Monday, June 20, 2011

in retrospect

Today I ate lunch with one of my friends, a cardiovascular tech who does the EKG and hemodynamic monitoring in the cath lab.  Actually, she was the one person who took the time to teach me a lot about reading EKGs and how to use Holter monitoring software to make reports.

I don't remember how we got started on it, but I started rambling about some of the "cool stuff" that I had the chance to see in real time when I worked in the ICU: torsades de pointes, other ventricular tachycardias,  ventricular fibrillation and other lethal arrhythmias that you hope you won't be encountering when you're reading outpatient Holter monitor recordings 48+ hours after you stuck your electrodes to your patient.

I paused for a minute, thinking about the last episode of torsades.

"The guy was actually dying," I told her.  He was really sick: on a ventilator for weeks and weeks, feverish in septic shock (from a strain of VRE that seemed to take forever to find, after endless blood culture draws and procedures ending in -centesis).  He was completely unresponsive by that point, and he was alone.

I remember sitting outside his room, looking at the monitor, watching in awe as the amplitude on his EKG twisted like crepe-paper party streamers.  I had seen it books, but never in real life.  He was a DNR, and so we sat there still, leaving the crash carts tucked against the nursing pods, as the torsades turned to coarse vfib that slowly grew finer until it was just a haphazard line.

I don't know why I didn't go in there and hold his hand, or even just sit with him.  I don't know why any of us didn't.  The idea of dying in the middle of the night, in a hospital bed, alone, just doesn't seem okay. Maybe we were feeling mildly inconvenienced by the idea of having to gown up to go into his contact precautions room or divert our eyes from the monitor or documentation.  I don't even remember what I was thinking while I sat there doing nothing. Hopefully something besides "wow, cool EKG!"

I wonder, had death started to become so familiar that it had lost its significance?  I really don't know.  After he died, I cut up his strips, somewhat somberly affixed them to pages and pages of strip sheets, labeled them, and thought about how sad they were -- how they told a story all by themselves.


  1. Hey friend, hope things are going ok!

  2. Hey E, how's everything, where are you these days?