kk095

[kk095]

Kaylynn’s Cardiac Experiment

From the outside, the building looked too perfect to be real.

Twenty-eight year old Kaylynn Carson stepped into the entryway of VIREN with the clunk of her boots echoing faintly off the white walls and smooth tile floor. For a moment, she paused- unsure if she was walking into a hospital, a research lab, or a high-end dentist’s office; it definitely wasn’t what she expected. The place smelled like nothing. Not bleach. Not chemicals.

No one was in the lobby.

No receptionist. No security desk. No distant phones ringing. No chatter or voices- not a soul. Just a wide, sterile room lit by long strips of ceiling lights, humming faintly overhead. There weren’t even chairs in the lobby area.

Kaylynn adjusted her Carhartt jacket and glanced down at the scuffed toes of her boots. Maybe she was early? They told her to be there at 4:45am sharp. She checked her phone- 4:33. She was early, alright. She was always early. Her dad used to tell her “if you were on time, you were already late!”

Kaylynn stood awkwardly, shifting her weight from one boot to the other, eyes drifting to the sleek lettering on the wall: VIREN: Vascular Interface Research & Enhancement Network.

Just as she was about to clear her throat and maybe call out a nervous “hello?”, a soft whoosh of an automatic side door broke the silence. From a hallway that looked indistinguishable from the white walls, a woman stepped into view, smiling too widely to be real.

“Kaylynn Carson?”

Kaylynn straightened a little, offering a smile. “Yes ma’am. That’s me.”

The woman was petite, brunette, and dressed in a tailored navy-blue blazer over matching slacks, not a wrinkle on her. “Welcome to VIREN, Ms Carson. I’m Dr Samantha. We’ve been expecting you! Come right this way!” she welcomed, sounding like she was giving a tour at a museum.

Kaylynn followed, boots thunking against the tile. “I, uh, just pulled in. Hope I ain’t too early.”

“Not at all!” Dr Samantha answered with a polished smile. “Punctuality is a virtue, and you’re our very first candidate. A very exciting day for all of us.”

The hallway stretched ahead endlessly, lined with overly bright lighting, doors leading to who knows where, and nothing else. No signage. No people. No windows.

As they walked, two more women joined them from adjoining hallways. One had bright red hair and a bubbly energy, wearing scrubs with a lanyard bouncing at her chest- she introduced herself as Mira, the cardiac tech. The other, taller with short, cropped, dark hair and a sharp, analytical look, introduced herself simply as Dr Kelly. She didn’t smile, and had a more stern presence.

“It’s an honor to have you here, Kaylynn” Mira spoke brightly. “You’re helping to change the future of heart research.”

Kaylynn chuckled softly, rubbing the back of her neck nervously. “Well… I ain’t a doctor or nothin’, but I’m happy to help y’all however I can.”

“That attitude” Dr Samantha began, her heels clicking softly, “…is exactly why we selected you for this program out of thousands of applicants.”

The group turned a corner and approached a sealed double door with a small fingerprint scanner and iris reader. Dr Kelly stepped forward, scanned herself in, and the doors hissed open.

“Let’s get you prepped, Ms Carson” Dr Samantha spoke. “Everything’s ready for you.”

Kaylynn offered a polite nod, but a thin sliver of uncertainty passed through her. Something about the way the hallways curved. The way it all felt too quiet. Too empty. Too new. Deep down, it just didn’t sit right with her.

But she followed trio inside anyway.

The exam room looked more like a showroom for expensive medical tech than anything Kaylynn had ever seen in a hospital.

Soft, recessed lights glowed from behind curved white panels in the ceiling. A horizontal touchscreen display ran along one wall, its light blue interface quietly cycling diagrams of the heart. A tall cabinet blinked with sterile-pack indicators, and a wide padded table- completely smooth and oddly uninviting, waited in the center of the room. Everything was silent and impossibly clean.

“You can set your things there, Ms Carson. Boots, jeans, jacket- everything but your undergarments. Then put the surgical cap on. We’ll begin shortly, alright?” Dr Samantha instructed, gesturing to a sleek, lidless bin with a glowing base.

Kaylynn gave a polite nod, trying not to let her hesitation show. “Yes ma’am.”

The trio turned to the wall, giving her space- at least in theory. Mira tapped through a digital checklist on a floating display, Dr Kelly crossed her arms and remained silent, and Dr Samantha began reviewing something on a sleek tablet, back turned but still relatively close by.

Kaylynn undid her Carhartt jacket slowly, folding it in half neatly and setting it in the bin. Her camo T-shirt followed. Then her jeans, which she peeled off carefully, as if trying to disappear while doing so. Lastly, her socks slipped off. The cold air made her skin pebble up with goosebumps. She folded her arms slightly, now standing there barefoot in just a black bra and matching underwear.

She was tall- 5’11 without her boots, with a sturdy build and a tanner complexion that hinted at long days out in the sun. Her shoulders were broad, Her legs thick and strong. She didn’t wear makeup, never had, but her features were striking in a quiet, natural way- high cheekbones, wide-set blue eyes, and soft lips that always looked like they were about to smile. She was a beautiful girl, but never realized it. 

Her light brown hair, tied back in a ponytail, shifted as she bent to pick up the surgical cap. She slid it over her head and tucked in the loose strands with clumsy fingers.

“All set, ma’am” Kaylynn spoke softly, looking towards the VIREN team. 

Mira turned first, offering her a warm smile that seemed genuine. “Great job, Kaylynn. Go ahead and sit up on the table, okay? We’ll get you comfy.”

Kaylynn climbed onto the table, sitting upright, arms crossed lightly over her torso.

“Now” Dr Samantha started, stepping forward with that same polished tone. “Let me walk you through what we’ll be doing today. It’s quite straightforward.”

She tapped her tablet, and the display on the wall shifted to a 3D diagram of the procedure.

“We’ll perform the procedure under regional anesthesia, so you’ll be awake and alert the whole time. We’ll begin by making a vertical incision here” -she pointed to the sternum- “and open the chest wide enough to access the pericardial cavity- the lining around your heart. Once we expose your heart, we’ll carefully affix the synthetic myocardial overlay. It’s a proprietary mesh that will enhance the strength and efficiency of your heart’s contractions.”

Kaylynn blinked nervously, slowly turning her eyes to the display.

“So wait... y’all are gonna cut my chest wide open like that while I’m wide awake? Ain’t I supposed to be asleep for something like this?!”

“Correct, Ms. Carson, you’ll be awake for the procedure. You’ll be under what’s called regional anesthesia” Dr Samantha answered smoothly. “Essentially, you’ll be numb from the chest down. I assure that you won’t feel a thing. The procedure is far less concerning than you might think. And your participation is a critical first step in developing enhancements that could benefit millions.”

“Your courage really means a lot to us, Kaylynn” Mira chimed in, grinning. “Your heart’s going to be stronger than a Navy SEAL’s by the time we’re done!”

Kaylynn let out a short, nervous laugh. “Well… I’m not sure I need all that, but I guess it’s worth it!”

Dr Samantha smiled without showing teeth. “Exactly. And the procedure will be over before you know it.”

Kaylynn nodded, settling herself back on the table as the lights overhead shifted subtly, and the surgical prep began.

Cardiac tech Mira moved efficiently now, pulling a tray of sterile supplies toward the bedside. “Alright, I’m just going get you hooked up real quick, hun. Nothing to worry about.”

She peeled back the wrapper on a set of EKG leads, her gloved hands surprisingly gentle as she pressed the stickers to Kaylynn’s chest and ribcage. “Sorry, these are always a little sticky.”

“It’s alright, ma’am” Kaylynn smiled politely for a moment. She tried to stay still, her eyes flicking toward the monitor as the soft blips of her heart rhythm appeared onscreen.

Dr Kelly stood nearby, arms folded again, silently watching the monitor light up with Kaylynn’s vitals.

Mira then wrapped a blood pressure cuff around Kaylynn’s left upper arm, taking her blood pressure manually, then leaning in with a stethoscope to listen to her heart. Kaylynn sat still, her hands flat on her thick thighs.

“Strong rhythm” Mira listened cheerfully. “You’ve got a good ticker, Kaylynn. Let’s make it even better.”

“Thank you, ma’am!” Kaylynn replied. She offered a faint smile, but her fingers twitched slightly.

After finishing with Kaylynn’s blood pressure, Mira picked up a small IV kit next. “Alright, you’ll feel a little poke now. Try to relax that arm for me.”

Kaylynn tensed involuntarily the moment the needle went in, wincing.

“Sorry…” The patient muttered. “I always hated needles.”

“That makes two of us” Mira smirked, taping the line in place. “But you did great. That’s the worst part of the prep, I promise.”

Kaylynn gave a small nod and looked down at the line taped to her arm. Everything felt oddly surreal. Cold room. Beeping monitor. Strange women treating her like both a guest and a specimen.

Dr Samantha finally stepped closer again, checking the wall monitor with an unreadable smile. “Vitals are stable. Let’s move her to Position A.”

Mira adjusted the table controls, easing Kaylynn into a reclined position. The padded surface hummed beneath her as it shifted.

Kaylynn stared up at the ceiling, voice soft. “So I’ll be awake the whole time?”

“Completely awake” Dr Samantha confirmed, briefly nodding. “But numb and comfortable. And you’ll have a front-row seat to everything!”

Kaylynn exhaled slowly and nodded, fingers curling lightly over the edge of the table.

She was ready. Or at least trying to be.

“Alright, Ms Carson. Mira and Dr Kelly are going to get you transferred over to the operating room.”

All Kaylynn could do is nod in response.

After Dr Samantha left the room, Mira and Dr Kelly began wheeling Kaylynn to the OR.

The corridors of VIREN were nearly silent, lit in cool strips of white light that pulsed ever so slightly with each passing second. Kaylynn lay back on the gurney, now partly covered in a paper-thin, light blue surgical drape over her underwear and bra, the surgical cap still snug around her ponytail. The quiet hum of the gurney’s wheels on the polished floor echoed around them.

Mira pushed the bed down the hall, one hand resting on the gurney rail. Dr Kelly followed a step or two behind, pushing the base with slow, smooth precision. Dr Samantha led the way several feet ahead, tablet in hand, barely glancing back.

Kaylynn’s fingers gripped the sides of the drape. Her exposed arms prickled in the cold, and the silence of the hallway made her heartbeat feel too loud in her own ears.

"It’s always this quiet in here?" The patient asked, voice soft.

"Early mornings are best for these types of procedures" Dr Samantha answered without turning.

"It's easier for us to focus" Mira added quickly, glancing down at her with a reassuring smile. "Almost there. You're doing great."

The OR doors slid open without a sound. The room inside was darker than the rest of the facility, not dim, but muted- a grey and chrome color scheme that gleamed like wet metal. Overhead, a ring of surgical lights encircled the central platform where the procedure would take place. Instrument trays were already arranged, each tool laid out with perfect precision.

"Transfer her" Dr Samantha ordered, gesturing toward the elevated table in the center of the room.

Mira and Dr Kelly moved smoothly, unlocking the side rails and guiding Kaylynn gently from the gurney to the cold, padded surgical table. The surface, like everything else in the room, felt impossibly clean.

"Okay, Kaylynn, we need to get you fully prepped now. That means removing the rest of your clothing." Mira explained gently.

Kaylynn hesitated, holding the blanket tighter around her. "You mean... all of it?!"

"Yes, it's absolutely necessary for the procedure. I promise, it’s all clinical. Nothing personal." Mira clarified.

Dr Kelly was already gloving up near the prep tray.

Kaylynn looked between them, then gave a slow, uncertain nod. "I just... I don’t love the idea of being naked in a room full of strangers."

"We completely understand" Mira answered calmly, though her hands didn’t stop moving. "But you’re safe with us."

They peeled back the blanket and helped her sit up. Kaylynn unhooked her bra herself with stiff, anxious fingers, handing it off quickly before lying back again. The underwear followed, slid down and whisked away with a quick, practiced motion. Mira draped a sterile paper sheet over her hips and thighs, though her chest and abdomen remained exposed.

The table felt even colder now.

Dr Kelly approached with a large cotton swab soaked in betadine and began scrubbing Kaylynn’s bare chest with long, circular strokes. The antiseptic felt ice cold on her skin.

“OOO! That’s freezin’!” Kaylynn squirmed.

"This just sterilizes the incision area to prevent post-op infections." Mira explained from the head of the table. "You're doing great."

Kaylynn looked up toward the overhead lights, her mind shifting gears."Y’all are sure none of this this ain’t gonna hurt?"

"You’ll be completely numb from the chest down" Dr Samantha replied calmly, stepping into view with a syringe in one hand. "You may feel pressure, but no pain."

“Alright, Kaylynn? We’re going to have you roll to your side so we can get that regional anesthetic in. You’ll feel a quick pinch in your back, okay?” informed Dr Kelly.

The twenty-eight year old nodded anxiously.

Kaylynn then rolled onto her side for a moment. She flinched slightly as the regional anesthetic was injected. The needle was deep, entering near the spinal column, and her breath caught briefly in her throat after feeling a pinch.

Mira reached down, resting a hand gently on Kaylynn’s shoulder. "Almost done. Just breathe."

After the injection was finished, Kaylynn was returned to her previous position.

Her legs and abdomen began to tingle, then go completely numb. She tried to wiggle her toes, but they didn’t respond at all. Her body was still, her breathing shallow.

"Y’all... I can’t feel my feet..." Kaylynn raised her eyebrows, forehead crinkling, a nervous edge creeping into her voice.

"That means the anesthetic is working" Dr Kelly answered Kaylynn gently. "Exactly what we want."

Dr Samantha glanced to the monitor. "Vitals steady. Positioning next."

The table’s sides clicked and adjusted with smooth, mechanical shifts, lifting and angling her until her chest was angled upward toward the ring of surgical lights.

"Begin sterile field" Dr Kelly spoke flatly, unfolding the final blue drapes over Kaylynn’s torso, shielding everything but the marked rectangle between her breasts, collarbones, and upper abdomen.

Kaylynn couldn’t move. She couldn’t feel a thing from the chest down. Her own heart thudded wildly behind her breastbone. 

And they were just getting started.

Dr Samantha stood to Kaylynn’s left, now in her surgical gown, hands gloved and fingers poised above the sterile equipment tray. Without a word, she selected a scalpel and lowered it toward the center of Kaylynn’s chest.

Kaylynn’s eyes widened. She couldn’t feel it, but she could see it- the blade effortlessly part her skin just above the sternum. Blood welled up immediately, but was quickly wiped away by Dr Kelly, who stood on the opposite side with gauze ready.

The initial incision was clean, almost graceful in its precision, but deep enough to expose the underlying  muscle and bone.

“Oh God...” Kaylynn whispered. “What’re y’all doin’ to me?!” Panicked Kaylynn, watching the vertical incision step-by-step.

“Remain still, Ms Carson” Dr Samantha uttered a little more firmly.

She set the scalpel down and reached for the next tool. A cautery pen sizzled against the exposed tissue, sealing tiny vessels and releasing a faint, acrid smell that drifted into Kaylynn’s nostrils.

Her breathing hitched. Her eyes were wide, darting.

The sternal saw came next.

Dr Kelly handed it off, and with mechanical precision, Dr Samantha aligned it just above the xiphoid process.

The high pitched whine of the saw filled the OR. It was sharp and metallic, a sound that vibrated through the table and up into Kaylynn’s spine.

She flinched, involuntarily.

The blade met bone.

There was a grind and crunch as the saw met her sternum. Kaylynn gasped- there was no pain, but the sensation of her own chest being sawed open was grotesquely horrifying. Her whole torso vibrated with the motion.

Her mouth opened, but no words came out.

Dr Samantha continued methodically, cutting a straight line up to the sternal notch. When the saw stopped, silence fell for half a second- then the click and snap of the rib spreader took its place.

Metal arms were inserted into the cut edges of Kaylynn’s split sternum. The crank turned.

Click. Click. Click.

Her chest was pried open.

Kaylynn’s head trembled slightly. Her breaths were shallow, her eyes glistening now. She looked up at the overhead light, voice barely audible.

 “I can feel it...that’s weird, y’all…” Kaylynn thought out loud, watching her chest get cracked open.

“Vitals holding, Samantha.” Dr Kelly noted, eyes on the monitor.

And there it was: Kaylynn’s heart.

Beating in full view.

