From the Wards
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Reflection on a Code Blue

The usual morning solitude of the small rural Kansas hospital was shattered with the overhead announcement no one wants to hear.

Code Blue.

Stillness turned to ordered chaos.

The room was quickly prepared for the impending arrival of the ambulance. We gathered as much information about the patient as possible. Nineteen years old. Overdose. Found unresponsive.

Before we had time to assemble these disordered pieces of the puzzle, he had arrived. The entire staff responded in militant and emotionless routine.

Their training directed every order made and followed, every chest compression, every attempt to gain IV access. It was like an orchestrated symphony performance; no room for one missed note.

As I stood at the periphery in observation, my mind started to wander. I let emotion in. I contemplated the young pregnant woman in tears that trailed behind the gurney. As I watched this young man being intubated, I thought about how he was only five years younger than me.

As my thoughts raced, my heart sank deeper into my chest. I wanted to flee the scene, until I heard a voice from the crowd surrounding the body. “Gillian, get in here.”

For a moment, time stood still. I looked around. Was there another Gillian in our midst? Dr. O couldn’t possibly be recruiting me to help in this life or death situation.

He repeated. “Come on, Gillian. Get in here.”

My heart began to race. The other medical student was also called to help. As we hurriedly slipped on gloves, we shared a quick glance. No words were uttered, but our eyes communicated our common fear. These fleeting moments of self-doubt vanished as my thoughts were redirected to the here and now, to the task that I was assigned to help save this man’s life: ventilation.

In that moment, there was no time for emotion, only rigid adherence to the timing of the artificial inspirations and expirations I was administering. Asystole continued. I lost all notion of time. After what I later learned to be a full 25 minutes of cardiopulmonary resuscitation, the sweet sound of a heart rhythm broke my focus.

For the first time in all my years of medical school, I was no longer an onlooker. I wasn’t stuck in the corner wondering when my time will come. I was recruited. I was entrusted. I was part of a team that brought life back to a human being. It was because of this moment that I gained the self-assurance to step up to clinical responsibility and no longer fear or run from it. I realized that I do have the inherent ability needed to be a physician, and that I needed to own that and build upon it.

From that moment on, I took ownership of my patients. I am no longer afraid to make suggestions concerning their care. Dr. O recognizing me as a capable member of the health care team, in such a critical situation, gave me the confidence to transition from a passive observer to an active and wholehearted participant in the practice of medicine.

Gillian Johnston Gillian Johnston (2 Posts)

Contributing Writer Emeritus

University of Kansas School of Medicine

I am currently a third year medical student at the University of Kansas School of Medicine. I am undecided as to my specialty of choice right now, but narrowing it down as we speak! I enjoy writing reflective pieces as I continue to navigate the waters of medical school. In my free time, I like to travel, run, bike, hike, anything outdoors! I also enjoy spending time with my family, friends, fluffy golden retriever, and my awesome F-15E airman!