By Benjamin Cooke, MSIII


I never knew his name, but for all I know, my face may have been the last he ever saw. The angst of his wife was obvious outside the room. Beside her, a dozen bustling figures of coats and scrubs craned for a view, poised to respond as they had been trained to do. She did not show outright fear, but a quavering lower lip suggested otherwise.

In the room, a tall man lay before me, feet extending beyond the end of his gown and stained sheets. Curled, unmanicured nails, thickened and yellow, scratched the hard plastic foot of the bed like a metronome as he was throttled by each compression. 

The curved aluminum laryngoscope cocked his neck backwards grinding against his incisors producing audible clacking heard even through the chaos. 

Mask on, sleeves up, and tie tucked, I arched over the man to generate all the force I had. 

Crunch. They never prepared us for the feeling. The cold, hard, resilient polymer which comprised the CPR dummies played poor tribute to the frailties of a human being. Beneath me I was certain that little remained. Each compression was like a vicious thunderstorm thrashing an abandoned camping tent of which the support frame had fatigued and broken in the relentless barrage. 

Somewhere beneath my pushing hands lay an organ; an organ heralded as the core of life, the foundation of passion, morals, scruples, and perseverance. But this is small comfort in light of circumstances like this.

The force I'm applying is lacking. Not in power but in dimension. A two dimensional force attempting to compete with a mechanism honed to contract in three dimensions over millions of years of evolution. Nevertheless, a few molecules of oxygen may make it to the brain and offer reprieve from a looming denouement. 

I could feel the perspiration building between my shoulder blades and the strain of every press radiating through my shoulders and down my spine. His jaw jostled from side to side making no cognizant attempt at control. 

Overhead the loudspeaker crackled. A brief distant rustling gave way to a voice discontinuing the code. 

He lay defeated and pale, speckled with blood and painted with swaths of iodine. His naked, crumpled fuselage only a vestige of a life just escaped. Lines and tubes dangle from his limbs and mouth like needles from a voodoo doll, still vibrating from the commotion moments earlier. The shards of his gown hung from the sides of his bed, tattered sartorial refuse, the collateral damage of a passionate outlet gone wrong and abandoned. 

In the corridor his widow held a wrinkled handkerchief to her mouth, eyes watering beneath her dated bifocals. A tall, well-dressed man holding a visitors pass bounded around the corner, eyes searching for familiarity. His resemblance to the man whom moments earlier stared blankly upwards at my frantic self was unmistakable. He found his mother on a chair, verklempt and quiet, small twitches reverberating through her delicate frame. 

In these moments I have never known what to say. My superiors had broached the issue in the past but it had always seemed an unfamiliar formality to this point. 

The son knew at first sight that what he had feared as ascending in the elevator had now come to fruition. Kneeling, he caught a fleeting kiss on the cheek as he grasped his mother's writhing hands but quickly recoiled and paced down the hall, alone with his grief. 

At first I had seen it as a perfunctory encounter; a sign of weakness in abandoning his beloved father's life-long companion in her darkest hour but the sentiment was quick to pass. In their ephemeral embrace there had been a strength. A power strong enough to erode one's appetite for social graces and the comfort of others; reducing a human only to their ability to breath, augmented by the organ recently failed in his father. 

The outer layer of his family onion had now peeled away, leaving the underlying layers to grow, toughen and fight their way through the world, now unprotected by the skin of its predecessor. 

This strength was driven by a flood of memories. From the childhood sandbox to the first day of school. The first bloody scraped knee when he was coaxed from the proverbial nest which was his training wheels, perhaps a summer too early and slammed into the curb. Picked up from his first sleepover when he wet his bed. First fishing trip. First heartbreak. First day of college to his first publication. The support for finding the love of his life and the gift of the children that came. The retirement, the downsizing, the laughter, and the fun. The vacations and the struggles. The tears and the hope. The old-folks-home and the ICU. The last visit which showed few signs of being THE LAST before LAST reared its ugly head. 

And now, it is a memory. A memory strong enough to bring a grown man to his knees, not in weakness but in resolute admiration. 

And by that measure alone, patient MRN _ _ _0854's life was a resounding success. Rich in every facet our ancestors considered the heart to embody.




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