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Pectoriloquy |

Yizkor for a student of Freud FREE TO VIEW

Emily Pinto Taylor, MD
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Editor’s Note:The author writes, “This poem was written following a fairly traumatic experience as a first-time code leader in the start of intern year. Reviewing his telemetry strip afterwards and seeing where his heart slowed and stopped, in real time, was a poetic moment in itself, and a nod to how little in control, even as code ‘leader,’ we often are in the face of death.” The author is an intern in Internal Medicine and Pediatrics at Yale-New Haven Hospital, who plans a career listening to patient's stories.

New Haven, CT


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;150(2):465-466. doi:10.1016/j.chest.2016.03.006
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    For there will be the laying on of hands and the letting go

    It was 6:17 on my first week of nights when I was called
    not sweetly, the low incessant beep of my pager
    but a whispered yell, an urgency atypical
    on this floor of sweet, demented adult-children
    (women who kissed my hands and held them to their cheeks,
    men who told me I looked like their wives after the war)
    my name, over and over.

    I keep thinking about his eyes, how they
    stared
    how I stopped,
    how she looked at me, the veteran nurse,
    wildness in her eyes like I’ve never seen before
    “should I start CPR?”
    And I, feeling until this moment a small, smart girl
    realize how crazy it is they gave me this position
    an imposter in navy blue scrubs
    a frantic nurse
    a small, staring man
    and the silence.

    (My whole body shaking, I wanted to say
    Idon’tknowIdon’tknowIdon’tknow
    but there is no room for not knowing in crisis).

    There’s no pulse, I said
    Yes, I said
    Call the code, I said
    Call my senior, I said
    Get the code cart, I said
    Help me, I didn’t say

    I ran back to get my stethoscope, as if
    listening to the static in your frail chest,
    the empty airwaves where once an irregular consistency lived
    might help bring you back from the dead.
    And I stood there, stethoscope in hand
    frantically trying to remember if we give Epinephrine
    and at what dose
    and at what point someone else would take over
    (be it a senior resident or God)
    and watched the fluid slosh out of your mouth
    as she pushed your whole body into the bed
    and you rose back up.

    OhmyGod
    and then the rush of cool breeze
    a wave of a dozen people
    and someone asked the air “what’s his code status?”
    And I then I knew I had failed.
    Because he, the former doctor, had told me “all of this,
    all of this is too much” and to just let him be
    and I looked down at my hands and saw it, in red letters
    Stop, I said
    He’s DNR, I said
    I’m so sorry, I said
    over and over and over.

    I didn’t stop shaking for the next hour.
    Everyone left, and we cleaned everything up
    calmed down the nurse,
    called his wife, who cried, at 84, but didn’t sound surprised,
    filled out the death paperwork
    brought in mint scents
    and I sat there, in the chair next to his bed,
    behind the closed door everyone was avoiding
    and held his hand and cried.

    The doctor who couldn’t save him;
    the intern who didn’t know what to do to let him go.

    The Lord being his heritage, let him rest in peace
    Yizkor
    And so I name you, student of Freud,
    he who taught me to do a radial artery stick on his own wrist
    who diagnosed his own atelectasis
    but was blind to his own cancer.
    I name you, and I pray for your rest,
    and as the intern who only knows to lay on hands
    and not yet how to let go;

    And let us say, Amen


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