Exposed. Vulnerable. Alive.

Kaylynn stared down past her collarbones, her breath catching in her throat.

Her own heart, red and glistening, thudded steadily in the open space of her split open chest. It looked surreal, rhythmic, alive, almost like it didn’t belong to her, like she was watching someone else’s body.

“I never thought I’d see my own heart beatin’ like that…” she uttered, stunned. “I can’t believe it didn’t hurt while y’all cut me open like that… I just can’t believe this is all happenin’ right now…” Kaylynn went on.

No one answered.

Dr Samantha carefully incised the pericardium, the thin, fibrous membrane surrounding Kaylynn’s heart. The fibrous tissue parted under her shears, revealing the muscular organ in its entirety underneath.

From a nearby tray, Mira handed Samantha a sealed, temperature-controlled case. Dr Samantha opened it like she was unveiling something sacred.

Inside was the overlay device.

A tangled, but ordered lattice of ultrathin metallic fibers, silvery and gleaming like strands of wire. It shimmered faintly as it sat between the Dr Samantha’s gloved fingers, delicate and terrifyingly advanced. It looked alive in its own way.

“This is the future of cardiology” Dr Samantha proclaimed, almost to herself. “Self-adjusting contraction. Synchronized pulse enhancement. Permanent, enhanced cardiac stamina.”

Kaylynn watched as Samantha leaned in. Mira adjusted the overhead lights, illuminating the surgical field with a sterile, white glow.

The mesh was positioned directly over Kaylynn’s heart. Dr Samantha’s hands were steady as she lowered it slowly, like draping a net over a living drum.

The instant the overlay touched her heart, the wires shifted- tightening, adapting, forming to the contours of the muscle with mechanical precision.

Kaylynn’s diaphragm twitched.

Her eyes fluttered. She didn’t know why, but she suddenly felt… off.

She looked up, nervously.

“Y’all… it’s on there already?” the patient asked.

“It is, Ms Carson” Dr Samantha confirmed, not looking up.

“It’s starting to integrate.” Observed Dr Kelly, eyeing the monitors.

The overlay’s pulse began to sync with the heart beneath it.

Dr Samantha leaned over Kaylynn’s open chest with an unsettling calm, her gloved fingers making tiny, deliberate movements as she calibrated the microfilament anchors of the overlay. With each adjustment, the wiry mesh flexed slightly, hugging the contours of Kaylynn’s heart with biomechanical precision.

Kaylynn blinked rapidly, the edges of her vision tightening. She licked her lips.

“Excuse me, ma’am…” she began politely, her Southern accent pulling a little tighter with unease. “Something don’t feel right.”

“That’s perfectly normal, Kaylynn” Mira answered, perhaps too quickly, her smile practiced and a little too bright. “Your body’s just adjusting to the interface.”

Kaylynn tried to nod but barely managed a twitch.

“Is it supposed to feel like this?” she asked. “Like… tight? Like somethin’s squeezin’ me from the inside out?”

Dr Samantha didn’t respond. Her gaze remained locked on the exposed heart, fingers twisting and maneuvering the final anchor into place.

Kaylynn’s breathing picked up.

“I ain’t gonna die or anything, right?” she spoke, her voice trembling. “Promise me I ain’t leavin’ this room toe tagged.”

Still, silence. Mira offered a rehearsed smile, but didn’t verbally answer. Dr Kelly didn’t even glance away from the vitals screen.

Kaylynn closed her eyes for a second, swallowed thickly.

“Dear Lord…” she mumbled, voice shaking, “if I die in here, please let it be quick… and please don’t let my Mama find out from a stranger.” She prayed, her mind racing.

Kaylynn then opened her eyes and gave a weak, strained smile, trying to calm her nerves a bit and talk about anything but what was going on. “Y’all ever been to Mississippi? S’where I’m from.”

Again, no answers from the VIREN team.

The overlay shimmered as it pulsed tighter, conforming more aggressively now- too aggressively.

Kaylynn’s chest rose faster. Her heart thudded stronger, faster.

She tried to keep talking, to push the fear down with words.

“Kinda feels like… like my chest’s… closin’ in on itself…”

Her eyes fluttered, looking back down at her open chest.

Still, the monitors beeped steadily. Still, the surgical team moved with clinical detachment.

The last anchor clicked into place.

Dr Samantha stepped back slightly, tilting her head as if evaluating a finished product.

Kaylynn’s lips parted, searching for air.

The overlay was now fully assembled and integrated.

The metallic mesh shimmered where it firmly gripped Kaylynn’s heart. Its wiry lattice had synchronized fully with the muscle, microfilaments flexing subtly in time with every beat.

Kaylynn’s breath caught. Her eyes darted toward Mira.

“I’m tellin’ ya… somethin’ still don’t feel right…” Kaylynn shook her head, her voice dry and high in her throat. “It’s getting’ worse. It’s too tight…”

Mira glanced at the monitor.

A soft beep. Then two. Then a rapid escalation.

Heart rate: climbing. Blood pressure: dropping.

“Doctor?…” Mira looked over at Samantha.

Dr Samantha didn’t look away from the overlay.

Kaylynn’s face drained of color in the blink of an eye. Her breaths became shorter, more desperate.

And then…

The heart bulged.

Just for a moment, but unmistakably. The left ventricle pressed against the wire overlay like an overinflated balloon trapped in a cage.

Another beat. Another bulge. A spasm. The muscle convulsed unnaturally.

Kaylynn gasped.

“Oh God!” she whimpered. “I knew I shouldn’t have volunteered for this thang!”

The monitors screeched.

Kaylynn then arched her head back and let out a piercing, blood-curdling scream that reverberated through the operating room.

And then, the left ventricle split.

The rupture wasn’t subtle. It tore open with a sickening wet sound, a flash of deep red erupting in the center of Kaylynn’s chest.

Blood filled the chest cavity rapidly.

Kaylynn’s scream turned into ragged sobbing.

“Oh God! It hurts so much! Y’all… please help me! I don’t wanna die!” she pleaded with the team, knowing something had gone seriously awry.

Her eyes darted upward. Her arms, still limp at her sides, trembled in fear.

Mira leaned closer, but didn’t say anything. Her hands moved, but her eyes betrayed the truth- this was spiraling out of control.

Dr Samantha remained composed. She didn’t bark orders. She didn’t flinch.

“Removing the overlay” she uttered coldly.

“Should we suction?...” Mira asked.

“Not yet. I need to remove the overlay first. I have to see the injury site.”

Blood spilled over the retractors, accumulating onto her torso, staining the light blue surgical drapes a deep crimson.

Kaylynn squirmed weakly, sobbing.

Dr Samantha’s gloved fingers began undoing the microfilament anchors with slow, meticulous movements.

Kaylynn screamed again, voice cracking. “Please! Help me! Oh God, please!”

Her chest heaved in pure fear as blood loss drained the strength from her limbs.

“I’m so scared! I don’t wanna die like this! Am I dyin’?!”

Dr Kelly spread the retractor wider to expose the heart more as Dr Samantha finished peeling the mesh free.

Kaylynn could see it all. Her own failing heart- a mangled mess of torn muscle and blood, and the faces around her: calm, methodical, unbothered.

She screamed again, no longer forming words. Just raw, human terror.

And the bleeding continued.

The rupture was massive.

Kaylynn’s ragged sobs echoed through the OR, almost drowned by the alarms blaring from the monitors.

Dr Samantha peeled the final edge of the mesh away- and that’s when it happened.

A sudden geyser of blood shot upward from the gaping ventricle.

It splattered across Dr Kelly’s gown and soaked through the sterile drapes. The mesh, now removed, clattered into the basin like discarded scrap.

“Clamp!”

Dr Samantha didn’t flinch. She calmly held her hand out.

Mira hesitated for the briefest of seconds before placing the instrument.

Kaylynn’s upper body trembled on the table. Her eyes were wide and absolutely terrified. Her lips quivered, pale.

“Please...” she begged weakly. “I don’t wanna die... I ain’t ready... I didn’t think it’d end like this…”

Her voice cracked as she tried to draw a full breath-but couldn’t. Blood filled her chest cavity, compressing her lungs.

“I’m scared...” she gasped, eyes tearing up. Her last conscious breath was a shallow, gurgled sob.

Then, her eyes rolled back. 

The monitor erupted.

Dr Kelly moved without hesitation. “She’s in cardiac arrest. Lost a pulse.”

“Crap. Starting massage” Samantha called out.

Dr Samantha reached in with both gloved hands and began direct cardiac massage, squeezing the torn heart between her palms. Blood spilled over her wrists with every compression.

“Get me some suction, I'll assess the damage. And push epi, one milligram.” Dr Kelly chimed in. 

Mira scrambled to respond, trying to keep up. Her eyes were glassy. Her jaw clenched tightly.

The room was silent except for the wet, squelching rhythm of hands massaging her ruined heart and the wet slurping of suction trying to keep up with the blood.

Dr Samantha leaned closer. “Let’s prep for internal defibrillation. If we don’t get something soon, we have to shock.”

Mira nodded, fumbling with the paddles.

Kaylynn’s head lolled to one side, eyes half-lidded and glassy, her skin ghastly pale and cool to the touch.

And none of them looked at her face.

Dr Samantha’s hands continued their relentless rhythm, compressing Kaylynn’s heart in her gloved hands, the slick muscle yielding with each squeeze. Blood glistened over her gloves, soaking into the sterile towels and pooling beneath the surgical field.

“Mira…” she spoke flatly, “set up an intubation tray. Just in case.”

Mira moved quickly, tools clinking into place beside Kaylynn’s motionless head. Her eyes flicked down- still no spontaneous breaths.

Dr Kelly leaned into the field. “I see the tear. It’s jagged, anterior wall. Suction closer- there.”

Mira leaned in with the suction wand, clearing the worst of the blood.

Dr Kelly threaded a curved needle through the shredded ventricle wall to begin closing the tear, her movements quick but precise. She looped thick suture thread, anchoring it deep.

“Hold pressure here” she instructed Mira, who pressed down just above the tear.

A soft sound escaped Kaylynn’s throat. A low, rattling gasp.

All three froze for a second.

Kaylynn’s eyelids fluttered. Then another shallow, involuntary exhale.

Dr Samantha didn’t look up. “Residual response. Massage is partially effective. Keep going.”

She shifted her grip and continued cardiac massage. The torn heart squelched weakly between her palms.

“Type and cross?” Samantha asked.

"Four units O-neg on deck” Mira confirmed, eyes still locked on Kaylynn’s face.

Dr Kelly pulled the final suture taut. Blood still seeped around the edges.

“Pressure’s not holding. The wall’s totally shot” she muttered.

“We reinforce it. Double-layer the stitch. You have thirty seconds before epi peaks.”

Kaylynn’s fingers twitched. Once. Then stilled.

Mira glanced at the monitor. “Still PEA.”

Kaylynn’s heart, now battered and sewn, pulsed faintly under her fingers.

The units of O-negative blood were now hanging. Dark red fluid flowed steadily through the line, vanishing into the port Mira had placed in Kaylynn’s arm.

“Bag’s running wide open” Mira reported.

Dr Kelly stepped toward the head of the table, slipping on a fresh pair of gloves. “I’ll intubate.”

Mira handed her the laryngoscope and endotracheal tube. Dr Kelly leaned over Kaylynn, positioning her head back with clinical precision.

“Jaw’s relaxed” she thought out loud, gently prying open the young woman’s mouth. Her gloved fingers gently displaced the tongue as she slid the blade into place.

The laryngoscope’s light shined down Kaylynn’s throat.

“Vocal cords visualized. Passing tube.”

Kelly guided the tube between the cords and down into Kaylynn’s trachea.

“Tube in.”

Mira connected the ambu bag, securing the ET tube with white surgical tape. The bag whooshed as it delivered breaths, Kaylynn’s chest rising and falling in hollow rhythm. “breath sounds present bilaterally” reported Dr Kelly.

Samantha remained at the side of the table, hands-deep inside Kaylynn’s chest, steady. But her eyes were on the monitor.

“Push another milligram epi and start her on 300 milligrams amiodarone IV.” Ordered Samantha.

Mira obliged, not saying a word.

After the meds were injected, the monitor gave a sudden sharp tone. The waveform fractured- regularity giving way to jagged chaos.

“There we go, V-fib” Mira reported to the team.

Dr Kelly’s eyes dropped to the exposed heart. “Confirming- ventricles are fibrillating.”

The heart looked like a bag of worms beneath the suture lines- quivering, chaotic, and uncoordinated.

Dr Samantha extended her gloved hand. “Internal paddles.”

Mira handed them off.

The paddles were cold metal, shaped to cup the heart itself. Samantha positioned them directly around the quivering ventricle.

“Charging to ten joules.”

A rising, high-pitched electrical whine began.

“Clear…”

She pressed the triggers on the handles of the paddles with her thumbs.

Kaylynn’s body jerked violently- arms and legs tensing and jolting for a moment. The heart itself thrashed beneath the paddles, then fell back into its fluttering tremble.

“Still V-fib” Dr Kelly called out, shaking her head.

“Charging to 20.”

Samantha adjusted the paddles.

“Clear.”

Another surge of current.

This time, Kaylynn’s body gave only a shudder- a subtle ripple through her thick, sturdy torso, like a dying reflex.

Her eyes remained half-lidded.

The heart spasmed, then sagged.

“Still fibrillating.”

Samantha didn’t speak. She simply held her paddles steady, and waited.

“Going again at 30. Clear…” Dr Samantha called out.

At the far end of the table, Kaylynn’s toes scrunched hard and involuntarily in response to the third shock, showing off the deep, wide, large wrinkles throughout the soles of her size 12 feet.

"Still no change. Going again at thirty joules. Clear!"

Dr Samantha's voice cut the sterile air like a scalpel. Mira stepped back as the internal paddles hummed to life.

Samantha delivered the shock. KA-THUNK. Kaylynn’s torso twitched slightly, her limbs jerking stiffly before dropping back to the table. Her fingers trembled and fell still, one heel thudding faintly against the table.

On the monitor, the jagged waveforms of v-fib danced unchanged.

Dr Kelly leaned closer to the heart. "Still fibrillating."

A pause stretched thin. Mira adjusted one of the lines. Samantha’s gaze remained locked on the heart.

"Again. Forty joules."

Another rising, high-pitched whine. Samantha didn’t flinch.

"Clear."

The internal paddles fired. Kaylynn twitched less this time- just an unnatural shrug of the shoulders, her jaw trembling slightly from residual energy. Her head lolled slightly to one side.

Her eyes, half-lidded and glassy, no longer tracked anything.

Blood still seeped slowly from the suture line.

The monitor stuttered.

"She’s still in V-fib, doctor" Mira confirmed, voice neutral.

Dr Samantha adjusted her grip once more.

"Charging again to forty."

A long, slow whine from the internal defibrillator paddles filled the silence, vibrating against the chrome surfaces and Kaylynn’s lifeless form.

Samantha hesitated for only a breath.

"Clear."

The next jolt struck. This time, Kaylynn didn’t move. No twitch, no tremor. Her arms lay limp at her sides, her chest slack. The heart inside her chest fluttered uselessly, then convulsed once... and fell into arrhythmic shivers.

The monitor’s waveform continued its erratic chatter.

Dr Kelly sighed quietly, then looked to Samantha. "Still V-fib. No cardiac output."

Samantha didn’t react. She slowly pulled the paddles away and turned toward the crash cart.

She set them down gently.

Then, flatly: "Let’s go ahead and stop. I’m not coding this redneck all morning."

She glanced at the wall clock, peeling off her blood soaked gloves. "Time of death: 7:46am."

The room fell into eerie quiet- the soft drip of an IV line, the quiet whoosh of the ambu bag as Mira delivered one last breath.

Click. Mira disconnected the ambu bag.

A hush settled. Kaylynn’s chest didn’t rise again.

Her skin was pale and torso blood-slicked. Her eyes stared through the harsh ceiling lights. Her heart lay exposed, fibrillating, sewn and shattered.

No words were exchanged.

Dr Samantha peeled off her gloves and dropped them into the biohazard bin. "We’ll need a pathology and engineering consult on the overlay matrix."

Dr Kelly nodded. Mira reached for an extra drape to cover Kaylynn’s open chest.

No one said her name.

No one closed her eyes.

They just moved on to postmortem care without missing a beat.

