No amount of defibrillating plastic dummies can prepare a person to be calm for his first code.

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June 2006 | Back to Table of Contents

End Notes

The End of the Beginning

By L. T. Nguyen, M.D.

An intern finds confidence during the first week on the job.

So far, so good. It’s Day 5 of my residency, and I haven’t killed anyone yet, although I wanted to kill the transplant fellow on multiple occasions.

Today started out fairly routinely—rolled out of bed at 5:30 a.m., saw all my patients by 6:45, rounded with the fellow at 7. As I visited with one of the kidney transplant patients, a nurse came to the doorway, frantic. “You guys, we need you in room 518. RIGHT NOW!”

I looked around, bewildered. What did she mean by “you guys”? Aside from the patient, I was the only other person in the room. I excused myself.

I heard a code blue called over the PA system. “Station 5C–Charlie, room 518.” I nearly soiled myself—this was my first real code.

No amount of defibrillating plastic dummies can prepare a person to be calm for his first code. In the 20 seconds it took me to get to room 518, I gave myself a quick pep talk: “OK, here it is. You have to step up to the plate and be a doctor. Prove that you’ve earned your degree. You can do this.”

I quickly scanned the room as I entered: crash cart, bevy of nurses, no doctors—except me. With confidence that I didn’t know I possessed, I shouted out orders to run the code. Catecholamines and endorphins surged through my body. It was an incredible feeling—sort of like a runner’s high, but much, much higher.

We managed to bring the patient back to sinus rhythm. Afterwards, I spoke with his family. It could be argued that this is the hardest part about being a doctor, as there are no pocket guidebooks on how to deal with people. And it’s something that is not easily taught, nor easily learned. I explained to the family what had happened and answered their questions. They repeatedly thanked me.

I gave myself one more pep talk before I left the hospital that night. “I can do this. I can do this well. Only 360 days left of my intern year.” MM

L.T. Nguyen is a resident in the general surgery program at the University of Minnesota.
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