The Proposition - 3
With a shrill decibel ringing in his left ear, Alpesh, or Pesh Nadeen, as he was more commonly called, groped blindly along the nightstand before hitting the snooze button on the alarm. When the sound continued, his dark brown eyes popped open. Cutting his gaze to the nightstand, he realized it was not his alarm, but his hospital pager going off. Scrubbing the sleep from his eyes, he sat up in bed. After picking up the pager and peering at the screen, he groaned before pressing the OFF button. He knew the code all too well. One of the ER docs was unable to come in for his or her shift. As supervisor, he had to either find a replacement or take their place. Considering there wasn’t much else exciting going on in his life, he grabbed his phone. He alerted the charge nurse that he would be filling in, and he would be there as soon as he could.
As he trudged into the bathroom, he didn’t bother lamenting that one of his few days off was being taken. Most of the other doctors he worked with had wives or husbands along with children. They never called in unless it was a grave necessity. So why shouldn’t he, as the only single and childless one among them, take up the slack? It was the honorable thing to do, and if there was one thing Pesh prided himself on, it was having an honorable character.
After a record breaking shower and shave, he hurried into the closet. He threw on one of his signature long-sleeved blue shirts and trademark khaki pants. Besides his white lab coat, it was his uniform. He never wore plain white shirts. Blue was a comforting color, and he always wanted to put his patients at ease and make them feel comfortable. Once he tightened his tie, he hurried out of the closet and over to the dresser.
When he grabbed his wallet and hospital authorization card, his gaze fell on the picture in the antique silver frame. His late wife’s smile radiated from behind the glass. Jade was gazing up at him with her twinkling blue eyes—both of them wore brilliant smiles while being outfitted in the traditional Indian wedding attire. Her long blonde hair fell in waves and was adorned with various ribbons, charms, and beads, as were the custom.
His chest tightened as he thought of the day his American-as-apple-pie-wife embraced his heritage by partaking in the full Indian wedding ceremony. Although there were many happy days and good times in the course of their six-year marriage, he couldn’t remember a happier day than his wedding day. It was the day they had finally come together as one—a uniting of two different people and cultures. The day had held such promise of a happy and long future together.
Turning away from the dresser, he also tried to turn away from the overwhelming grief that gripped him. Two years had passed since the horrible day when his thirty-five year old wife had been snatched away from him. Not a day went by when he didn’t miss her, when he didn’t dread coming home to an empty house not filled with her laughter or her sweet presence. No one could quite fathom the true agonizing turmoil he had been through—only a select few, who had also had their heart torn from their chest, fully understood the gaping hole of emptiness left behind.
With a heavy heart, he headed out the door. On the short drive in to work, Pesh didn’t bother turning on the radio to drown out the voices of sorrow echoing through his head. He knew it was no use. No matter how hard he tried, he could not rid himself of his pain. Family and friends had afforded him one year of grieving before they had been on him to move on. Desperately, they tried to get him to realize that the last thing his Jade would want was for him to continue carrying a torch for her—to spend his life sad and alone. He’d tried to prove to them he had moved on, but that only resulted in projecting what he thought was love onto a woman who was just as confused about her life as he was. He’d vowed after that mistake that he wasn’t going to let anyone dictate when it was time for him to move on from Jade’s memory. If he was to love or marry again, he would be the one to take the steps.
He made the same rote pilgrimage from the staff parking lot into the hospital. Every day was just the same, one right after the other. He’d barely had time to ease on his white medical coat when he heard his name being paged over the intercom. Rushing over to the sink, he scrubbed up as quickly as he could before whirling around. Using his back to open the door to the doctor’s lounge, he did his best speed walking down the hallway to the trauma area. The moment he swept through the glass doors, the staff pounced on him.
Two nurses were at the man’s head. One held down the face mask as the other pumped air through the bag into his airways. Another was stationed at the man’s side doing CPR compressions intervals on the chest.
After donning a pair of rubber gloves, Pesh glanced to the charge nurse as he hurried to the man’s side. “Male, forty-five, collapsed at the jogging park during a run. No known medical history. Coded once on the trip over,” she quickly informed him.
“BP is dropping,” another nurse called behind him.