The harsh, bright overhead lights still shined above Kaylynn’s body, casting sterile illumination over the table. No one had moved the rib spreader. Her chest cavity remained pried open, heart still faintly twitching. 

Mira moved first. Wordlessly, she reached across the table and shut off the heart monitor. The room dipped into a deeper silence as the erratic beeping vanished.

Dr Kelly unclipped the EKG leads one by one, letting them fall loosely to the sides. She tugged out the IV lines with quick, practiced pulls. Blood welled briefly from one site before gauze was pressed over it.

No one met each other’s eyes.

“Can’t believe it’s already Tuesday” Kelly muttered. “Feels like the weekend never even happened.”

Mira gave a faint laugh, distracted as she rolled up the lengths of disconnected IV tubing. "Guess that’s what these twelve hour shifts do to you, huh?"

Samantha stood at the end of the table, arms crossed, eyes on Kaylynn’s lifeless body. “Send the overlay to engineering. I want the device failure documented before end of day.”

“Yes, doctor" Mira replied, nodding.

Still, no one closed Kaylynn’s eyes.

Mira stepped down and approached her feet. She pulled a small white tag from the equipment tray nearby, filled it out, and looped it around Kaylynn’s left big toe. It dangled freely, lightly brushing the wrinkled sole of her foot.

Dr Kelly peeled off her gloves, snapping them into the biohazard bin. She paused only to stretch her fingers before heading toward the door.

Mira followed her.

Dr Samantha lingered only a moment longer. Then, with one final look at the body on the table, she reached to the wall panel and shut off the surgical lights.

Darkness settled.

The toe tag swung slightly in the cool, still air.

The door closed behind them with a soft click.

Kaylynn was all alone. Uncovered. Eyes still open. 

She had walked into the VIREN facility at 4:33am nervous, polite, and hopeful. A little over three hours later, she was left lifeless and cut open on an operating table.

Kaylynn Carson had trusted them. Trusted the smiling staff and their soft reassurances. She let them split open her chest open, touch her heart, and experiment in the name of something bigger. All for a chance at getting back on her feet financially. All for the money VIREN promised her in the application.

She was a kind, simple girl from Mississippi- a little too trusting, a little too naïve. In the end, her warmth had been met with sterile gloves and stone-cold detachment. The moment her heart stopped beating, she became nothing more than a data point, a failed variable in a trial that would quietly be revised and repeated.

Outside, in the parking lot, her pickup truck still sat. Empty. Quiet. She would never climb back inside it and drive it home.

In the end, she would be forgotten. Her records shuffled into silence. Just another case at VIREN.

[kk095]

Dr Jen’s Seizure

*Good evening everyone! I'd like to try something a little different tonight by utilizing one of my other recurring characters as a patient for once. Hopefully you enjoy the story!*

First year ER resident Dr Jen Zhang didn’t stand out at first glance. Petite and soft-spoken, she moved through the emergency department like a whisper rather than with a commanding presence. Her scrubs were always clean and tidy, ID badge perfectly aligned, shoes quiet against the tile floors, her shoulder length hair with bangs always neat. She was the kind of resident who apologized before asking a question, who triple-checked dosages before administering even the most routine medication, and who still looked slightly startled every time someone referred to her as “Doctor.”

Jen had grown up in a household where excellence wasn’t praised- it was the expectation. The daughter of strict, uptight parents, she had been raised in the narrow corridor between high performance and quiet obedience. Straight A’s were the baseline. Anything less was unacceptable. There was no teenage rebellion, no school dances, no late-night parties or messy breakups. At twenty-six, she had never been kissed. Never dated. Never broken the rules. She carried herself like someone who was still waiting for permission to take up space.

Despite her quiet demeanor, Jen was sharp, quick-witted, intuitive, and deeply compassionate. The attendings had noticed it early. Dr Lindsay saw it in the way Jen handled a combative trauma patient without flinching; Dr Sarah saw it in her notes, which were meticulous and thorough. She learned fast, worked hard, and rarely complained. Her hands trembled the first time she inserted a central line, but she got it done on the first try. Lindsay had told her afterward, “You’re better than you think you are”, to which Jen had blushed so deeply that even her ears turned red.

Jen idolized her seniors- watched the way Lindsay barked orders during a code, the way Nurse Heather moved with practiced efficiency, the way Nurse Nancy had an answer for everything, and the way Sarah never seemed to second-guess herself. Jen admired them all, but she carried a low-grade fear of disappointing them. Even praise made her uneasy, as though she hadn’t truly earned it.

On most nights, she stayed late. Not because anyone asked her to, but because she couldn’t bear the idea of not knowing enough or missing something. She studied protocols between patients. Replayed procedures in her head on the ride home. She didn’t go out much. Her apartment was small, quiet, and filled with color-coded flashcards and half-finished cups of herbal tea. She told herself she’d catch up on life eventually. There was time.

The emergency department was often a blend of urgency, bright lights, blood, and noise, but Jen found meaning and fulfillment in the chaos. There was something sacred in stitching a wound, intubating a crashing patient, or holding pressure on a bleeding artery. She didn’t need to be the loudest voice in the room. She just wanted to be useful, steady, and a part of something.

She was all potential. A careful, quiet light not yet fully aware of its own brilliance.

And perhaps that’s why it felt so strange the way that light would go out. Not with ceremony. Not with warning. Just like flipping a switch. As if some unseen cord had ripped, and all that promise had nowhere left to go.

There had been nothing unusual about that particular night.

Jen had been on shift since the early afternoon, tucked into her corner of the ED, reviewing labs, entering notes, following up with consults. She’d been quiet, as always- present, attentive, a reliable extension of the team. She’d asked Dr Lindsay a question about a patient with chest pain, her voice soft, almost hesitant. Later, she’d helped Heather re-stock the crash cart, checking the expiration dates with meticulous care, oblivious to the fact those meds and bits of equipment would be used on her a little while later. No one noticed anything wrong. Why would they?

She had smiled once, just briefly, when Dr Sarah tossed her a protein bar and told her to eat something, for God’s sake. It was a moment like a hundred others in a shift that felt like a hundred more. Background noise, fluorescent light, footsteps pitter-pattering, beeping monitors. A totally normal night.

Then came the scream. It hadn’t come from a patient. It came from Heather. The young nurse saw that Jen was on the ground over by the main nurse’s station, her body jerking, arms flailing, eyes open far too wide. Just like that, the night’s mundane rhythm broke.

Everyone descended onto the scene and sprung into immediate action. Jen was quickly moved to a table in trauma room two, stripped barefoot, light blue scrub pants soaked at the groin from peeing herself, her black sports bra lightly damp with sweat. She convulsed violently atop the trauma room table, muscles tensing in full tonic-clonic fury. Her limbs flailed with a raw, involuntary power- arms slamming against the side of the table, back arching with each wave of short-circuited chaos firing through her brain. At the far end of the table, her small bare feet flexed and spasmed, toes curling tight, white nail polish catching the fluorescent lights. The young resident’s size 6 feet tensed with each movement, the thin, wavy wrinkles in the soles of her feet on full display, as if every muscle fiber in her body were rebelling all at once.

Her eyes were wide. Staring. Terrifyingly present. Brows raised, forehead crinkling, her lips pale and parted around the guedel airway the team just jammed between her white teeth. Gurgling rattles escaped her throat, interspersed with harsh, gasping grunts as her body fought against itself. EKG electrodes clung to her fair skin, wires shifting with each spastic motion. Two freshly placed IV lines snaked from her arms, already running fluids and anticonvulsants at full tilt.

"Jesus..." Sarah muttered as she stepped into the room behind Dr Lindsay. "How long has she been seizing?!"

"At least five minutes since Heather found her." Nancy called out, gripping the ambu bag attached to a mask that hovered just above Jen's face, poised to take over. "Ativan already pushed. No response." Heather added.

"Push Ativan again!" Lindsay barked, eyes scanning the monitor. "Sinus tach, 130s. PVCs showing up. She's gonna crash if we don't get this under control." Dr Sarah spoke, looking over at the heart monitor. 

Jen groaned again, a pitiful, guttural sound. Her eyes never blinked.

Heather moved quickly, getting the next dose of meds ready while Nancy worked to maintain airway positioning. Sarah grabbed the laryngoscope, more by habit than decision, preparing for the inevitable, before setting the metal object on a tray beside the table. Jen's body continued to jackknife in brutal rhythm: uncontrolled, raw, and seemingly endless.

"Give her a round of IV Keppra, the seizure isn't slowing." Lindsay shook her head.

"Pushing now. No change so far." Heather pinched her lips, looking towards both Lindsay and Sarah. 

Time collapsed into a blur of motion. Jen's seizing showed no sign of slowing. Every few seconds, her back would lift violently from the table, arms trembling, fingers splayed. The heels of her bare feet beat against the padded table in erratic, scraping thuds. Toes scrunched and released, her legs twitching from overstimulated nerves.

Then, without warning, she just stopped. The resident’s body collapsed into stillness. A limp, sweat-slicked heap on the trauma room table. Nancy placed two fingers on Jen’s neck to feel her carotid. “No pulse!”

The monitor screamed: pulseless ventricular tachycardia. The jagged peaks of the arrhythmia ran across the screen.

"Start compressions! Let’s get the paddles ready!" Lindsay moved fast, already at Jen's side, snipping her black sports bra off. Heather stepped onto the stool beside the table and drove her gloved hands into Jen's sternum. The table rattled with each violent thrust. Jen's head lolled with every pump, her hair lightly damp and clinging to her temples. Her pale lips parted beneath the end of the bite block. Her chest- flat, delicate, and skinny, caved deeply under the pressure, recoiling hard, her belly rippling unnaturally with each compression. Her toes scrunched and relaxed reflexively, flashing the white polish on her nails and the fine, delicate throughout her soles.

Sarah lowered the defibrillator paddles to Jen's bare chest, gel smearing as she pressed down firmly. "Charging, 200 joules!"

The monitor beeped a ready tone.

"Shocking! Clear!!!"

Jen's body tensed and convulsed. Her heels lifted an inch off the table and slammed back down with a thud, her wrinkly soles the center of attention once again. Her arms twitched violently to the sides. Her torso arched, then slumped. Her eyes- wide open and unblinking, stared upward, blank and helpless. As the controlled electrical current passed through her, she let out a harsh, drama gasp- a reflex, not breath.

"Still v-tach! No pulse!" Nancy called out, bagging twice more. Jen's chest rose with the forced air, then fell again.

"One milligram epinephrine in." Lindsay reported, already prepping the next round.

Lindsay then moved to the head of the bed, leaning in, intubation equipment in hand now, taking the laryngoscope from a tray beside the table. The laryngoscope slid across Jen's tongue, prying her jaw open wider. The vocal cords flashed into view. The 7.0 ET tube passed smoothly through them. No gag. No resistance.

"Ok... tube’s... in! Confirming placement." Dr Lindsay thought out loud, putting the finishing touches on the intubation.  

Post-intubation, there was another shock. Another lifeless jolt. Jen’s limbs spasmed. Her toes curled tight. A single tear, unnoticed, slipped from the corner of her right eye, cutting a slow trail down her cheek.

The rhythm worsened: coarse v-fib.

"Looks like v-fib. Charging again to 300. Clear!"

The team zapped the beautiful young resident again. Jen’s petite frame convulsed violently. Her chest snapped upward and then crumpled back. Her body trembled, reacting, and then went limp. Her face, once animated and alive, had begun to fall slack. Jen’s pupils were already fixed and dilated just 6 minutes into her cardiac arrest. 

Minutes passed, each one faster than the last. More epi and amiodarone. More shocks. More compressions. The room blurred into repetition: charge, shock, pump, breathe, repeat. Her rhythm didn’t budge one bit.

"Looks like refractory v-fib..." Lindsay muttered, shaking her head. Her tone was clipped, almost mechanical.

The monitor screamed its resistance. Still no change whatsoever, practically mocking the team's efforts. 

Jen's eyes, impossibly wide, stared upward as if waiting for something that wouldn't come. Her chest sank with every forceful compression from Nurse Heather, chest thudding faintly beneath the pressure and force of the resuscitation efforts. The resident’s body trembled but never fought back. Her hands bobbed gently at her sides, perfectly in sync with the chest compressions she was receiving.

Before everyone knew it, they were twenty-five minutes into the code.

Heather was still compressing- gloved palms crashing into Jen’s sternum. Lindsay stepped closer, her expression unreadable. Without a word, she reached down and gently took Jen’s hand in her own. It was cold. Stiff. Small. Lindsay held it to her chest, looking down into Jen’s face, seeing those unblinking eyes and tear-streaked cheek.

Lindsay finally spoke, breaking the tense silence. "Heather, hold compressions, please."

The nurse nodded, then stepped away. The rhythm on the monitor didn’t change. Just the same jagged, chaotic waveforms as before.

"Nancy, let’s go ahead and disconnect the ambu bag." Continued Lindsay.

A soft click and quiet hiss followed. Jen’s chest stopped rising.

After a pause, Lindsay’s voice was firm, but low, still holding Jen’s hand close to her chest. "Time of death, 23:35."

Sarah immediately silenced the monitor without saying a word.

No one moved at first, the words still buzzing around in everyone’s heads for a bit.

Heather stepped back a little further from the table, slowly. Nancy removed the EKG wires, her latex gloves brushing Jen’s cool skin.

The resident didn’t move at all. She didn't react to anyone's touch in the slightest. 

Her small, petite frame lay motionless on the table, sweat-dampened and exposed. Dr Jen’s bruised, battered chest no longer heaved. The resident’s pale lips remained slightly parted. The faint crinkle in her brow had softened only slightly, frozen somewhere between fear and fatigue. Her eyes still stared upward, wide, lifeless, and unblinking. Nancy gently leaned in and closed them. Two fingers. One smooth pass.

The bite block was left in place, along with the detached endotracheal tube. Faint indentations marked where Jen’s teeth had clamped down on the bite block during the seizure.

Lindsay never let go of her resident protégé’s hand while the team continued postmortem care on her. Dr Sarah began filling out the toe tag, writing in absolute silence. The tag was looped around the big toe of Jen's left foot, brushing gently against the bottoms of her feet. 

Heather reached for the white sheet, folding it once before drawing it upward. She hesitated for a second as she hovered over Jen’s face. Then slowly, gently, pulled it up over her chin, her nose, her eyebrows. Jen looked impossibly small beneath the sheet. Shrunken. As if the fullness of her promise, her potential, and her presence… had simply disappeared.

No more alarms. No beeping. Just eerie silence in trauma room two. A silence that said she would not be coming back. And that somehow, the world would keep turning without the beautiful, promising resident who was taken so unexpectedly. 

In this alternate reality, Dr Jen died in the same place she had spent so many nights learning and growing - where she had studied every rhythm, memorized every protocol, followed every word from Lindsay and Sarah. The trauma bay had been her classroom and her proving ground. And in the end, it became the setting of her final moments on this earth.

Jen never got her big moment. Never found her voice. Never knew how much everyone believed in her. And now they never got to tell her.

The resident’s story ended not with triumph or transformation, but with silence - the kind that creeps in when potential slips through your fingers before you realize you were holding it at all.

All that remained was a beautiful young doctor toe tagged and under a sheet, in the very place she was meant to come into her own.

[kk095]

Olivia’s Unfinished Story

*Happy Friday, everyone! I wanted to try something a little different this time around. I hope you enjoy!*

Her name was Olivia.

She was the kind of woman you might overlook in a crowd- slim, fair skinned, with straight, light brown hair that she kept neat and cut to her shoulders. Her bangs sat just above a pair of green eyes that always seemed to be watching, not out of shyness, but observation. At 5'8, the twenty-eight year old carried herself with quiet poise, a strange mix of bookish awkwardness, and buttoned-up grace. Her wardrobe was sensible- cardigans and slacks, modest blouses, neutral tones. It wasn’t that she lacked style; she simply didn’t think anyone was looking closely enough to warrant the effort.

By day, Olivia worked a corporate job in a beige office on the twelfth floor of a building with too much glass and not enough personality. Her cubicle was tidy. Her emails were prompt. She was the type who remembered birthdays, who always signed her messages with "Best," and who brought her lunch from home in reusable containers labeled with masking tape. Her coworkers liked her well enough, though they never really knew her. She existed on the periphery- reliable, polite, self-contained.

