Opinion-Editorial, Medical Students

When the 'Steaks' Are High

I was 21 when I first became a doctor. My scrubs were a black buttonup dress shirt from Kohl's and an apron covered in steak sauce.

My operating theater was a dining hall full of aghast Pennsylvanians. I scrubbed in by sanitizing with a moist towelette and taking a deep breath. I was whisked away to the commotion by my colleagues. They shouted, "Joe's a doctor! Joe's a doctor!"

The truth, which you have already figured out, is that at 21, I was not a doctor. I was a server at Outback Steakhouse, and I had just been thrown into my first critical care scenario. Sure, I had longed for the day I would enter medical school with the eventual goal of becoming an emergency physician, but this was not the swearing-in I had imagined.

"She's choking!" they shouted.

The patient was an 80-something-year- old female status-post alimentary assault by an unidentified sirloin. She was alert but distressed. Review of systems seemed positive for choking. On exam she looked like she was choking. I made my diagnosis: choking.

Given the desperation on the faces of crowd, she was not going to stay stable for long. I was her only hope.

I would not disappoint.

At that moment I became Dr. Joe, the Doogie Howser of Bucks County. This was my patient, and it was my job to make her well. I knew the Heimlich maneuver. Well, I knew of the Heimlich. It was like a friendly punch to the gut, right?

One thrust; nothing.

Two thrusts — still nothing.

Three thrusts. Nothing. No budging.

"She's turning blue, Dr. Joe! Do something!" She went limp in my arms, and breathing ceased. I felt for a pulse and unsurprisingly, there was none. I was losing her.

I laid her down and looked around. Now what? My nurses were frozen in place. My ED was starting to look a lot more like a restaurant again. The crowd was closing in. No, I would not panic. I needed to think. "Save her, Dr. Joe!"

The summer prior I had taken a CPR course at the behest of my mother (my attending physician, you might say). I knew what came next. It was a Code Red. And not the Code Red we call when we run out of Bloomin' Onions. No, for the next 15 minutes I pumped my patient's chest to the tempo of "Stayin' Alive" like her life depended on it. Because, well, it did.

It was then the paramedics arrived. They were appreciative. After all, they were in presence of Dr. Joe, makeshift medicine man of Outback Steakhouse. They knew I was a little wet behind the ears. Maybe it was just sweat. Nonetheless, they thanked me and took my patient away.

She would go off to inpatient, I would return to my tables. The mayhem ended just as quickly as it began. For the time I was happy to be just another 21-year-old again.

I went home and hung up my black apron, my onetime superhero's cape. I longed for the day I could replace that with a white coat. I wiped my brow and took my first long breath. For then, at least, you could say Dr. Joe was taking a sabbatical.

Days later I received the bad news. I learned my patient did not survive the ordeal. She had suffered an anoxic brain injury, and three days after was taken off life support. I also learned that in my fervent attempts to preserve my patient, I broke nearly every rib in her body. You could almost hear Hippocrates rolling in his grave.

I was crushed. Maybe my cape needed to stay folded on the shelf. Maybe Dr. Joe was not all he was cracked up to be. Or maybe I was just a 21-year-old kid who jumped into the fray when no one else would?

I dreaded returning to work on my next shift. I could already feel the scowls and the whispers and the disappointed jeers. Yet, first thing I felt was a slap on the back. "Great job buddy," I heard. "You're the man!" "Fantastic work!" "Way to go, Dr. Joe!"

Surely they had heard the news, right?

"Why is everybody congratulating me?" I asked a coworker. "She didn't make it." "So what?" he said. "You jumped right in, when everybody else was watching. That took guts." Guts, I thought. I guess it did.

I knew I could not blame myself for what transpired. After all, I was thrust into an implausible scenario. I assumed a role to the best of my ability with the skill set of a Samaritan. What others saw is my ability to maintain composure, continue thinking, and tune out the distractions while under pressure. I was given the gift of an unfortunate event that would inspire me to hone my craft.

I want to pursue emergency medicine because it is what I was born to do. I may not be some superhero or Dr. Joe the amazing juvenile doctor, but with the right training I can achieve even greater than that. You can teach a person how to do a proper Heimlich and perform effective CPR, ideally without cracking every rib. What you cannot teach is to have guts and a willingness to help.

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