Sunday, September 27, 2009

The Final Opus

It was midnight and the Emergency Room door opened like a curtain on a Broadway. A lone man sat in blue at the countertop, writing. Behind him, the chorus, working feverishly on the protagonist - the script rehearsed a thousand times before.

Clothes off, Story?, facemask, C-collar, endotracheal tube, breath sounds, telemetry, IV’s, blood work, pulse ox, Stop.

Resume, Pulse?, patches, register, call the lab, Allergies?, epi, atropine, Pressure?, twitching, NG, x-ray, Stop. Pulse?

Resume, pacing wire, max output, capture?, not quite, “potassium?”, not ready, blood gas, foley, Capture! Stop.

Resume, blood gas, no capture, damn, tweak, better, pulse?, yes. Lab?, no, Which meds?, cardiologist, Go.

Vent, hoist, prep, stick, contrast, open, shock, balloon pump, a-line, movement, labs, blood gas, peep, transport, c-spine, CT, Go.

Then intermission.

It’s hard to imagine the enormity and speed of it all. The cast. The direction. The audience in the hall. The cast of characters working together in hopes of seeing a small glimmer of life. From the man in blue who arrived there first, seeing the terrified look on the woman’s face, to the orderly that swept the floor as the curtain fell once more, I wondered.

It’s a strange thing, this concert: brutal, raw, exciting, exhausting. Drama, romance and tragedy together. It’s a story told a thousand times at the world’s most expensive theaters across the country. And as doctors, we receive a free pass backstage to witness, first hand, a drama like no other. Yet despite that privilege and exclusivity, none of us knows how the play will ultimately end.

More often than not, the story ends sadly as the Playwright predicted. The play, sometimes, goes on too long. But before the final curtain is called, the brief respite from the inevitable lends solace to the bereaved as they gather friends and family to reflect on remarkable chapters before them. Finally, with tears and the hugs, quiet descends and the the stage emptied while the cast of characters never hear their much deserved applause.



Margaret Polaneczky, MD (aka TBTAM) said...

All the worlds a stage....

Great post.

Edwin said...


Beautiful, brilliant post! Perhaps the longest running stage-play in modern history; but some of the best actors don't get a second try; and some of the worst, of course, come back week after week after endless week.

Ed Leap

DrV said...

Holy Toledo, Wes. Where did that come from?

DrWes said...

Dr. V.

Sadly, it came from reflecting on a recent code I had experienced.