But at night, in a small apartment with a flickering desk lamp and chipped mugs of tea, Olivia became someone else. She wrote under the name "S.R. Quinn," a pseudonym she guarded like a secret lover. Her stories- twisting, cerebral mysteries filled with unreliable narrators and haunted minds, had attracted a quiet, devoted following online. Some of her readers speculated about the author's identity, but she never gave herself away. Olivia preferred it that way. Her characters said all the things she couldn’t. They unraveled in ways she never allowed herself to. Writing, for her, was a kind of release- a hidden doorway she stepped through every night.

She lived alone, but it never really felt lonely. Her walls were lined with shelves full of books, and her laptop bore the fingerprints of a thousand edits.

She had routines: the same route to work, the same booth at the quiet café near her apartment, the same brand of peppermint gum always tucked into her bag. Sometimes, on the subway, she would look at the people around her and wonder who among them led secret lives, too. It comforted her to think she wasn’t the only one pretending.

There were things she still wanted to do. A novel half-finished. A mystery not yet solved. A character she hadn’t quite figured out.

She had no idea she would be the latest patient in our emergency department. Last night, that’s exactly what happened to Olivia.

The trauma bay lights cast a sterile glow across her pale skin, and her chest bucked beneath gloved hands performing deep, violent chest compressions. The monitor beside her beeped incessantly in arrhythmic protest, displaying a jagged line of ventricular fibrillation. Beneath it, a stack of empty syringe caps and torn vials spilled from the tray, scattered among crumpled wrappers and used IV bags.

She lay supine on the table, stripped barefoot and topless, her bare chest glistening with conductive gel under the harsh overhead lights. Her green eyes were wide open- glassy, unblinking, eerily serene. The endotracheal tube jutted from her mouth, hugging her pale lips, secured tightly with tape, and the soft hiss of the ambu bag filled her lungs with each squeeze. Her pants remained on, the dark fabric in contrast to the table. There were no bruises, no blood, no visible trauma. Just a stillness that didn’t belong in a room like this.

The rhythm of chest compressions played like a grim metronome, gloved hands stacked over her sternum, pushing deep and fast. Each thrust drove Olivia’s chest down in sharp, unnatural motions, her ribs caving beneath the pressure. With every compression, her chest recoiled slightly, the skin pulling tight before collapsing inward again. The force rippled outward through her torso, making her belly tremble faintly.

The defib paddles were pressed against her bare chest. “CLEAR!” Dr Lindsay called out.

Her back arched as the jolt surged through her, then fell limp again. No change. Someone stepped up to resume CPR. The rhythmic thud of gloved hands on her sternum resumed, tilting her motionless face slightly with each thrust.

After that unsuccessful cycle of CPR, the paddles pressed back down against her bare chest, gel smearing beneath them. “CLEAR” Lindsay called once again. A sudden jolt of electricity surged through the writer’s body. Olivia’s back arched sharply, her spine lifting off the table in a stiff, unnatural bend. Her legs jerk in response- one foot kicking upward involuntarily, the other twisting inward, toes curling hard. For a split second, both feet hover awkwardly in the air before crashing ungracefully back down to the table. Her soles, flushed pale from poor perfusion, land heel-first, the deep, wide, soft wrinkles of her size 10 soles visible before her body goes slack again, motionless except for the rhythmic force of compressions that resumed after.

Another shock was delivered. A gasp escaped Olivia’s lips, though it was more of a reflex than a sign of life. Another cycle CPR ensued. A dose of epinephrine. Gloved hands moved with rehearsed precision, voices sharp, clipped, and clinical.

“Still in v-fib, Linds.” Nurse Nancy informs, shaking her head. “No pulse.” Dr Jen the resident chimes in.

“I’m shocking again. Re-charging the paddles to 360. CLEAR.” Lindsay responded, Heather halting CPR and stepping away from the table.

KA-THUNK! Olivia’s body jumped. The flat, lifeless gaze remained on her face. Her expression was untouched by fear or pain, frozen somewhere just before the end.

The next shock came and went. Her body jerked with unnatural stiffness, like a puppet pulled by unseen strings. For a breathless second, she froze midair- fingers curled, toes flexed, then collapsed on the table once more, as if gravity remembered her all at once.

Chest compressions resumed, but not for long. For a moment, the room stilled- hands hovered, eyes glanced to the monitor. A flatline stared back at everyone, unbroken and absolute.

“No cardiac activity on the monitors.” Jen the resident informed, calm and even, like they’re noting the time of day.

Nancy leaned in, shining a penlight across both of Olivia’s eyes. Nothing. No flicker, no constriction, no reaction whatsoever- just the blank, glassy look of fixed and dilated pupils.

A quiet pause passed.

“She’s been down forty minutes.” Lindsay speaks, voice low but certain. “Let’s go ahead and call it. Time of death, 1:11am.”

The ambu bag was detached from the ET tube and set beside Olivia’s head on the table. Chest compressions stopped for good. Heather shut off the monitor, muting the flatline. The paddles were placed back on the crash cart, the ECG leads peeled away, electrodes discarded in silence.

Olivia had written dozens of stories. None of us knew that, of course. Not Heather peeling off her EKG leads, not Dr Lindsay logging her time of death, not Dr Jen placing the sheet over her body. In life, she had been anonymous. In death, she remained so.

But somewhere, tucked into online archives and under a username no one could now trace, there were worlds Olivia had built. Complex characters. Tangled mysteries. Paragraphs people had read and re-read and bookmarked to revisit. She had more to tell. But last night, her story ended right here in our emergency department.

[kk095]

The Clinical Trial

The sterile, sleek white walls of the research facility gleam under recessed lighting, giving the space an ultramodern, almost futuristic vibe. Everything is clean, clinical, and controlled. The faint hum of machines and the soft tap of footsteps on polished floors echo in the otherwise hushed corridor.

Dr Lindsay Wilkes steps through the frosted glass entryway doors with a small smile tugging at her lips. Dressed in a fitted gray blazer over a white casual top, dark jeans, and her usual quiet confidence, she looks more like a visiting speaker than a test subject. Her light brown hair is pulled back into a neat ponytail, and a thin silver necklace rests just above her collarbones.

Waiting for her near the intake desk are the trio running the clinical trial.

Dr Anna- early 40s, commanding presence, jet black hair pinned in a French twist, is the first to greet her. “Dr Wilkes” she begins, voice smooth and welcoming. “We’re honored to have you here. Your impressive background makes you a perfect candidate.” Dr Anna compliments.

Next to her is Dr Olivia, younger- in her early 30s, and a touch more energetic, all sharp cheekbones and quick glances, followed by Nurse Ashley �� blonde, polished, clipboard in hand, her smile just a little too wide. “We’re big fans of yours. ER doctors make the most interesting subjects.” Ashley adds. Lindsay laughs lightly, brushing a loose strand of hair behind her ear. “Well, I’m just excited to be a part of this. I’ve been reading up on your work- it’s absolutely fascinating.” Lindsay replies enthusiastically.

“Oh, Cardexor has the potential to change the game.” Dr Anna replies, referencing her experimental medication without hesitation. “Performance enhancement, cardiac precision, stamina… all by gently modulating ion flow. You’re going to be part of history!” Dr Anna boasts.

The trio guides Dr Lindsay down a pristine hallway to a large, open exam room. Inside, the air smells faintly of antiseptic and ozone. A sleek white bed sits beneath a wall mounted monitor.

“Alright, Lindsay.” Nurse Ashley says, setting her clipboard down on a nearby countertop “we’ll have you get out of your clothes now. You can leave your personal items on the tray beside the bed.” The nurse instructs Lindsay.

The ER doc nods and starts to remove her blazer and shoes, then peels off her jeans, folding them neatly. Within moments, she’s barefoot on the cool tile floor, clad only in a gray sports bra and compression shorts. The silver necklace still rests around her neck- a small piece of personal flair amid the clinical setting.

Lindsay hops onto the exam table, sitting upright as sticky ECG leads are applied across her chest and torso. The monitor lights up with a steady rhythm- normal sinus. IV lines are started, her blood pressure is taken. Everything checks out. Everything’s good to go. Dr Olivia studies the monitor. “Vitals are solid. Baseline EKG is clean. You’re textbook, Dr Lindsay.”

Lindsay grins. “Let’s hope I stay that way!”

Dr Anna offers a nod, though her expression doesn’t quite match the enthusiasm. “We’ll begin the first infusion shortly. Just relax. If anything feels off at any point, speak up. This is cutting-edge science, but you’re still in control.” Anna tells Lindsay.

The team exits momentarily to prepare the first dose, leaving Lindsay alone on the table, feet dangling slightly, watching the quiet green blips on the monitor. She seems calm and confident. She has no idea that her name will soon be the third entry in a growing list.

Dr Lindsay reclines slightly on the padded exam table, IV already in place. The ultramodern room remains relatively calm, with faint mechanical beeps from the heart monitor and the subtle hiss of the air conditioning from a vent in the ceiling. A flat-panel screen nearby glows with her live vitals- all still perfectly normal. Her blazer is neatly folded on a nearby chair. Barefoot, dressed down to a charcoal gray sports bra and black compression shorts, she looks more like a training athlete than an ER physician about to become a patient.

Dr Anna re-enters the room and steps up with a small vial of clear liquid, hooking it to the IV line, careful and precise in her movements. “This is it- Cardexor, the newest evolution in cardiac modulation.” she tells Lindsay with an excited smile, though there’s a flicker of something unreadable in her expression. “You’re officially our tenth volunteer in the trial!”

“Great, double digits. Glad I get to be a part of this!” Lindsay says lightly, giving a small smile, eyes flicking toward the monitor, her vitals still normal.

Dr Olivia adjusts the infusion pump. “We’ll be starting with a conservative dose and monitoring for about twenty minutes. Most of the pharmacokinetics are pretty quick. You should start noticing some sensations within a few minutes.” Dr Olivia explains.

“Side effects?” Lindsay asks, watching the clear liquid drip down the line into her vein. “Tingling, maybe some lightheadedness. Nothing to be worried about.” Dr Olivia answers too quickly. Nurse Ashley, standing at the foot of the table, gives a practiced smile but avoids eye contact with Lindsay.

A few minutes pass. The room is quiet except for casual small talk and monitor beeps. Then…

“Hmm… I’m… feeling something…” Lindsay murmurs, brow furrowing slightly. “There’s a little tingling in my chest. Like pins and needles.” Continues Lindsay. Dr Anna nods, jotting something on a digital tablet. “That’s totally expected. That’s just the Cardexor fine-tuning those ion channels, nudging the signal transmission. All part of the process.” Dr Anna dismisses Lindsay’s symptoms. Lindsay shifts a little. “My head’s kind of floaty too, almost like I got up too fast.” Complains Lindsay. “You’re doing great, this is all normal.” Nurse Ashley says with gentle encouragement, though her eyes flick quickly to the monitor. Lindsay’s heart rate has crept up from 100bpm into the low 120s- just high enough to be noticeable, but not necessarily alarming.

Dr Olivia presses the back of her hand to Lindsay’s forehead. “No fever. Any tightness in your chest?” she asks. “No… just… pins and needles.” Lindsay breathes in slowly, and though she’s still calm, there’s a subtle tension in her voice now. “We’re right on track.” Dr Anna smiles, a little too tightly.

Lindsay closes her eyes for a moment, her brows raising ever so slightly as she took a slow, steadying breath. She was still trying to convince herself it was nothing- just her body adjusting, just nerves, perhaps. The fluttering in her chest lingered like an aftershock, faint but persistent.

A soft beep drew Ashley’s eyes to the monitor. Lindsay’s heart rate had climbed again- nothing dramatic, just a little higher than before. But it stayed there, holding steady at the new pace like it had found a rhythm it wasn’t supposed to. None of the women said anything. For a moment, the room was filled with an unnatural stillness, like the quiet just before a storm.

An hour or so passes since the infusion started. Lindsay sits upright on the exam table, legs extended and crossed at the ankles, her bare heel resting on the padded surface. She rubs her sternum with the heel of her hand, the gesture casual at first, then more deliberate. “There’s this weird tightness now…” she tells the team, her tone light, but her eyes searching. “I also feel a pinch. Right in the center.” Continues Lindsay, gesturing to the location on her chest. Dr Olivia steps in with her usual serene smile. “That’s not uncommon. Some participants report transient chest sensations while the ion modulation stabilizes.” Olivia explains. “Transient?” Lindsay replies. Nurse Ashley adjusts the IV line, her movements smooth and practiced. The telemetry monitor gives a soft beep, a little quicker than it was earlier. Lindsay glances at the screen, noting the climb: heart rate hovering in the low 130s now. “Still sinus.” Anna informs, peering at the readout and tapping a few notes into the tablet. “We’ll push a little metoprolol just to keep things where we want them.” Instructs Dr Anna. Lindsay nods, overhearing them, breathing through another round of pins and needles. She shifts her shoulders and tries to relax, but the rhythm feels off inside her chest- like something ticking out of sync.

Then, just for a second, Lindsay catches a look. Olivia’s eyes flick to Anna, subtle, concerned, but enough to tighten something low in Lindsay’s gut. She offers a half-smile to cut the tension. “Okay… what was that look all about? I’m not gonna be toes up in the morgue anytime soon, am I?” Lindsay half-jokes. Anna chuckles. “God, no! You’re doing great. These are just fine-tuning effects. Your body’s just adapting. It means the compound is working.” Anna explains away.

Lindsay leans back a little, not totally convinced, but willing to believe it for now. “Alright. Just don’t let me die half naked in my compression shorts.” Quips Lindsay. They all laugh, perhaps a little too quickly.

Ashley hangs another saline flush, and the monitor continues its steady beep… beep… beep, like a ticking clock. Lindsay closes her eyes briefly, exhales, and rests her hand against her chest again. Something’s not right. But she doesn’t know just how wrong it’s about to get.

The clinical room, once sterile and composed, now buzzes with a subtle but unmistakable undercurrent of tension. The rhythmic beeping of the heart monitor had sped up, edging into a range that triggered the machine’s soft warning tones. Lindsay sat upright on the exam table, eyeing the monitors. A sheen of sweat began to form across her collarbones, and her breathing, while controlled, speeds up.

She presses the palm of her hand against her chest, fingertips trembling slightly. “I’m still feeling it…it’s worse…” she utters quietly. “It’s much sharper now- like a pinch just behind my sternum.” Adds Dr Lindsay, concern in her voice. Anna glances up from the monitor with a tight smile. “That’s probably the beta stimulation- it can happen at this stage.” Anna downplays Lindsay’s symptoms. Olivia stands beside her, cross-checking a second monitor. “Heart rate’s up, but still within protocol range.” She informs. “Still in protocol? That’s good.” Lindsay repeats, her voice flat, lips twitching into a weak half-smile.

She exhales and glances around the room. “Have you guys ever tested this on ER docs before? Or am I your guinea pig with a stethoscope?” jokes Dr Lindsay. Ashley chuckles softly from the IV station. “Nah, you’re our star subject! Clean vitals, athletic background- you’re ideal.” Ashley responds. But Lindsay wasn’t buying the reassurance this time. Her eyes flick over to the monitor again. The QRS complexes had widened. Her trained gaze pick up on it, even before the machine sounded another beep, this one more insistent.

She narrows her eyes. “Wait, that’s… V-tach.” Lindsay looks to Anna. “You’re seeing it too, right?” asks Lindsay. Anna hesitates for half a second- just long enough for Lindsay to catch it. “It’s a nonsustained run. We’re monitoring. You’re still stable.” Anna brushes it off. “Stable? That’s a curious word choice for this rhythm.” Lindsay firmly replies, her voice tighter now. Olivia busied herself at the bedside, adjusting the telemetry leads. “You’re still perfusing well. BP’s solid. Let’s get some fluids in, maybe push a touch of lidocaine.” Olivia chimes in.

Ashley moves efficiently, drawing up meds. The quiet hiss of saline through the IV port was almost drowned out by the monitor’s quickening beeps. Lindsay’s heart rate hovers just over 160- still with a pulse, still conscious, but each beat seemed more jagged than the last. “I’m not trying to be dramatic, but if this keeps up much longer, someone’s going to need the crash cart.” Lindsay murmurs to the team. Anna’s voice was gentle. “It’s ok. We have a protocol for situations like this.” Anna was clearly running out of things to say to dismiss Lindsay. Dr Lindsay turns her head slightly toward her. “You answered that a little too fast, Anna. What’s really going on here?!” Lindsay knows something’s off.

