This is my submission for the 2022 On The Job story event. Most of the medical terminology thrown around is of no importance for understanding this story. However, the word 'sat' (an abbreviation for 'saturation') is a measure of blood oxygen.
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Once she graduated from her premier medical school, Amy naively thought the worst was over. Surely internship couldn't be as bad. But it was. No, actually it was worse. Much worse. She went for days with minimal sleep working at one of two different hospitals. Her fatigue was so great at times she found herself fantasizing about simply going to sleep once she got to her apartment. And there was no time or energy for relationships or sex; she even realized on one of the few times she wanted to use her vibrator for a little 'me time,' it had been so long the batteries had corroded.
Amy looked forward to her next year of training, the so-called 'first year residency' which followed the internship. Although during residency the training doctors were responsible for more patients, they usually had two interns working below them doing most of the direct patient care and all the tedious activities known as scut work. This allowed the residents to spend more time reading, learning and teaching.
After her internship year she had a week's vacation. She made a quick visit to her folks but mainly rested, slept in, cleaned up her apartment and got new batteries for her vibrator. On her first day back at Mercy Hospital, she met her new team and the two interns who would work with her for the first month. Much to her relief, they seemed to be reasonably intelligent and ambitious. Her team would be primarily responsible for the medicine ward on the fifth floor and the ICU.
Whichever intern was on call had a tiny room with a recliner chair right behind the nurses station where the intern could quickly be summoned to see patients who might need immediate attention. Each of the four residents' call rooms, one of which she would use every fourth night, were downstairs and featured nice 'soundproofed' walls, a very comfortable twin bed, a bedside table with a phone, a small sink and desk with a chair for late night reading and computer work. And even though the walls were bare, she was delighted to see this nice, quiet room and was hopeful she'd have few nighttime interruptions due to her apparently good interns.
The first two weeks were fairly busy for her as she led the interns from being book-smart to being doctors and caregivers. Once they got the basic understanding of their duties and the flow of the hospital, she was able to relax a little more. She still had to visit and examine each patient daily but a few simple words to the intern were frequently all it took to have the right things done. Since she was far less stressed in her new position, she was able to relax around the nursing and ancillary staffs, some of whom were delightful people.
Roughly a month into the year she was called to the emergency department one night to assess an older lady for admission. Mrs. Schmitt still had a thick German accent one could easily hear between her deep breaths as she sat bolt upright, clutching her oxygen mask. The emergency staff had determined she had heart failure and would need a night or two in the hospital to clear the fluid from her lungs. As Amy was reviewing the chart, an attractive woman about her age and wearing hospital scrubs sat down next to her.
"Hi, I'm Bea, the night respiratory therapist. You gonna admit her?"
"Uh, yeah, she's pretty sick."
"You're Doctor Swanson, aren't you?"
"Oh, sorry, yes I am. Please call me Amy."
"Hi, Amy. Just give me a page if you need anything set up with her oxygen. Right now, she's doing OK on the mask but if her sats drop, let me know."
"Will do. Thanks for your help." Amy watched the tall woman saunter out of the small office and down the hall. She was fairly lean but sported some nice curves and had medium length brown hair worn in a pony tail. 'Nice gal,' she thought to herself knowing so many people would not have introduced themselves or volunteered to be called with any issues.
Mrs. Schmitt improved in her first few hours and by morning was already talking about going home. On rounds with the interns, the attending physician and Amy, Mrs. Schmitt was cautioned an extra twenty-four hours would be a good idea to make sure she would do well in the long run. By the next morning, however, she had deteriorated and was placed back on oxygen. An ultrasound of her heart called an echocardiogram determined her heart function was dramatically lowered down to about twenty percent of normal. Amy went to her room to discuss the findings.
"Mrs. Schmitt, I'm afraid I don't have good news for you."
"Ja? Vat's wrong?"
"Your heart is extremely weak. You apparently had some heart attacks in the past and they severely damaged your heart."
"Ach, no problem. Chu vill make me better, nicht?"
