our last words
There is a memory that sneaks up on me at unexpected times, usually in the quiet moments, while waiting alone for an elevator or on my walk in to work in the mornings. Or, just before I fall asleep at night, the memory jerking me to full awareness and heart-piercing pain. It shoves its way into my mind, and I’m helpless to stop it.
* * *
I am back in the hospital’s emergency room, standing at the foot of my father’s bed as the ER physician tells me he may need to shock my father’s heart to bring it out of the rapid and unstable rhythm it has adopted. The heart monitor alarms over my father’s head. The heart rhythm itself might not be worrisome, but his blood pressure is dropping as the heart races, and this has everyone nervous and hovering nearby. The nurses have wheeled the crash cart to just outside my father’s room. I notice it – a hulking, red box on wheels, filled with everything needed to revive and resuscitate a crashing patient – and I feel nauseous.
First, though, the doctor will try adenosine to break the rhythm. His heart may stop temporarily, he tells me. There could be a period of asystole, and he could have chest pain.”
I know this, as I have used this medication before, when I was an internal medicine resident treating a patient with supraventricular tachycardia (called SVT for ease). The hope is that the adenosine will break the rapid heart rhythm, setting it back into its normal beat. But the ER doctor isn’t sure if Dad’s heart rate is due to SVT or to atrial fibrillation. He thinks this will help him figure it out.