Another glance passes between Anna and Olivia- brief but tight.

“What was that look?! You did it again!” Lindsay shouts, more nervous this time. Olivia leaned closer, offering a steadying hand on Lindsay’s shoulder. “You’re fine. This is what the close monitoring is for. You’re in good hands.” Olivia tries to reassure. Lindsay gave a single nod, but her gaze drifted back to the monitor. The screen now showed a classic wide-complex tachycardia, consistent with sustained V-tach. Her expression remained composed, but her breathing had deepened, a thin tremor in her arms now visible. “Okay… stay strong, Linds…” she whispers, mostly to herself.

Several minutes pass, and the EKG monitor let out a steady whine as her heart continued to race inside her chest. Her breathing came in shallow, focused puffs. “I’m still with you…” she murmurs, glancing from one face to the next. “This is still manageable… right?” asks Lindsay, growing increasingly uneasy. Dr Anna didn’t answer immediately. She was at the head of the bed, eyes locked on the monitor. “V-tach, still with a pulse.” Anna confirms, more to Olivia and Ashley than to Lindsay. Dr Olivia steps to Lindsay’s side, readying the crash cart. “We need to cardiovert you. Now.” States Olivia. Lindsay’s eyes shift to the defibrillators, then back to Olivia. “Oh…” Lindsay utters. “Yep. We’re going to get this handled for you.” Ashley said, voice quick and clipped as she peels open a fresh pack of defib pads. “Synchronized. It won’t be fun.” Ashley adds.

“Are you sedating me?” Lindsay asks. A beat of silence passes. Dr Anna shook her head. “We can’t in your case. And you’re still responsive. It’ll hurt- but it’s absolutely necessary.” Anna explains, her tone more stern. Lindsay swallows hard, a flicker of fear behind her eyes, but she nods. “Do it.”

Ashley places the pads quickly- sternum and apex, while Olivia set the charge. Dr Anna presses gently but firmly on Lindsay’s shoulder to keep her still. “Lindsay, we’re going to shock you now, ok?” Informs Dr Anna. Lindsay just nods in response, her stare blank.

“Defibrillator is charged to 150 joules. Everyone stand clear for me.” Olivia calls out.

The first shock is delivered, and hits her like a freight train.

Lindsay’s chest shoots forward, her back bending a bit. A strangled cry exits from her throat- pure reflex. Her heel scraped along the thin mattress, toes curling hard, showing off the fresh white nail polish on her toes along with the thin, wavy wrinkles throughout the soles of her size 12 feet. The monitor responds with a blink… but the rhythm held steady in V-tach.

“Still in VT.” Ashley mouths, frowning at the screen. “Olivia, charge again to 150.” Anna instructs, already reaching to steady Lindsay again. Lindsay’s breath caught. She didn’t say a word, but her eyes- glassy now, fixed on the ceiling like she was bracing herself for a wave.

“Defibrillator is charged to 150 joules. Everyone stand clear for me.” Olivia calls out.

The second shock came, feeling harder than the first. This time, Lindsay screamed. It wasn’t theatrical- just a raw, involuntary sound that erupted from somewhere deep in her chest as the electricity races through her. Lindsay’s necklace swung against her collarbone with the motion. Her face contorted in pain, eyebrows raised, forehead crinkling, and for a moment, she didn’t seem to breathe at all. “Still no change, everyone.” Ashley informs.

Olivia’s hands were already moving. “Charging defibrillator to 200 joules.” She calls out. Lindsay blinked slowly, chest rising in shaky bursts. “Do it…” Lindsay rasped, through gritted teeth. The third shock landed like thunder.

Her entire body tenses up hard, shoulders shrugging forwards, both her hands making loose fists. Lindsay let out a pained moan, feeling the quick jolt of electricity work its way through every square inch of her 6’1 body.

Then, there was quiet. The monitor let out a softer tone. It was still fast, but regular. “Sinus tach.” Ashley confirms. A small breath of relief escaped her lips. “She’s back.” Anna smiles, feeling relieved. Lindsay let her head fall to the side, breathing fast and shallow, face pale, lashes wet. “Jesus. Never again!” she blurts out . Anna gives her a tight nod. “You’re stable for now. That’s what matters. We’ll let you rest for a bit.”

Over the coming little while, Lindsay remains in sinus tachycardia. Lindsay lay back against the inclined bed, a sheen of sweat still clinging to her collarbones. Her chest rose and fell with steady rhythm now, the erratic pounding finally tamed into something bearable. Electrodes remain stuck to her skin, telemetry still beeping softly nearby, but the atmosphere in the room had shifted.

Dr Anna stood at the foot of the bed with her arms crossed, watching the monitor with clinical focus but no urgency. Olivia leans on the nearby counter, half-sipping from a water bottle, while Nurse Ashley updates a chart on the tablet in her hand.

“You’re doing great, vitals improving.” Anna told Dr Lindsay with a smile that, for the first time, didn’t feel rehearsed. “HR’s holding steady in the 120s- definitely an improvement from earlier.” Adds Anna. Lindsay let out a breath through her nose, almost a laugh. “As an ER doctor, I’ve shocked plenty of people in my day. I never thought I’d be on the receiving end.” she jokes, reaching up to rub where the defib pad still sits.

“You took it like a champ.” Olivia chuckles. “Didn’t have much of a choice, did I?” Lindsay replies, managing a grin. “You all decided I was the world’s best science experiment.” Lindsay quips. Ashley offers her a bottle of water and a gentle pat on the shoulder. “Hang in there, Doctor. You’re helping us learn something important.” Encourages Nurse Ashley.

Lindsay takes the water and sips, but her fingers tremble faintly around the plastic bottle. It was subtle. Easily missed. And maybe she was just a little out of it, considering she was just shocked three times.

The heart monitor beeped at a calm, consistent pace.

Still, she noticed the way Dr Olivia’s eyes flicked to the screen just a second too long. How Anna’s posture stiffened just slightly when Lindsay shifted in the bed. How Ashley’s smile didn’t quite reach her eyes. Lindsay caught it just barely. “You all okay?” she asks, raising an eyebrow. Anna laughs nervously. “The worst part is over. You’re doing just fine.”

Olivia added, “We’ve got eyes on everything. You’re in good hands.”

Lindsay leans back, letting the water bottle rest on her lap. She wasn’t sure if the creeping unease was just her imagination or the return of something real. But for now, she chose to believe them. The lights dimmed slightly as the sun began to set outside the high windows. Machines hummed softly. Monitors blinked. Everything was fine.

Another twenty minutes had passed. The room had grown still again, except for the soft beeps of the heart monitor. Lindsay sat upright, her color a touch better, a thin blanket drawn across her lap. Her breathing had evened out. Olivia had just made a quiet note in the chart, and Ashley was adjusting an IV pump when it hit.

Lindsay flinched. It was sudden and sharp. Her hand shot to her chest, pressing just beneath her left collarbone. Her brow creased, forehead crinkled, as she leaned forward, lips parting in a shallow gasp. “Oh god… something’s wrong.” Lindsay murmured. The heart monitor confirmed it a second or so later, the steady rhythm giving way to a rapid, fluttering series of beeps.

Ashley’s head snapped toward the screen. “Telemetry just jumped, she’s spiking again.” Informs Ashley. Anna crossed the room in three strides. “Lindsay, talk to me. What are you feeling?” Dr Anna asks, her tone clipped and stern. “chest pain… palpitations… Something’s really really wrong…” answers Lindsay. She sucked in a breath. Her eyes darted to the monitor and back to Anna. Her composure was crumbling now- still holding, but fraying at the edges. “Rate’s climbing. 160 and rising.” Olivia informs. Anna’s voice stayed even. “We’ve got it. You’re still in a rhythm we can manage.” Anna reassures. But even as she said it, she was pulling on a pair of gloves, and Ashley was already prepping another IV med. The room had taken on a charge- quiet, but tense.

Lindsay’s grip tightened on the edge of the bed. Her breaths came faster and more shallow. “I thought we fixed this! Why is it happening?!” Lindsay shouts. Ashley and Olivia exchanged a quick glance. Nothing overt, just enough to register. Lindsay caught it. “Okay. That look? I know that look.” Lindsay shook her head. “You’re okay, Lindsay.” Anna said, but it was too quick. Lindsay looked up at her, face pale, lips slightly parted. “Don’t lie to me!” Lindsay snapped. “We’re not. We’re on top of this.” Anna replied softly. The monitor beeped louder, faster. A warning tone now. 165. 170.

Lindsay slumped back slightly, wincing, her voice more fragile this time. “I feel like my heart’s trying to leap out of my chest…” Lindsay groans. Olivia moves closer to the crash cart- still calm, but with new urgency in her step. Ashley hovered by the meds, ready. “We’re staying ahead of it. Just hang with us.” Anna places a hand gently on Lindsay’s shoulder. Dr Lindsay nodded, but her eyes didn’t leave the monitor.

The sharp, rhythmic beep of the heart monitor was suddenly replaced by a blaring, erratic wail. Lindsay’s body shifted uncomfortably for a split second, her hand clutched tightly to her chest. “OH GOD…” she winced, her voice tight, barely audible. Her eyes went WIDE, pupils dilating as her body slumped.

“Lindsay?!” Dr Anna was already moving with a pep in her step. The monitor blared. Pulseless ventricular tachycardia. “Code blue!” Olivia shouted, her hand slamming the red button on the wall. Ashley lunged for the crash cart, tearing open drawers with trembling precision. Anna took lead, her voice cutting clean through the chaos. “Get the pads ready. Ashley- bag her. We need to intubate.” Anna commanded.

The air in the room thickened. Olivia snipped off Lindsay’s sports bra and began deep, strong chest compressions. Lindsay’s chest rocked beneath each forceful push. Her face, once full of quiet strength, now lay pale and motionless. “Pads ready. Charging to 200,” Ashley called out. “Hold on! Hold on! I’m intubating!” Anna pressed the laryngoscope into Lindsay’s mouth, hands steady as she passed the 8.0 ET tube down her trachea. “Tube’s in. Confirm with bag.” Anna barked. “Good rise. Tube’s good.” Ashley confirms, already squeezing the ambu bag rhythmically. “Alright, I’m going to go ahead and shock her now. Everyone stand clear!” Olivia announced. Everyone backed away.

The shock hit Lindsay. Her back arched violently, chest shot up, her hands making weak fists, plopping back down a second or two later.

“No change, resume compressions.” Anna ordered, jaw tight. “Ashley, push epi, one milligram IV.” Olivia called out, hands back on Lindsay’s chest, pushing hard and fast. Ashley administered the meds without a word.

The seconds bled together. Another round of compressions, and the meds were pushed. “Charging again- 300 this time.” Ashley took over the defibs. “Clear!!!”

Lindsay’s body twitched sharply in response. Another rush of electrical current through her tall, athletic body, but she devolved into v-fib.

“Still no pulse, looks like maybe v-fib on the monitors” Olivia observed softly, her voice starting to fray. Anna’s expression didn’t shift. “Another amp of epi. Get ready for amiodarone- 300 milligrams, push.” Commanded Anna.

The meds were pushed. CPR continued. The monitor continued to shriek.

“Charging to 360. Stand clear, everyone!” Ashley called out.

The third shock caused Lindsay’s feet to kick up an inch or so above the table, slamming back down with an ungracious THUD, showing off the thin, prominent, wavy wrinkles throughout the soles of her size 12 feet.

Anna’s gloved hands reached towards Lindsay’s neck, feeling for a carotid. “still no pulse, v-fib on the monitors.” Dr Anna shook her head.

The code continued. And Lindsay? She lay still, on the receiving end of deep, violent chest compressions. Her chest caving in, recoiling rhythmically, her toned belly with abs rippling out. The room, once full of optimism, was now silent except for the rhythmic thud of chest compressions and the hiss of forced ventilation.

The room was still bathed in harsh fluorescent light, sterile and too bright for what was unfolding. Alarms blared in their usual chaotic rhythm, but everyone had long since stopped reacting to them. On the monitor, the jagged, erratic waves of ventricular fibrillation darted across the screen. Lindsay’s body lay still on the table, her chest rising and falling only with the force of chest compressions.

“Charging again to 200. Everyone stand back for me.” Olivia announced, her voice flat from repetition. The shock hit Lindsay’s body with a jolt. Her 6’1 frame was tossed around effortlessly, arms slightly flinching outward, as the energy surged through her lifeless heart. The monitor stuttered. For a half-second, something vaguely organized sparked across the screen, then back to v-fib.

Ashley didn’t stop compressions. Her brow was damp with sweat, jaw clenched tightly as she counted under her breath. “Twenty-one… twenty-two…”

“Charging again. 250 this time.” Olivia called out. Anna just nodded, her eyes locked on the monitor, watching with clinical intensity. There was a subtle weight behind her expression now- grim acceptance beginning to settle in her bones.

The next shock was delivered. Lindsay’s body jerked once more. Another violent convulsion that looked nothing like life. Still v-fib.

“Still no pulse.” Ashley informed, pausing just briefly before going back in with compressions, her palms hitting harder than before. “We can keep going” Ashley suggests, almost pleading, her voice cracking.

Anna shook her head. “Nope. We lost her.” she said firmly, stepping back from the foot of the bed. Her voice was calm, almost too calm. “The trial drug caused mass dysfunction of the cardiac conduction system. Her heart’s no longer conductive, so we’re going to have to stop here and call time of death.” Anna explained, cold and matter of fact.

Ashley froze mid-compression. Her hands hovered above Lindsay’s chest for a second or so before she finally withdrew them. Dr Olivia didn’t say anything. She just reached over and pressed the power button for the heart monitor, which still displayed refractory v-fib. “Alright, everyone. Time of death, 18:45.” Anna broke the silence.

The room was eerily quiet now. No more beeping monitors. No more shouted commands. Just the stillness that followed the end of a code.

Lindsay’s body lay motionless on the table, chest rising no more, her head slightly turned to one side, eyes wide open, staring somewhere no one else could follow.

Nobody moved at first. Anna, Olivia, and Ashley just stood there, still in their gloves, gowns, and masks. A heaviness pressed down on the room, like it was holding its breath with them. Finally, Ashley stepped forward, reaching for the ambu bag still attached to the endotracheal tube. She unhooked it slowly, the rubber disconnect giving a soft click that echoed far louder than it should have. Olivia followed, gently peeling the defib pads from Lindsay’s chest. Anna moved in closer, hands steady as she carefully removed the EKG wires from Lindsay’s torso, one by one. No one spoke, but everyone did their part.

Ashley unwound the IV tubing from Lindsay’s arm, slipping the catheter free with an almost reverent gentleness. A soft trickle of blood followed, quickly wiped with gauze. Then, with quiet care, Olivia reached up and used her fingertips to gently close Lindsay’s wide open eyes. That blank, unblinking stare was gone.

Anna reached down, pulled a toe tag from the drawer, and began to fill it out. Her handwriting was neat and quick: “Lindsay Wilkes, MD. Time of death: 18:45.” She slipped the tag over Lindsay’s left big toe and fastened it in place, letting it dangle against the wrinkled soles of her feet.

“She’s the third one this week.” Anna spoke finally, her voice low and flat, shaking her head. “Yeah, back to the drawing board, I guess.” Olivia murmured, folding her arms across her chest. No one added anything. There was nothing left to say at that point.

Ashley stepped forward again and drew the white sheet up, first over Lindsay’s torso, then her face, tucking it in gently like she was putting someone to bed. For a long moment, the three of them stood in silence. At the end of the table, the toe tag swayed slightly, brushing softly against the soles of Lindsay’s feet, forever symbolizing Lindsay’s tragic end in what was originally supposed to be a positive experience.

[kk095]

Shay’s Sudden Arrest

The automatic doors hissed open, letting in a pair of paramedics. Between them rolled a stretcher bearing a young woman with sun-kissed skin, tangled blonde hair matted slightly to one side, and piercing blue eyes that blinked against the bright hospital lighting. She looked more like someone headed to a weigh-in than someone checking into an emergency room.

“Name’s Shay Strong, twenty-six year old female.” one of the medics called out as they proceeded towards Trauma Bay One. “Passed out cold during light sparring- she’s a pro MMA fighter. Trainer said she looked a little off just before she hit the mat. Tachycardic on scene, BP’s a little soft. No trauma. No drugs or alcohol on board as far as we can tell.” The second medic rattled off.

