the instructor had told us.)
“There’s no pulse. We don’t have time. Let’s do it!” I hear myself saying out loud.
I am confident, I am determined, and I don’t know where this is all coming from but I interlace my hands, one palm over the dorsum of the other, and place them right above the man’s xiphoid process. I push down all of my body’s weight into his chest. In the classroom, I had practiced compressions counting in Spanish, my mother tongue, but I know I should count in English this time, out loud, so that I can be replaced if I need to.
At almost thirty compressions, I am assessing myself. I need to ask for help. I am thinking my compressions are not going deep enough. (You must go at least two inches in depth, Patrick, our instructor, had told us. Allow the chest to recoil completely after each compression so blood can flow into the heart. The quality of compressions is crucial.) Am I bending my elbows? I shouldn’t do that. My arms should be extended. I know I am not going deep enough. It should feel different than it does, I think, so I tell my husband to take over, and as his hands replace mine, I continue to count out loud for him. We decide not to give mouth-to-mouth respiration, and I instruct them to keep on compressing. On the third round, my husband asks our teammate to replace him. I keep counting for him too. The girl I had asked to call 911 now returns with the AED, and I and the guy next to us rip open the man’s shirt so she can place the pads on his chest. It is teamwork, and we are working well together.
The Automatic External Defibrillator begins its assessment and I continue doing compressions as it does. Its robotic voice informs us it is ready to apply the electric shock and we all clear the body. My arms extend out like a bird’s wings to make sure nobody is still touching the man.
“Ok. Go!” I say. The girl presses a shiny green button on the machine. The man’s body jumps up dramatically, distancing itself from the floor for a second. I begin compressions again. My husband is looking for a pulse.
“We have a pulse!” he shouts. I stop compressing. I put my hands together. I even applaud a little. At some point during compressions, I remember feeling suddenly afraid that the man would not ever wake up. Please don’t die. Just please don’t die, I had whispered under my mask. And now he has a pulse again.
The strangest thing I see is the transition between deadness and aliveness, the way this man’s face gets filled again as though with something. The way the muscles on his face gain movement once more, abandoning the blankness of an inanimate object, a doll of sorts, for something where the presence of consciousness can be somehow “felt” or interpreted. I don’t think I will ever forget that moment.
The man remains confused for a few seconds and then he raises his head, attempting to look around and at us, and asks, “What… what happened?” We tell him that he collapsed on the train. We ask him his name several times. His chest hurts, he says. We probably hurt a few ribs. He keeps saying, “I think I overdid it. I was rushing too much. I was trying to catch my flight.” I read the identification card around his neck. He is a crew member for United Airlines.
“I shouldn’t have,” he says.
“You don’t have to worry about anything right now. Just relax. You are the most important thing right now. Just relax. I think it’s going to be okay,” I tell him, caressing his hand.
The EMT crew arrives fifteen minutes after all of this started. They are thinking they will be dealing with an unconscious man. I tell them that we brought him back. We resuscitated him.
“He has a pulse. He is conscious,” my husband tells them.
“Did you do compressions?” they ask us. “Did you shock him? How many times?”
We tell them we have given him four rounds of compressions and one shock. They thank us, and I feel so damn proud.
All of this time, I have kept my kids on the periphery of my field of vision. I remember going through a list: My kids, my purse, the procedure, the man’s face, his body’s reactions. It has all been present at different levels simultaneously.
When this has all passed and I finally have a moment to myself the one thing I can’t believe is that I have actually been able to manage all those details at the same time, to juggle it all. “I didn’t even think of the kids,” my husband tells me. I have always wanted, so much, to feel that I was capable of this: to recall and to apply what I know while managing the new, under a circumstance of life and death. I have always had to manage more than one thing at a time —studying, working, children, and housework. There have been so many moments, though, when I have doubted myself, or when I have allowed another person’s actions or comments to influence my belief in myself. But something was born this day, no doubt. Something essential. I feel invincible; I know I am not. Yet, perhaps there’s a lot more inside me that I still don’t know, that I can still discover.
The feeling is powerful. It is utter exhilaration. I turn to my kids, still standing there, stiff like statues, eyes wide like those of a frozen fish. I ask them what they think and feel about what they have witnessed. I still remember the time when I was four years old and my father stopped the beat-up car he drove in the middle of the street to save a dying bird, place it gently in the back seat and take it home to care for until it was able to fly again. I am hoping my kids can remember this too: the day their mother and father saved a man’s life.
My oldest child does not know what to say about any of it. Days after, he still will not know. I think it will take him some time to process it all. I know, in some ways, I am underestimating the power of the experience.
“Mamá, I’m scared!” the younger one says. “I think I’m going to have nightmares today when I sleep.”
We finally gather our stuff and keep walking. The man is in good hands now, I tell myself. The EMTs are here. Still, I will continue (and remain) hoping that he is okay.
When we abandon that hall and reach the top of the stairs away from the scene, my husband and I look at each other and high five.
“We saved a man’s life!!!” I say. It is all surreal and overwhelming. The rush through my body is wildly intense. (It will still be whenever I remember all of this.)
Many minutes later, when we are finally near our airport terminal, my husband taps my shoulder.
“Look!” he says.
I turn around and see the EMT crew approaching. The man we had saved is on a gurney now, sitting upright, an oxygen mask on his face. He looks well. They pass us by. The man does not recognize us. I smile. It’s the greatest metaphor of all, isn’t it? Life, moving on, no matter what, as it always does.
When the gurney crosses the doors into the world outside, I start laughing almost hysterically. My kids think I have gone mad. I am feeling a sudden rush of something else: like I love the entire world; like the world is the same bandit it has always been, yes, but I love it —nonetheless— with all of my heart. I laugh. I am euphoric. And for the next hour, I keep on laughing every time I think about everything that has happened.
“I’m not religious, you know?” I say to my husband. “But I’ll take this as a sign. I think I’m on the right path.”
“You are,” my husband says, “I’m super proud of you.”
“You are?” I ask.
“You just led a code at the airport!” he says.
“I did! I led a code at the airport, dude. I led a code and he survived.”
I know not everything will be as seemingly perfect as this was. I know very well I won’t always be smiling, rainbows and sunshine everywhere. That if I ever meet this man I have helped stay here, in life, I may have to come to terms with his part in our story: the contrast, perhaps, between my naive exhilaration and the possibility that his life might have changed in some significant way.
I’ll take things as they come, however, one step at a time, one small effort after the other. And when the time comes to laugh again, if I can, I’ll allow myself to laugh again, really hard, like I love the world, like I can’t wait to try once more, and I can’t wait to learn all I’m going to learn.