“I understand that she has arrested several times,” Kim yelled. He was furious from a combination of fear and exasperation. Drawing on his vast clinical experience, he knew his daughter was at death’s door, but no one was giving him a straight answer, and no one was doing anything but stand around and figuratively stroke their chins. “What I’m asking is why it’s happening.”
Kim stared at Jason Zimmerman, the pediatric cardiologist to whom he’d just been introduced. The man looked off, pretending to be absorbed in watching the cardiac monitor that was tracing an erratic rhythm. Something was terribly wrong.
Kim twisted to look at Claire Stevens. Over her shoulder, he caught sight of Tracy and Marsha.
“We don’t know what is going on,” Claire admitted. “There’s no pericardial fluid, so it’s not tamponade.”
“It seems to me it’s something inherent in the myocardium itself,” Jason said. “I need a real EKG.”
No sooner had these words escaped from the cardiologist’s mouth than the monitor alarm sounded. The cursor swept across the screen tracing a flat line. Becky had arrested again.
“Code blue!” one of the nurses shouted to alert the others out in the intensive-care unit proper.
Jason responded by pushing Kim away from the side of the bed. Immediately he began external cardiac massage by putting his hands together and pumping on Becky’s frail chest. Jane Flanagan, the anesthesiologist who’d responded to the initial code and who was still there, made sure the endotracheal tube remained in proper place. She also upped the percentage of oxygen delivered by the respirator.
ICU nurses brought the cardiac crash cart on the run. They practically collided with Tracy and Marsha who had to leap out of the way.
Inside the cubicle there was a flurry of activity as the doctors present all lent a hand. It was apparent to everyone that the heart had not just stopped effective beating, but that all electrical activity had ceased.
Tracy clasped a hand to her face. She wanted to flee but she couldn’t. It was as if she were frozen in place, fated to watch every agonizing detail.
All Marsha could do was cringe behind Tracy, fearful that she would be in the way.
Kim initially stepped back, recoiling in disbelief and horror. His eyes swept back and forth between the monitor screen to his daughter’s pitiful body being savaged by the pediatric cardiologist.
“Epinephrine!” Jason yelled while he continued his efforts.
The nurses at the crash cart responded by efficiently filling a syringe with the medication and handing it off. After several changes of hand, it was given to Jason who stopped his massage long enough to plunge the needle directly into Becky’s heart.
Tracy covered her eyes and moaned. Marsha instinctively put her arms around her, but couldn’t take her own eyes off the ghastly drama unfolding in front of her.
Jason went back to the massage while he eyed the monitor. There was no change in its relentless tracking straight across the screen.
“Bring the paddles!” Jason yelled. “Let’s see if we can get some electrical activity going with a shock. If that doesn’t work, we’re going to have to pace her, so be prepared.”
The experienced nurses had already charged the defibrillator. They handed the paddles forward. Jason stopped his massage to take them.
“Everybody back!” he yelled while he positioned them. When everyone was clear, and the paddles where he wanted them, he pressed the discharge button.
Becky’s pale body jerked and her white arms flailed. Everyone’s eyes went to the monitor, hoping to see some change. But the cursor was not cooperating. It persisted in its straight, flat line.
Kim pushed forward. He didn’t like the way Jason was doing the massage. “You’re not getting enough excursion,” he said. “Let me take over.”
“No.” Claire said, coming up behind Kim and pulling him back. “Dr. Reggis, it’s not appropriate. We’ll handle this. I think you should wait outside.”
Kim shook off the pediatrician. His pupils were dilated and his face flushed. He was not going anywhere.
Jason responded to Kim’s complaint. As a man of small stature, it was hard for him to develop much force in a standing position. To make it easier for himself, he climbed up onto the bed and assumed a kneeling position. Now he got better chest compression. It was so much better that everyone present could hear several of Becky’s ribs snap.