Dr Lindsay approached and glanced up from the chart she’d been reviewing and nodded for them to bring her in. She was already tugging on gloves as she stepped into the bay, with Dr Jen the resident trailing behind her and Nurse Heather circling around.

“Hey Shay, I’m Dr Lindsay. I heard you fainted today?” she said as the stretcher clicked into place beside the trauma room table. Shay nodded, her voice low and a little hoarse as they transferred her over to the table. “Yeah. Just felt… weird, ya know? Like, a little dizzy I guess.”

She didn’t look like the type to go down easy. Even lying flat, she carried herself like someone used to getting hit and getting back up. Her toned arms were a canvas of bold, dark ink- coiled serpents on one bicep, a geometric tiger on the other, the edges of color disappearing under the bands of muscle. A glint caught the light where a nose ring curved through her right nostril, and as Heather snipped her sports bra to attach monitor leads, Lindsay caught the flash of a piercing through her nipples. Some cursive ink framed the sides of her ribs and curved along her right thigh was a floral tattoo, all intricate.

Heather worked quickly, pressing leads to Shay’s chest and murmuring quietly. “HR’s 132. BP’s 92 over 58.”

“Got PVCs on the monitor. Could be nothing. Could be something.” Dr Jen chimed in, already pulling up a blank EKG strip.

Lindsay leaned over to meet Shay’s eyes. “Any chest pain? Shortness of breath? Dizziness before you went down?” the doctor asked. “Not really. Just… I don’t know. I’ve been feeling off the last couple days. Figured it was overtraining or something.” Answered Shay. She didn’t look panicked. Just slightly dazed, maybe a little too quiet for someone her age in that kind of shape. That in itself was a red flag.

Lindsay exchanged a glance with Heather. “Let’s get labs, full cardiac panel. EKG, portable chest X-ray. And let’s call cardiology early- I don’t want to wait on this one.” Ordered Lindsay. Jen scribbled notes while Heather gently guided Shay’s arm to insert an IV. The tattoo of a phoenix flared up from her forearm, its wings half swallowed by gauze and tape. Shay looked up at the ceiling, blinking slowly. “This is probably nothing, right?” Shay asked. Lindsay hesitated before answering. “We’ll know soon. But your heart’s throwing out some signals we don’t want to ignore.” Answered Lindsay, her tone neutral and calm.

By the time the EKG machine spat out its second strip, Dr Jen was already frowning. “Frequent PVCs.” she muttered, holding the paper up toward the overhead light. “This isn’t just stress or dehydration. Something’s messing with her conduction.” Added the resident. Lindsay leaned in, scanning the sharp, jagged rhythms marching across the strip. “It’s diffuse. Not localized. And look- ST depressions in the lateral leads.” Dr Lindsay pointed out. Heather appeared from the hallway with a tray of labeled tubes. “Cardiac panel’s off to the lab. I rushed it- told them we’d owe them coffee.” Nurse Heather informed them.

Jen was already pulling up the portable chest X-ray on the trauma room computer. It took a moment for the image to load, but when it did, Lindsay narrowed her eyes at the screen. “Mild cardiomegaly. You see it?” Dr Lindsay noticed. “Yep.” Jen answered. “Heart’s too big for someone her age, especially with this kind of conditioning.” The resident continued.

Shay, still lying flat on the table with a light sheen of sweat forming on her collarbone, blinked over at them. “I take it this isn’t just a pulled muscle?” Shay chimed in, sensing something was off. Lindsay offered a tight smile. “We’re just being thorough. Something’s irritating your heart- could be an infection, could be something else. We’re running some tests to find out exactly what’s going on.” Explained Lindsay. Shay gave a small nod, unfazed. “Good. I’ve got a fight scheduled in eight weeks.”

Heather shot Lindsay a glance over the top of the monitor. Troponin’s already popped in the system: elevated significantly. “Alright. Let’s get a stat echo. I want to see her heart up close.” Lindsay said, tone shifting. Jen paused. “Should we call cardio back? We haven’t heard anything.” asked the resident. Lindsay nodded. “And book her a CT angio chest just in case. If this is myocarditis or worse, we don’t want to wait. Something’s going on here.” Responded Lindsay.

Heather slipped a BP cuff around Shay’s arm again. “Still tachy. 140s. BP 91/56.” Updated Nurse Heather.

Shay looked at all of them, calm but now visibly more alert. “You guys keep looking at each other like something’s wrong.” Shay chimed in. Lindsay didn’t sugarcoat it. “We’re seeing some strain on your heart. The kind we don’t normally see in healthy twenty-somethings.” Lindsay told Shay, succinct and to the point.

There was a beat of silence. Shay’s eyes dropped to the edge of the table. Her shoulders stayed still, but something in her expression flickered. Heather raised her brows slightly, exchanging a quiet glance with Jen behind her. Lindsay didn’t press it yet. “Let’s get that echo first. We’ll talk more when we’ve got a clearer picture.” Lindsay told the two of them.

Lindsay turned and stepped out towards the hallway just as the cardiologist on call, Dr Weiss, arrived with a rolling echo cart and a resting skepticism in her tone. “You called me for a young athlete with some PVCs?”

Lindsay crossed her arms. “Elevated troponin. PVCs, mild cardiomegaly on X-ray. And a gut feeling.”

“Alright, I need to work with a little more than a gut feeling, Dr Lindsay.” Dr Weiss responded, pushing the echo machine into the trauma bay. Dr Lindsay rolled her eyes “yeah, what do I know.” She thought to herself.

Shay remained still as cold gel was spread across her chest, the ultrasound probe tracing between tattoos and muscle. On the screen, her heart came into view, beating fast. The walls thickened. Movement reduced. Echoes of fibrosis scattered like shadows across the septum. Dr Weiss’s jaw tightened. “That’s not what I hoped to see.” She thought out loud. “Alright, make sure she gets a CT angio of the chest. Call me back when you get the results.” Dr Weiss stated, before getting the echo equipment and leaving the room.

Jen and Heather worked quickly and got Shay over to radiology. The radiology wing was quiet, insulated from the steady buzz of the ER. The fluorescent lights shined faintly overhead, casting a sterile glow across the white floors. A lone CT tech tapped at the console as Dr Jen walked alongside the stretcher, Shay lying supine. Nurse Heather hovered nearby, keeping an eye on the monitor attached to the portable stand.

Shay hadn’t said much on the way over, just muttered something about her chest feeling “weird.” Still calm. Still out of it.

“Alright, Shay, We’re gonna get a scan of your chest. You’ll hear some mechanical noises. Just stay still for us, okay?” the tech explained softly. Shay nodded.

With practiced efficiency, Heather and Jen helped guide Shay off the stretcher and onto the scanner table. She moved like someone weighed down by lead. Her arms were positioned overhead, palms relaxed, fingers curled slightly. Her blonde hair spilled behind her head like a golden halo, the tattoos on her arms displayed on her skin like stories written in ink. Something coiled and dark sat on her ribcage, rising and falling with each slow breath. The tech returned to the control booth. The scanner whirred to life.

Jen folded her arms, watching through the glass of the observation room. The lights within the CT room glowed around Shay’s still form. It was almost peaceful.

Then, without warning, Shay’s body twitched. Her chest rose awkwardly- then fell flat. Her fingers curled into loose fists. Alarms erupted. One sharp, continuous tone. Inside the control booth, the tech’s eyes went wide. “She’s coding!”

Heather was already moving. “She’s in v-tach!” Heather eyed the monitor. Jen burst through the door, grabbing the crash cart parked just outside the suite. Shay’s body was still on the scanner table, her arms still overhead, eyes wide open now, staring at nothing. Her lips parted slightly, unmoving. “Pads on!” Heather shouted. Her hands moved quickly. “Charging to 200!” Jen shouted. Heather climbed halfway onto the CT table, hovering over Shay’s torso. “Ready!” Heather nodded.

“CLEAR!”

Shay’s body jumped. Her shoulders shrugged forward. Her head lolled slightly to the side, eyes wide and unblinking. No change. “Still pulseless.” Jen shook her head, eyes locked on the monitor. “Charging again to 300!”

The second shock caused the young MMA fighter’s body to jolt sharply. And then, the monitor beeped. One beat. Then another. “She’s got a rhythm!” Heather shouted. A carotid pulse returned beneath Jen’s gloved fingers. Weak. Thready. But there. The silence that followed was no longer peaceful. It was hollow.

Shay remained unconscious, still laid out on the CT table, chest rising and falling with ghostlike shallowness. Her nose ring glinted beneath the fluorescent light. A single drop of sweat slid down her temple.

Jen swallowed hard, voice low. “Sinus tach. Let’s get her back to the trauma bay, now. Let’s keep Dr Lindsay in the loop.”

Back in trauma room one, Dr Lindsay was gloving up as Dr Jen and Nurse Heather wheeled the young fighter in, the monitors above her head still blinking erratically. Shay was conscious (barely) but she looked far worse than she had thirty minutes ago. Sweat clung to her skin in a thin sheen, her breathing fast and shallow, chest rising and falling like she’d just run ten miles.

“She coded in the CT scanner- pulseless v-tach. We got her back after two shocks, but she was down for about a minute.” Dr Jen rattled off quickly. “Jeez…” Dr Lindsay muttered under her breath, moving beside the gurney. “Get her back on the table. Full workup. Get cardio back down here just in case.” Ordered Dr Lindsay.

Heather worked fast, placing leads back onto Shay’s bare chest. The pro fight laid there, barefoot, down to just her compression shorts. Patches of electrode adhesive still stuck to her sweat-damp skin. Her ribcage rose and fell quickly, tattoos stretching and shifting, black and gray roses climbing her right side, inked vines curling around her hips. Her arms, marked with fierce script, coiled dragons, and edgy ink, lay still at her sides, fingers curling slightly with each shallow breath.

“Shay? Can you hear me?” Dr Lindsay leaned over her. Shay’s eyes fluttered open, barely focused. “Mm… yeah. What… happened?” she mumbled. “You passed out during your scan, but you’re back. You’re okay.” Lindsay answered gently.

But she wasn’t. The heart monitor beeped rapidly- perhaps too rapidly. Nurse Heather glanced at it, then turned toward the others. “Guys, she’s running hot again. 160 and climbing.” Heather shook her head. “Let’s push some mag and prep for another round of epi if needed.” Dr Lindsay barked. Then the monitor’s tone changed. Heather’s voice cut through the room like a blade. “V-tach. Pulseless.”

Alarms began to blare again. “She’s coding!” Jen shouted. “Start compressions!” Dr Lindsay ordered. Heather jumped onto the stool and began rhythmic chest compressions. Shay’s body jolted with each one, her bare chest rising and falling unnaturally. Her tattoos danced under Heather’s gloved hands- one hand pressing just over the roses coiling across her ribs, where her heart was supposed to be working. Her chest caved in, recoiling hard, her toned belly with abs rippling out.

“Charging to 200 joules, everyone CLEAR!” Lindsay called out, taking charge. Shay’s body flopped hard on the gurney when the shock hit, pierced nipples twitching slightly, her arms limp at her sides.

“Still v-tach. No carotid pulse.” Heather called after a glance at the screen. “Back on compressions, Heather. Push one of epi and one of amio.” Dr Lindsay ordered. Jen moved fast, syringes sliding into the IV line. Shay’s skin was growing cool under their hands. Her breathing had stopped altogether. Her jaw slackened.

“I’ll take over for a cycle or two” Lindsay said, moving in to relieve Heather on compressions. Lindsay’s long arms pumped with sharp, trained force. “Come on, Shay. Come on.” Lindsay said under her breath, pumping away at Shay’s chest. “meds in!” Dr Jen called out.

After a cycle of compressions and a little time for the meds to kick in, the next defib shock was administered. Another shock. Another jolt. Shay’s body twitched sharply in response to the dose of electricity. Still no pulse afterwards. Heather rechecked the monitor. “Now it’s v-fib.”

“Keep going, charge again. Let’s hit her at 300.” Dr. Lindsay said, panting now from compressions. The next shock caused Shay’s feet to kick up above the table and drop back with a thud, showing off the deep, wavy wrinkles in the soles of her size 8 feet. “Still no change.” Jen eyed the monitor, checking the rhythm. Dr Lindsay shook her head. “Keep going.”

The room stayed locked in resuscitation mode. Every move crisp, controlled, coordinated. But behind the monitors and meds, a silent current was beginning to build. 26 year old Shay Strong- healthy, undefeated in the ring, fierce as hell, was slipping further away with each failed shock. Now, she lay sprawled across the trauma bay table, her blonde hair a total mess, her arms limp at her sides. The chaotic beeps of the monitors gave way to chaos in an instant.

“She’s still in v-fib, no pulse!” Jen called out, eyes locked on the EKG rhythm twisting across the screen like a coiled snake.

“Alright, let’s run through a cycle or two of compressions and go from there.” Dr Lindsay barked. “Heather, swap with me and start compressions.” Lindsay directed. Heather launched into CPR, pressing hard and fast into Shay’s chest, her tattooed ribcage rising and falling unnaturally with each deep compression. The motion caused her small perky breasts to jiggle slightly.

“Charging to 200!” Lindsay called after the cycle of compressions were finished, the machine emitting a rising, high pitched whir. Everyone stepped back when the shock was delivered. KA-THUNK! The MMA fighter’s toned, athletic body was tossed around effortlessly on the table by the defib’s electricity. Unfortunately, there was no change.

At the head of the bed, Jen kept an eye on the ambu bag and airway, squeezing rhythmically, watching the monitors like a hawk. Her gloved hands trembled just slightly. “Still no pulse.” the young resident murmured. “Next epi’s in.” Nurse Heather confirmed between cycles of CPR, her arms visibly tiring but steady. The flat, wet thud of her palms against Shay’s bare chest punctuated the room like a grim metronome.

“Let’s go again, charge to 300. Everyone… CLEAR.” Lindsay’s voice was firm, her blue eyes scanning around the room. Shay’s toes scrunched up involuntarily in response to the shock, wrinkling the soles of her feet once more, showing off the black nail polish on her toes. A high pitched tone screamed through the room. “Come on…” Jen whispered under her breath. Still no change.

“Push another 150 of amiodarone. Let’s tube her. 7.0 ET.” Lindsay signaled to Jen, who was already sliding the laryngoscope in. Shay’s mouth hung slack, jaw open, eyes half lidded. Despite everything- the tattoos, the muscle tone, the toughness- her body looked terribly vulnerable now.

The resident quickly slid the tube in place, securing it with some tape. “Tube’s in. Still no rhythm change.” Jen confirmed, voice tight. Heather didn’t stop. Her hands pounded against Shay’s sternum repeatedly, sending ripples through the inked skin of her torso. The nose ring caught a glint of light with each compression. Her chest looked raw and bruised. “Hold compressions. Charge to 360. Everyone CLEAR.” Lindsay ordered. Shay’s body tensed up hard, almost shivering for a second or two. Still v-fib.

The room was quieter than before. The thud of compressions, the hiss of oxygen through the ambu bag, the alarms on the heart monitor silenced. A minute passed. Then another. Dr Lindsay’s hand slowly came up. “That’s twenty-five minutes down.” she informed the team sternly. Her gaze moved across the room, catching Heather’s tired face, Jen’s white knuckled grip on the ambu bag. “She’s not coming back, is she?” Jen thought to herself. Her eyes flicked to the monitor one more time. Still v-fib. Dr Lindsay gave it a moment longer. Then softly, “Heather, hold compressions. Time of death… 13:42.” Announced Lindsay. Nurse Heather stopped compressions. The room seemed to exhale all at once. The monitor, now silent, showed the jagged, erratic waveforms of refractory v-fib.

No one moved right away. Shay lay motionless on the table, her chest rising faintly from the final puffs from the ambu bag, her body glistening under the harsh, bright overhead light. For someone so strong, she looked impossibly fragile now. Lindsay peeled off her latex gloves slowly. “Let’s clean her up.” she said softly, more to the room than to anyone in particular. No one spoke. They just moved. Careful, efficient, and quiet. The fighter had gone down, and not even the best resuscitation could bring her back.

Trauma Room One was quiet now. Shay laid motionless on the trauma bay table, her athletic frame still positioned how they’d left her- flat on her back, arms at her sides, a faint sheen of sweat clinging to her skin. The harsh rhythm of CPR had ended moments ago. What remained was eerie stillness.