Machines began beeping on and off, a symphony of noise heralding impending doom. “Okay, we need to shock him again.” The crash cart was rolled up to the gurney. Pesh grabbed the paddles. “Charging. Shocking at 260 joules.”
“Clear,” Pesh commanded. The nurses administering compressions to his chest and the intubation bag stepped back, holding their hands off the man. Pesh brought the gelled paddles to the man’s chest. As the electrical charge raged through the man’s body, his arms and legs flailed.
Pesh glanced at the heart monitor. “Still asystole. Again.”
“Charging at 360 joules,” a nurse replied.
“Clear.” As he brought the paddles once again to the man’s chest, Pesh muttered, “Come on, come on, beat, dammit,” under his breath. It didn’t matter how young or how old, he hated to lose a patient. Although the body shuddered and jerked in reaction to the electricity, the heart remained frozen. Although it was a losing battle, he called, “Clear!” once again.
When the man’s vital signs didn’t change, Pesh shook his head. “We need to open him up to massage the heart. Get me the rib spreader and the chest saw and page one of the residents,” he ordered. He took a face mask from another nurse and slid it on.
After making a quick incision in the man’s chest, Pesh took the saw from one of the nurses. Once he had sawed through the sternum, he shifted to the side to allow a nurse to move closer to work the crank on the rib spreader. Pushing aside the hard bone of the sternum, he gently took the man’s still heart in his hands. No matter how many times he’d had to do it before, there was still something so humbling as holding the most important muscle in the human body in the palm of your hand. Squeezing it over and over, Pesh mimed the usual pumping the organ did.
Seconds ticked agonizingly by as they waited to see if the damaged heart would restart. When it remained still, Pesh sighed and closed his eyes for a moment. He eased back from the man. Glancing up at the clock on the wall, he said with regret, “Calling time of death: nine forty-seven a.m.”
“Want me to handle the family?” the resident asked.
Pesh shook his head. “No. You get him closed back up. I’m sure they’ll want to see him.” He took off his bloody gloves and tossed them dejectedly into the hazardous materials trash can and then removed his mask. He walked over to the glass doors of the trauma area where a paramedic stood surveying the scene. “Do we have a name on him?”
The paramedic flashed the guy’s driver’s license. “Aaron Chapman.”
He walked down the long hallway before pushing open the button on the mechanical door that led out of the emergency area. In a room to the side of the waiting room, the man’s wife and two teenage sons sat in hushed silence. As he opened the door, he said a silent prayer for strength. This was the most difficult aspect of his job. While he relished in the long hours of saving lives and diagnosing illnesses, this part drained him both emotionally and physically.
The woman, who appeared to be in her late thirties or early forties, rose from the chair she was sitting in. “Yes?”
He held out his hand for her to shake. “I’m Dr. Nadeen. I was assigned your husband’s case.”
She bobbed her head and took a step forward. “How is he?”
“Your husband experienced a severe myocardial infarction.” At her blank look, he replied, “A heart attack.”
“Oh my God, I can’t believe it. He’s had some high cholesterol, but he’s been running every day. I was only ten minutes from here dropping the boys off at school, and I told them I bet their dad had fallen and broken his ankle or something. Of course, I wondered why he wouldn’t call instead of the hospital…” Realizing she was rambling, her voice cut off. Her hand hovered over her throat. “But he’s okay now?”
Pesh shook his head. “I’m very sorry, but the heart attack caused too much damage to the heart. We were never able to revive him after he was brought in.”
The woman’s eyes widened to the size of dinner plates. “No, no, NO! Surely there is something you can do!”
“I’m so very sorry. We did everything we could to save him, including multiple attempts of resuscitation past what the paramedics originally did, but he did not respond to our attempts.”
The woman’s wail pierced through to Pesh’s soul. She collapsed back against her sons, who now had tears in their eyes. Stoic on the outside, Pesh stood by her side as she sobbed uncontrollably. Most doctors when playing the Grim Reaper would deliver the bad news and then retreat. Pesh believed that part of a patient’s care also meant the care of their family. That’s why he ignored his pager going off in his pocket. It was only when his name was paged over the intercom that he took a step forward. He placed a hand on the widow’s shoulder. “If you would like to be with him until the funeral home arrives, you can follow me.”