Yo estoy maloliente.

Time change happened in Mexico this past weekend. Just happened to fall on my shift this weekend making my 24 hrs into 23 hrs. Hey, if I have to lose an hour twice in one year at least one was to my advantage.

A patient came to Urgencias Saturday night in respiratory distress. The time lapse is kind of relative, but sometime later and she was coding, ACLS protocol was initiated....or was attempted. At NMH last month when a code was called respiratory was there for an airway, surgery was there for venous access, pharmacy was there with needed drugs ready, and by the time anyone arrived the primary team was already underway with CPR. The first time it happened at NMH I realized I was standing there detached from the whole scene enfolding before me. This was a soul they were fighting for. I took a step back and looked at the scene again and wondered what was happening that I couldn't...that none of us could see. We were fighting for his physical life, but was there another battle going on in that room, a battle for his soul? I didn't know the patient, he'd been intubated/sedated his whole time at the hospital. I wondered was Jesus in that battle? And wondering about that second battle, made our whole effort seem just so pointless. At the end another student leaned over and said, "The hospital just spent a million dollars in the last 30 minutes." We spend sooooo much money for life, and for what? When the patient's mother arrived shortly thereafter her howl was heard throughout the unit, "NOOOOOOO! HE WAS JUST FINE YESTERDAY!!" Even with the miraculous abilties of medicine today it's events like these that remind us all that our physical life will end one day. It's a fact. An inevitability. And so this past weekend while standing on a wobbly stool so I could be up and over the patient to come down at a 90 degree angle with methodical compressions I wondered at my own efforts to keep her heart pumping. Was this battle already over? Really, what was the point to what we were doing?

To be honest, I am a little disturbed that as a doctor I would find a fight to the end futile. I know that I will do it. I'll fight to the physical end and then past it for anyone. But it's not this physical fight that matters. And in fighting it I feel....no, I know, I'm fighting a battle that in eternity doesn't matter. And in fighting it, it makes me feel pointless too.

Hasta!