Dr Lindsay stood at the foot of the bed, her eyes fixed on Shay’s pale face. Her mouth was slightly parted, her chest unmoving. The bruising from the chest compressions was already starting to show- deep purples and dark reds spreading across the middle of her chest. The endotracheal tube remained in place, protruding from her pale lips. Nurse Heather stepped to Shay’s side and gently detached the ambu bag from the ET tube, setting it on the nearby cart. The heart monitor, still showing v-fib, let out a soft, continuous tone that filled the room with a hollow kind of finality. Dr Jen reached over and silenced it with a tap of her gloved finger.

Heather leaned in again, her hands methodical and respectful as she disconnected the EKG leads from Shay’s chest. One by one, the stickers peeled away, leaving behind faint impressions on her pale, clammy skin. Dr Jen removed the IV lines from her arms and coiled the tubing neatly before tossing it into the biohazard bin.

Lindsay took a toe tag from the tray and filled it out in quiet pen strokes. She looped the string gently around Shay’s left big toe, the tag dangling against the wrinkled soles of her foot. Dr Jen found a clean white sheet at the end of the gurney and pulled it up slowly, covering Shay’s legs, her torso, then finally her face.

Dr Lindsay stepped closer, gently placing her fingertips beneath Shay’s chin and tilting her head just enough to shut her half-lidded eyes. One last glimpse of life, now gone. The faint line of a nose ring caught the light again.

The room was still. The chaos from earlier felt like a distant memory, something that had happened in another place, to another person. Now, there was only the quiet presence of the three clinicians standing beside a body that had, just a little while ago, been fighting to stay alive.

Dr Lindsay gave a single nod, then turned and stepped toward the door. Heather and Jen remained a moment longer, hands at their sides, saying nothing, each taking one last look at Shay’s covered, toe tagged form before exiting the room.

[kk095]

Renee’s Respiratory Distress

It’s a slow weekday in our emergency department just around lunchtime. The ER is relatively quiet, and most of the trauma bays and exam rooms are open. Our team chats casually amongst themselves, sipping coffee, reviewing charts, and checking their phones.

The calm is interrupted when the automatic doors slide open, EMS wheeling in a stretcher. Dr Lindsay’s head snaps up at the sudden motion, her easy conversation with Nurse Nancy cut short. On the gurney sits a barefoot woman in loose black slacks, her blouse removed in the ambulance. EKG electrodes dot her fair skinned chest, wires trailing from the portable monitor. The woman is gasping, her lips tinged faintly blue. Her straight, shoulder length red hair is a tangled mess, strands clinging to the sweat on her temples. Sharp, bright blue eyes flick frantically between the faces around her, wide with terror and uncertainty. There’s a slight crease between her brows, as if she’s trying to keep control but failing. The paramedic at her side keeps a firm grip on her trembling shoulder.

Nancy is already moving, stepping toward the stretcher. “What do we got?” Lindsay asks, following Nancy, voice stern but professional. The lead EMT fires off a rapid report as they push through the hallway: “This is Renee. 38 year old female, sudden onset of severe shortness of breath and chest pain at work. Hypoxic, tachycardic, hypotensive. Maybe a PE? No signs of trauma. No history of asthma or respiratory issues.”

In a breathy, winded tone, Renee speaks. “I… c-can’t… breathe…” she struggles tremendously to get each word out. Nancy places a steadying hand on Renee’s shoulder. “You’re okay, hunny. We’ve got you. We’re gonna take a good look at you, ok?” Nancy reassures. “it… it… hurts… w-when… I… breathe…” Renee tries to respond, barely getting enough air. “it’s ok sweetie, we’re gonna make you feel better.” Nancy soothes.

Once Renee is wheeled into trauma one, Dr Sarah and Nurse Heather follow close behind. Monitors beep incessantly as the team transfers the redheaded woman from the EMS gurney onto the trauma room table. Nancy moves quickly but gently, adjusting the oxygen mask and checking the IV lines already in place.

The 38 year old sits upright on the trauma room table, her chest rising and falling quickly, taking shallow, uneven gasps. Her anxiety is visible, her blue eyes darting around the room. Dr Lindsay steps in first. “Renee, I’m Dr Lindsay. You’re in the ER. Can you tell me what’s going on?” asks the doctor. Renee shakes her head weakly, her chest heaving. She grips tightly at her sternum, fingers pressing against her ribs as if trying to hold herself together. “W-what’s… happening… to… me?…” she mumbles, the words barely escaping her lips. “You’re safe, hun. We’re figuring this out, okay?” Nurse Nancy intervenes.

Dr Sarah and Nurse Heather work in tandem. A d-dimer is drawn for clot detection. An ABG is taken to better check the patient’s oxygen saturation. A bolus of IV fluids are started to counteract her hypotension. A portable echocardiogram is performed by Dr Sarah, which displays evidence of right heart strain.

Even after these interventions and tests, Renee’s heart rate is climbing into the 150s, her systolic BP is in the 80s, and her O2 saturation is in the 70s.

Renee sucks in another dramatic, broken breath, her hand weakly grasping Nancy’s scrub sleeve. Her fingertips are cold and clammy. “my… my… chest…” she gasps, feeling as if there are a million tiny, razor sharp bits of glass inside her lungs. “Stay with me, sweetheart. You’re doing great. Just focus on breathing, okay?” Nancy tightens her grip on the patient’s hand. Renee’s eyes flicker to the monitor, taking in the blaring alarms and the flashing red numbers. She knows something’s wrong. Her gaze shifts to Lindsay, pleading silently for reassurance. “We’ve got you, Renee, you’re doing good.” Lindsay tells her. But behind Dr Lindsay’s composed face is a subtle sense of worry, and Renee picks up on it.

Over the coming minutes, Renee starts experiencing rapid, terrifying deterioration in quick succession. Initially, her heart rate spikes significantly, shooting into the 160s as her body struggles with severe respiratory distress. She gasps desperately for breath, struggling to draw in air, as her lungs and heart begin to fail under the weight of whatever’s happening to her body. It’s almost suffocating. Renee’s breathing becomes more and more labored and erratic, the sound of agonal gasps filling the room. Her chest heaves violently with each frantic gasp, but each inhalation is shallow and desperate. Her skin becomes pale, lips bluish, and there’s an almost grayish hue around her face as hypoxia sets in. This isn’t just the cold medical stuff, it’s visually disturbing to the staff and to the patient herself, who is acutely aware of her body failing on her. Her heart rate spikes dramatically- 160s, 170s, 170s, and the EKG starts to show signs of v-tach.

Despite the chaos, Renee’s mental clarity remains fully intact as she slowly realizes that something much more serious is happening to her. She’s not just experiencing a panic attack. She’s aware that she’s rapidly losing control. She gasps in a panicked voice, choking on her breaths: “Am… I… dying…?” Her voice is frantic, each word more strained than the last. There’s no crying, but her face is contorted in terror, her eyes wide and glassy. Her hands clutch the edge of the table in a desperate bid to hang on. “we’re gonna make sure that doesn’t happen hunny. Just try to relax for me and take slow, deep breaths, ok?” Nancy answers.

Our team’s urgency builds as her condition continues to deteriorate. While they’re still moving with clinical precision, the panic is very palpable. Nancy, despite the mounting tension, tries to keep the redheaded woman calm with quiet, reassuring words: “You’re going to be ok, Renee. Just stay with me, ok?” But even Nancy’s voice wavers as the minutes tick by, and it’s clear that things are slipping away.

In the coming minutes, Renee’s eyes widen In pure terror, as if understanding that the end is near. Her body quivers for a moment- one last desperate attempt to breathe. Then, her body goes limp, her eyes flicker once more before glazing over. A moment of silence hangs in the air as the team processes the sudden, brutal reality: she’s in pulseless v-tach!

The room erupts into a flurry of motion, but there’s an undercurrent of precision and expertise to every action. Dr Lindsay stands at the end of the bed, her hands steady despite the growing urgency. “Vitals are crashing, let’s move fast. Heather, on her chest, let’s go!” Lindsay commands. Nurse Heather lowers the table and gets on the patient’s chest, beginning compressions, her hands pressing down hard and fast on Renee’s sternum. Dr Lindsay looks at the monitor, confirming v-tach. “Hey Linds, I need to intubate now. 7.0 ET please.” Informs Dr Sarah. Sarah wastes no time. She stands at the head of the bed, positioning the intubation tube with practiced ease, and quickly slides it into the redhead’s airway, securing it with some surgical tape. Nurse Nancy connects the ambu bag, squeezing much needed oxygen into Renee’s lungs. Lindsay turns to Dr Sarah, who is putting the defib pads on her chest. “Let’s go with epi first. 1 mg IV push.” Dr Lindsay orders. Sarah administers the meds intravenously while Heather pumps away at Renee’s bare, skinny chest. The redhead’s chest caves in, her belly ripples out from the force of Heather’s chest compressions.

After a minute or so, the patient remains in pulseless v-tach despite intubation, 1mg epi, and a few CPR cycles. Lindsay decides it’s a good time to shock Renee. “ok, let’s charge to 200. Everyone… CLEAR!” Dr Lindsay calls out. KA-THUNK!!! There’s a pause after the shock, and all eyes are on the monitor, hoping and praying for ROSC. “No change. Resume compressions, Heather. Sarah, push 300 mg of amiodarone.” Orders Dr Lindsay. Another round of epinephrine is administered in swift silence. Heather completes two cycles of compressions after the second dose of epi is administered. At that point, the defibrillator charges again, the team holding their breath as they await the jolt. “Ok, recharging to 300. Everyone… CLEAR!” Barks Dr Lindsay. The electricity rips through Renee’s petite body, her chest heaving with the force of it. The monitor briefly catches a moment of regular rhythm, only for it to plummet into v-fib. “Crap! She’s in v-fib. Let’s push another milligram of epi, then shock again.” Dr Lindsay says, her tone a mix of frustration and determination. The team is relentless. Dr Sarah prepares the IV meds, while Dr Lindsay keeps a watchful eye on the monitor. The drugs flow through Renee’s veins, but still, the monitor remains unforgiving. “Ok, meds in. Let’s shock again at 360. Everyone… CLEAR!” The defibrillator charges for the third time, and the cute redhead’s body tenses up again, shoulders shrugging forward, eyes wide open, but the result is the same: nothing. Lindsay sighs following the shock. “She’s not responding. Let’s go for another 150 milligrams of amiodarone and shock her at 360.”

The next amiodarone dose is halved, and Dr Sarah administers the medication with a calmness that contrasts the panic in the room. The defibrillator makes a rising, high pitched hum as it charges, and once again, sends a quick jolt through Renee’s chest. Her hands make loose fists, and the upper half of her body shivers for a second or two. Nothing. The 38 year old’s heart doesn’t budge. “Still nothing. We’re not giving up.” Dr Lindsay directs Nurse Nancy to ensure the ambu bag is being squeezed at full capacity. Heather resumes chest compressions. The team remains laser focused, and administers another 360 joule shock when Heather finishes her cycle of CPR. The jolt, more violent than the others, leaves the room holding its breath. Renee’s feet kick up at the far end of the table, slamming back down hard half a second later, showing off the soft, smooth soles of her size 6 feet. Even after this shock, v-fib persists.

The team continues their efforts, almost on autopilot at this point. CPR, ambu bagging, and another 1mg push of epi, but v-fib remains. Lindsay then orders the team to shock the patient for a sixth time. “Charging to 360. Everyone… CLEAR!” Lindsay calls out. Renee’s chest shoots up, her back arches dramatically, and her body plops back down on the table ungracefully a second later. All eyes shift back to the monitors. “Still in v-fib, Linds.” Sarah shakes her head.

Dr Lindsay takes a breath, steps back, folding her arms, looking at the team, her face unreadable. “She’s in refractory v-fib, we’re gonna have to call time of death.” Lindsay explains to the team, succinct and to the point. “heather, hold compressions.” Lindsay continues. Heather stops, and steps back from the table, away from the patient. Nancy detaches the ambu bag from the ET tube, a small amount of air hissing out. “Alright. Time of death, 12:37pm.” Announces Lindsay, her bluish gray eyes looking at the clock in the lefthand corner of the room, pulling off the latex gloves on her hands.

The room becomes eerily quiet, the frantic chaos of the code blue replaced by an unsettling calm. Dr Lindsay stands back, looking down at Renee, her eyes still WIDE open and unblinking, face still pale and distorted in terror, detached ET tube sitting between her pale, cyanotic lips. The heart monitor that still displays the jagged waveforms of v-fib is turned off. Nancy stays at the head of the bed, taking a moment to look down at Renee’s face. Her eyes are wide open, frozen in a moment of sheer terror. Nancy swallows, her throat tight, before reaching forward to gently close the redhead’s eyes for the final time. “I’m so sorry, hunny.” Nancy whispers under her breath, her hands lingering just a moment too long.

The rest of the team methodically moves through the motions, detaching the EKG wires and removing the IV lines with almost robotic efficiency. Defibrillator pads are peeled off of Renee’s battered chest, the adhesive strips coming away with a slight tug, leaving a red imprint on her skin where the pads had been.

Dr Lindsay fills out the toe tag, her movements deliberate and almost ritualistic. The tag, printed with Renee’s name, age, and the official time of death, dangles from her left big toe, brushing against the soft, smooth soles of her feet. Nurse Nancy places a sheet over her body, her hands trembling slightly as she covers the redhead’s lifeless form.

Lindsay glances over to Dr Sarah and then to Nurse Heather, the weight of the moment settling into their collective silence. Finally, she turns her attention to Nurse Nancy. “I’m going to request an autopsy.” Lindsay says, her voice clinical but with a slight edge of concern. “We never confirmed the PE. It might help us piece everything together.” Continues Dr Lindsay. Nancy nods silently, her face still pale, her eyes lingering on the covered body. She takes a deep breath and steps back, looking at Renee one last time. “What a shame. She went down so fast…” she mutters, her voice thick with emotion.

The room stands still for a moment, the weight of what just happened hanging heavily in the air. A life taken too soon. A woman who had been alive, pleading for her life just minutes ago, is now toe tagged and under a sheet. A nameless, faceless statistic in a death report. The rest of the team turns and leaves the room, each of them silently processing the brief but intense encounter.

Later on, Renee’s autopsy report and labs came back. It was determined that her cause of death was a massive, acute saddle PE. These types of blood clots can sneak up rather quickly and unexpectedly, leading to a deadly progression of events. When Renee woke up this morning, she never in a million years would’ve expected she’d have her time of death called in our ED. But just like that, Renee became the latest beauty to pass away in our emergency department.

[kk095]

Nurse Heather’s Morbid Curiosity

Trauma room two is quiet, contrasting the non stop, frenetic energy that’s usually found in seemingly every crack and corner of the emergency department. The bright, fluorescent overhead light above the trauma room table hums faintly, but the rest of the room feels still. Somewhere down the hall, the pitter-patter of footsteps and voices chatting is heard, but in trauma two, you can hear a pin drop.

Nurse Heather stands alone beside the trauma room table, focusing on the task at hand. On the table is 32 year old Rachel- a tall, thin, redheaded woman. Unfortunately, Rachel just passed away in our emergency department after suffering a sudden cardiac arrest. The team did everything they could for the redhead, coding her for over half an hour. Now, she’s just the latest beauty to have her time of death called in our ER.

Rachel’s skin is ghastly pale, and ice cold to the touch. Her bluish green eyes remain half open, seeming to follow Nurse Heather’s every move. The redheaded woman’s body still shows evidence of the thirty minute battle to save her. The ET tube remains in place, sitting between her pale lips. EKG electrodes cling to her bare torso, their wires snaking out. Defib pads are attached to her chest. IV lines are still in place in each of her arms.

Heather lowers a gloved hand over the deceased patient’s face, gently shutting her eyes for the final time. As she does that, an intrusive thought enters her mind: “what would it be like to be her?”

As Heather zones out, becoming lost in this thought, she imagines the faint sound of a heart monitor. It’s a faint, soft beep at first, but in a split second, the beeping begins to grow louder, sharper, and more incessant, until it completely fills Heather’s mind.

A sudden, jarring alarm breaks through the rhythm of the beeps. The sound seems to stretch on, rising higher, more frantic. Then with an abruptness, Heather is there. She sees herself on the table now.

