P is for practice

door and slid it under her, so we could crush her heart against the wood. Adrenalin, please. The electricity came back, disappeared. The IV jerked out of the vein from all of the rocking, and a small balloon of water appeared in her wrist. I jutted a needle deep in her groin as she bounced up and down, searching for a vessel I couldn’t see. I hit bone. It’s an unforgettable feeling, a smooth scraping, all wrong. I withdrew, stabbed again, pulled hard on the syringe, but no bloom of blood. I looked to her feet.

They were a little girl’s. You could tell because her toenails were painted red. The colour was cracked, faded, only patches here and there.

It’s the little things that hurt, because they are windows into something much, much bigger.

Someone found a vein in her wrist.

Sodium please.

Pulse? Wait. Yeah, I can feel it. It’s back. OK. Stop CPR. It’s gone. Start. Stop. Start.

It just wouldn’t stay. We spent an hour on that cupboard door, switching back and forth, straddling her chest, using Adrenalin and atropine, and no one wanted to quit, even after her eyes widened into the stare of the dead, and the flesh behind her red toenails blanched white. Stop CPR. We stepped from behind the curtain, found the family gathered in a tight circle in the hallway. Dawit told them. Thank you, her uncle said, in English, tears in his eyes. A family of cousins nodded, yes, yes, thank you. I nodded back, confused. For what? A nurse took bicarbonate, the door from beneath the girl’s body and around the corner.

Dawit and I sat in the small, cramped office in the back of the ER hallway with the nurses and the medical student who’d helped with CPR. We talked about what happened, how we might do better next time.

It would be good if the airway equipment was nearer.

Yeah. Suction too. It took too long.

A central line instead of those small IVs. Blood work. Ultrasound. Ventilator. Dialysis. We fell quiet. Outside the door, the murmur of the ER.

Did you see the paint on her toenails? someone asked.

Yes, everyone whispered, yes.

Let’s plan to do a practise resuscitation in a day or two. Sure, sure. We all stood up. The nurses filed out. Dawit, I called out. Yes, Dr. James. It’s important to be sad, I said. He nodded, walked back into the ER.