"Mrs. Schmitt, I'm afraid we can't make your heart any stronger. We can try medicines to make it easier to work, but the damage is permanent."
"I go home, no?"
"Maybe in a few days. I hope so. Uh, have you considered living with someone to help you?"
"Nein! I take care uv myself!"
"OK, we will arrange for some nurses to visit you and see how you are doing."
"Nein! No help! No strangers come to my house."
"OK," she sighed wearily wondering why some older folks were so set in their ways they wouldn't even consider minimal help. She moved on to another important topic. "Uh, when people have such damage to their hearts, if they have another heart attack, it will stop beating. If that happens, do you want us to try and save you? You know, shock the heart, beat on your chest, put you on machines?"
"Natürlich I vant dat. Chu are my doctor and chu must help me."
"Even if it meant you were living on machines for the rest of your life? Maybe with brain damage?"
"Gott vill take care uv me. Chu do everything and he vill do ze rest."
Amy left the room quite frustrated. CPR in this case had at least a ninety-nine percent chance of failure and the risk of permanent brain damage, if she survived, was virtually guaranteed. Reluctantly, she put a 'Full Resuscitate' note on her chart.
Two nights later Mrs. Schmitt did indeed arrest. A code blue was called and Amy tore out of her call room, ran up the stairs and to the room. A nurse was doing poor chest compressions and chaos reigned.
"Everybody, listen up. Andrea, take over on the chest. Do about a hundred to one-twenty compressions per minute, at least three inches deep. Bill, stand across from her and you two switch-off every two minutes, but first put the pads on her and connect to the defib. Suzanne, you're on meds. Milly, you document. Bea, bag mask her until anesthesia intubates her. Let's see what the rhythm is..."
The craziness quickly became an orderly team designed to revive the poor lady. Once the tube was down the trachea, Bea delivered the oxygen directly through it. Every few minutes Amy would call a halt to the activities to get a good reading on the EKG. She noticed Bea would stretch her back during those seconds, something which seemed to accentuate her modest breasts. Once when she bent back down over Mrs. Schmitt, her loose scrub top sagged down revealing a tantalizing view of her bra-covered breasts. Amy, who could appreciate attractive people no matter their gender, gave herself a mental slap to focus on the job at hand and avoid looking at the comely Bea.
After twenty minutes it was clear the old heart had given up. As was her custom, Amy asked every person in the room if they had any more suggestions or if they were willing to stop resuscitation. The only one who voiced any reluctance to stopping was Bea.
"Her oxygen levels are great; the lungs are expanding nicely and the breath sounds are clear on both sides."
"That's good, Bea, but we need a heart to pump the oxygenated blood around and it doesn't seem to want to restart."
"Yeah, I see that. No, I guess it's OK if we stop."
Once everyone agreed, Amy 'called the code' at one fifteen a.m., thanked everyone for their help and stepped out to write her final note on the chart. While she was finishing her note, she heard some sniffles from outside the door. There she found Bea leaning against the jamb with tears in her eyes.
"Hey, Bea, you did great in there."
"Thanks, Doctor, uh, thanks Amy. It's so sad. I talked to her just the other day. No family, not even many friends, all alone and here she dies surrounded by people doing horrible things to her."
"I know.
I know.
I tried to talk with her about it but she insisted we do everything."
"Well, she's at peace now, I guess." The tears continued to drip down her face.
"Hey, Bea, how about a hug?" Amy wrapped her arms around Bea and gently patted her on the back. "You did great and you should be proud. I know I'm proud of you."
"Thanks, Amy. Means a lot to me. Let me wipe my eyes and blow my nose and I'll go check my patients on the fourth floor."
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After that awful night, Amy and Bea became casual work buddies. When Amy was on call in the hospital they would share snacks in the lounge, have two a.m. lunches together and talk about everything under the sun. Bea was fairly reserved talking about her personal life but she did describe finishing her college and respiratory therapy training before moving to Centerton.
