I witnessed my first code while I was doing my first internal medicine rotation at a hospital in the Twin Cities; it just so happened to be one of my team’s patients. He was a difficult and grumpy guy who regularly swore at his nurses and refused parts of his health care. A couple days prior to the code, my team and I were group rounding when we visited him. He was his usual disgruntled self that day; he wouldn’t open his eyes, kept his answers short, and refused to participate in most of the physical exam. My senior resident and attending physician stepped outside his door briefly to discuss logistics of another patient’s care, about which they had just received a page. While I waited in the room for them to return I noticed that the patient had a tiger tattoo on his arm.
“Do you like baseball?” I asked.
With his eyes still closed he responded, “No, why?”
“Oh, the Detroit Tigers are in the World Series this year and I noticed the tattoo on your arm.”
He laughed, opened his eyes, and his face lit up. “No, the tiger represents a fighter,” he said.
“You mean like UFC fighting?” I replied.
“That’s right,” he said, as we proceeded to have a conversation about his children, his wife and his past represented within that tattoo.
The day we arrived at his code, the room was already full of people—with another internal medicine team already running the code. Once we entered the room our team attempted to fill in the other team currently running the code on the patient’s health care specifics; other physicians, nurses and medical students were watching and trying to help as best they could. The guy that I had just made a connection with was lying pulseless on the bed. Person after person pounded on his chest. All I could do was watch the rhythm of his body move while I thought about his kids and wife.
This continued for several minutes and he eventually regained a weak pulse, despite his cyanotic face. One of the attending physicians dismissed all the medical students at that time so that we could be on time for grand rounds. As medical students started to pour out of the room some of them started hugging and giving each other high fives. In the hallway next to a dying man, they were congratulating each other on their chest compressions.
Horrified, I walked with the group toward grand rounds and began to contemplate if and when I should say something. To my relief an attending physician spoke up and said, “Is everyone alright?” as we piled into the elevator. So thankful we were going to debrief, I turned toward him and another medical student. But he continued, saying, “Oh, I’m sorry Bonnie, you didn’t get to do chest compressions. You will next time.” I looked around the elevator and hoped the stranger standing next to me was not a member of the man’s family when the attending turned toward her and said, “Aren’t you excited about the future of medicine?” As we all tumbled out of the elevator, I continued walking blankly to grand rounds in disbelief. While I got my food and found a seat I overheard two medical students talking with their attending physician about the recent events. As they laughed, they said, “Yeah, I think it was a tiger on his arm or, at least, what used to be a tiger.”