Nurse Heather watches from the foot of the table from the third person perspective, her eyes locked on her own still form. It’s like she was watching a movie of sorts. On the table, Heather sees herself unconscious, intubated, completely limp and motionless, in cardiac arrest. Her chest rises and falls with each puff of the ambu bag. Her mouth is slightly open, the breathing tube sitting between her lips. Her eyes are WIDE open, staring up above in a look of pure terror. There’s a tinge of something unspoken in those wide, unblinking eyes, but Heather can’t quite put her finger on it.

The room is absolutely chaotic. Her coworkers (and friends), are all there, but everything feels oddly distant. It’s like they don’t know who she is, and she can’t interact with them. They’re all moving around her body with a sense of urgency.

Dr Lindsay is at the side of the table, serving as the brains of the operation. Standing beside Lindsay is Dr Sarah, who’s keeping an eye on the heart monitor. At the head of the bed is Nurse Nancy who’s ambu bagging. Last but not least is Dr Jen, who’s performing chest compressions. Heather’s skinny chest caves in, recoiling hard, her flat belly rippling out from the force of each individual compression.

“Let’s go ahead and try shocking her. Charge the paddles to 300.” Dr Lindsay dictated to the rest of the team. The defib paddles were gelled, charged, and firmly pressed up against Heather’s chest. “Ok. Everyone… CLEAR!” Lindsay raised her voice. KA-THUNK! Heather’s body jolted violently in response to the controlled dose of electricity. There was a brief pause after the shock, all eyes on the heart monitor. “No change, still in v-fib. Let’s hit her again at 360.” Dr Sarah chimes in. The defibrillator paddles are re-charged, gelled, and pressed back up against Heather’s chest once again, the next shock being sent into her body. Heather’s feet kick up at the far end of the table, slamming back down hard half a second later, showing off the soft, prominent wrinkles in the soles of her size 8 feet.

After the second shock, Nurse Nancy places two fingers on Heather’s neck, feeling for a carotid pulse. “Poor baby…” Nancy says under her breath, shaking her head, not feeling anything. “We still have v-fib, let’s shock again at 360.” Lindsay ordered, her blue eyes trained on the heart monitor. The defibrillator paddles are readied once again, and the next shock is administered. Heather’s chest shoots up, her back arches, eyes staring helplessly above before plopping back down hard on the table a second or so later. Following this shock, there’s another pause. “No change, she’s still in v-fib, Linds.” Informs Nurse Nancy. The defibs are prepared again, and a shock is promptly delivered. Heather’s body was effortlessly tossed around on the table by the electricity, her head rolling to the side, but again, the same dead rhythm remains. “No change, let’s try one more time.” Suggests Dr Sarah. Without any hesitation, the paddles were grabbed once again, and the next defibrillation attempt was administered. THUD!!! Heather’s skinny body flopped ungraciously on the table, the electricity racing through her lifeless body.

Following this shock, Dr Lindsay looked at the monitor for a moment, then exchanged looks with Sarah, Jen, and Nancy. “she’s in refractory v-fib.” Stated Lindsay, her tone of voice filled with resignation. “I’m gonna go ahead and call it, we can’t code her all night. Time of death, 2:21am.” Announced Lindsay. Without missing a beat, the team begins postmortem care. Nurse Nancy detaches the ambu bag from the ET tube, setting it on the table beside Heather’s head. Dr Sarah reaches for the heart monitor, turning it off. Dr Jen disconnects the EKG wires and wipes the defib gel off Heather’s chest. Nancy places a gloved hand over Heather’s face, and gently closes her eyes. “I’m so sorry hunny.” Nancy tells Heather. A toe tag is filled out and placed on the big toe of Heather’s left foot. The tag dangles gently against the soft, wrinkled soles of her feet as her body is covered up.

As the scene wraps up, Heather snaps back into reality. Her feet are planted firmly on the ground, looking down at the trauma room table where Rachel, the redheaded patient still lay. Heather doesn’t react to the vivid events that transpired in her mind. No gasp. No confusion. No dramatic “what just happened?!” Just back to normal.

Her hands, still gloved, work delicately, covering the redheaded woman’s body with a sheet. As she drapes the sheet over Rachel’s face, Heather can’t help but steal a glance at her face. The surreal feeling of that brief fantasy still lingers in the back of her mind.

Heather pulls her gaze away and makes her way towards the door. She pauses at the doorway, turning back for one last look at the covered form on the table. For just a moment, something flickers through her mind. She doesn’t voice it aloud, but thinks it to herself as she exits the room. “Maybe someday, I’ll get to be the one toe tagged and under a sheet in here.”

[kk095]

Ella’s OD

The fluorescent lights in Trauma Room One buzzed faintly, casting a glow on our usual team of medical professionals who stood like statues, their faces unreadable. Dr Lindsay stood at the head of the exam table, arms folded, her sharp eyes flicking towards the doorway. Nurse Nancy adjusted her gloves, the faint snap breaking the silence, while Nurse Heather prepared the crash cart nearby, her hands steady despite the silent tension in the room.

In an instant, the stillness shattered as the trauma bay doors flung open with a loud thud. A gurney barreled through, along with two paramedics. One was perched on top of the stretcher, rhythmically compressing the chest of a young lady. “22 year old female!” the paramedic started, breathless but focused, pumping away at the patient’s chest. “Suspected overdose, cardiac arrest for 15 minutes. She’s intubated- no response to multiple doses of Narcan. Seven shocks, two doses of epi on board!” the medic continued.

Twenty two year old Ella’s bare chest caved in hard, her small perky breasts with pierced nipples jiggling slightly in sync with each individual compression. Her fair skin had taken on a ghastly pallor, her colorful tattoo sleeves a stark contrast to her otherwise lifeless appearance. Her green eyes, wide open, stared into nothing, frozen in a gaze of terror that sent a chill through the room. The breathing tube taped firmly in place peeked between her pale lips, and the hiss of the ambu bag punctuated the chaos.

“Let’s transfer her on my count!” Dr Lindsay commanded, stepping towards the gurney. The team moved as one. “One… two… THREE!” With a coordinated heave, they transferred Ella onto the trauma room table. “Nancy, get me a rhythm check!” Dr Lindsay ordered as Nurse Heather connected the defibrillator pads to Ella’s chest. The monitor let out a shrill alarm as it revealed a chaotic ventricular fibrillation pattern. “She’s in v-fib, Linds” Nancy announced, her voice steady despite the grim reading. “Charge to 200!” Lindsay called out, snapping her latex gloves into place. “Everyone… CLEAR!” The team took a step back as Lindsay delivered a shock. Ella’s body was thrown around dramatically by the jolt of electricity, her green eyes still locked in that haunting gaze. “Ok, no change. Heather, resume compressions!” Lindsay barked, her voice sharp. Nancy jumped in without hesitation, her hands working Ella’s fragile frame as the room became a cacophony of beeping monitors, barking orders, and the rhythmic thud of chest compressions.

As the EMS team hurried out, their job done, the doors swung shut behind them, leaving the trauma team to take over the fight for Ella’s life. Nurse Heather stood at Ella’s side, her hands interlocked and pumping firmly on the young woman’s bare chest. The compressions sent tremors through Ella’s thin frame, her green eyes still frozen open, giving the room an eerie, haunting feel. “Charging to 300!” Dr Lindsay announced, her voice cutting through the noise. Her gloved hand hovered over the defibrillator controls as the machine emitted its rising electrical whine. “CLEAR!” she called, stepping back as Heather lifted her hands, and the team momentarily froze. The shock surged through Ella’s torso, causing her body to jerk violently before collapsing ungracefully back onto the table. The heart monitor beeped erratically, showing no change, still in ventricular fibrillation. “Resume compressions!” Lindsay barked without missing a beat. Heather immediately resumed, her palms pressing down rhythmically. Sweat glistened on her brow, but she didn’t falter. At the head of the bed, Nurse Nancy ambu bagged. “Come on sweetie, come on…” Nancy leaned in a little, whispering to the patient, gently stroking Ella’s short, jet black hair with bangs.

The door to the trauma room swung open again, with Dr Sarah and brand new, first year resident Dr Jen entering briskly, both already in yellow gowns and gloves, ready to dive into the chaos. “What do we have?” Dr. Sarah asked, her sharp gaze scanning the room. “22 year old female, suspected overdose.” Lindsay replied quickly, not breaking stride. “She’s been down for 18 minutes and counting, no response to Narcan, nine shocks, three rounds of epi. Still in v-fib.” Relayed Dr Lindsay. Dr. Jen moved to the head of the table, assessing Ella’s pale, motionless face. She adjusted the ambu bag, delivering a few firm breaths through the endotracheal tube. “Good tube placement.” she confirmed, her tone clipped but professional. “Any signs of underlying trauma?” Sarah asked as she grabbed the ultrasound probe from the cart. “None reported by EMS.” Nurse Nancy chimed in as she adjusted the IV line, prepping another dose of epinephrine. “All signs point to an overdose.” Lindsay added. “Let’s confirm in a minute. I’m going to see what her heart’s doing.” Sarah muttered, sliding the ultrasound probe across Ella’s chest. The ultrasound screen displayed a fluttering, twitching heart, no organized contractions. “Damn it.” Sarah shook her head. “Push another round of epi and hit her again at 360. We need to get her out of this rhythm now.” Lindsay ordered, her voice firm. Nancy moved swiftly, injecting the dose into Ella’s IV line as the defibrillator began to charge again. The team exchanged a brief, nervous glance before focusing back on their patient.

Heather’s gloved hands pressed down on Ella’s bare chest with rhythmic precision, each compression forcing her sternum to cave and recoil as it fought against the unnatural motion. The force of Heather’s efforts sent subtle ripples through Ella’s body, making her head bob gently in sync. Her short jet-black hair clung to her pale forehead. At the end of the table, Ella’s bare feet, marked with ink from scattered tattoos, bounced lightly with each downward motion. The movement was unnervingly rhythmic, almost like a puppet on strings. The high pitched whine of the defibrillator charging filled the room, growing louder as the next shock prepared to fire. Nurse Nancy, standing by with the ambu bag, occasionally squeezed it to deliver air into Ella’s lungs, though it felt futile against the relentless tide of chaos. Dr Sarah’s voice cut through the background noise. “Charging to 360!” Heather paused her compressions, lifting her gloved hands and stepping back as Dr Lindsay called out, “Clear!” The shock hit Ella’s chest like a thunderclap, her chest shooting up, her back arching before collapsing back, motionless. Her head lolled to the side, her green eyes staring into the void, still wide open, as though bearing silent witness to the battle raging around her. “No change, still in v-fib.” Dr Jen quickly checked the monitor, seeing the same disorganized rhythm. “Resume compressions” Dr Lindsay ordered, her voice sharp but controlled. Heather immediately resumed, her movements unwavering despite the sweat dripping from her temples. Ella’s head began to bob again, her feet tapping softly against the end of the table, the eerie rhythm matching the relentless beeping of the heart monitor. Dr Sarah exhaled sharply, wiping her brow. “We need to break this rhythm. Let’s prep for amiodarone. Nancy, 300 milligrams IV push.” Nancy nodded, grabbing the vial and syringe from the cart. Meanwhile, Dr Jen leaned over Ella, her voice soft but firm as though addressing the patient directly. “Come on, Ella. Don’t give up on us!”

The room was a whirlwind of controlled chaos as the minutes ticked on. Heather’s hands moved without pause, the rhythmic pressure of her compressions forcing Ella’s chest to yield, each pump a desperate attempt to restart the fragile heart beneath. Nancy prepared the amiodarone, her hands steady despite the mounting pressure. She pulled the syringe from the vial, the liquid gleaming under the harsh lights. “Amiodarone, 300 milligrams.” Dr Lindsay confirmed as Nancy injected the drug into the IV line, her movements swift. Dr Sarah glanced at the monitor, noting the continued, disordered chaos of Ella’s rhythm. “We’ve got to break this.” Sarah shook her head. “resuming compressions…” Heather panted, already positioning herself. “Go ahead.” Lindsay said, her eyes scanning the room for any hint of a shift in the young woman’s condition. With each downward push, Heather’s palms met Ella’s sternum with brutal force, her movements unrelenting. The sound of compressions echoed through the trauma room, filling the space with a macabre rhythm. As the cycle of compressions finished, the defibrillator was recharged once again. The air in the room thickened as everyone held their breath, waiting for the next shock. “Charging to 360.” Dr Lindsay called out. “Everyone… CLEAR!” The shock ripped through the room, the sound of Ella’s body being practically thrown off the table a sharp reminder of how tenuous the battle for her life truly was. Still no change. The monitor continued to display the erratic waves of v-fib, mocking their every attempt. Lindsay’s gaze turned to Nancy. “How long has she been down?” asked the doctor. Nancy’s eyes flicked to the clock on the wall, and her voice wavered slightly as she spoke. “Twenty six minutes Linds.” Answered Nancy. “We need to make a decision. She’s not responding to anything.” Dr. Jen inhaled sharply, her gaze briefly meeting Dr Sarah’s. “Push another epi.” Lindsay said, her tone sharp, eyes never leaving the monitor. Nancy quickly prepared the next round of epinephrine. The team had already been through so much, and they were running out of time. Their movements, while practiced, were also beginning to show the strain of prolonged, relentless effort. Heather resumed compressions as the drugs were delivered.

The room buzzed with the constant hum of machines, the beeping of monitors and the rhythmic sound of chest compressions. The team worked in near perfect unison, but the clock was their enemy. With each passing minute, hope seemed to slip further away. “Charging again to 360.” Dr Lindsay’s voice echoed, her eyes locked onto the defibrillator as it whirred to life again. “CLEAR!” As the shock hit, Ella’s slender frame jerked violently on the table. The force of it caused her bare feet to kick up at the far end, lifting off the table for a split second before slamming back down with a thud. For a brief moment, the soft, subtle wrinkles of her size 9 soles were on full display. “Still no change.” Dr Sarah observed, eyes narrowing at the monitor, where v-fib still flashed across the screen. “Keep pushing!” Lindsay urged. “We can’t stop now. Another round of compressions, Heather.” Lindsay added. Heather didn’t waste any time. She leaned back into position, pressing her palms into Ella’s chest with a brutal force. With each compression, Ella’s head lolled, her hair swaying ever so slightly with the rhythm, her face still locked in terror. A series of beeps followed, signaling that the defibrillator was ready once more. “Charging to 360 everyone.” Dr Jen called out this time, her voice tinged with urgency. “Clear!” Once again, the shock hit Ella’s chest with brutal force, and her toes curled, reacting to the shock with an involuntary response, showing off the black nail polish on her toes, along with the cute wrinkles in the soles of her feet. Still, the heart monitor continued to display the chaotic spikes of v-fib, unyielding in its disarray. “Nothing…” Dr Lindsay muttered. “AGAIN!” The team, now pushing past exhaustion, administered another round of shocks, one after another- 360 joules each time, but with no change. Finally, after a third unsuccessful shock, the room felt tense.

Nancy glanced at the clock. Her voice, barely above a whisper, cut through the tension. “Forty two minutes, Linds.” The words hung in the air. Forty-two minutes. The odds of success were growing slimmer with each passing second. Dr Sarah exhaled sharply, glancing at Dr Jen, whose brow was furrowed in concentration. They all knew what the numbers meant, but none of them dared to speak it aloud. The monitor still showed v-fib, mocking all the team’s efforts up to that point.

Dr Lindsay’s voice broke through the tension. “Heather, resume compressions!” Heather didn’t flinch. She was already back in position, hands pressed firmly against Ella’s chest, delivering yet another round of brutal, unrelenting compressions. The steady rhythm echoed, a constant in the chaos, as if her life still had a chance- if only for a moment longer.

Dr Jen, her eyes focused on the monitor, took a step to the head of the bed. She moved slowly, her gaze drawn down to Ella’s face. Ella’s green eyes remained unnervingly wide open, staring helplessly at the ceiling. The glazed, lifeless death stare made her appear more like a forgotten doll than a beautiful young woman in the throes of a desperate fight for survival. The vacant gaze was cold, unblinking, locked in place as if her body had already accepted what her mind could not. Jen swallowed hard, her throat tight with a mixture of professional detachment and the raw sting of helplessness. She leaned in, pulling a penlight from her scrub pocket and shining it into Ella’s wide open eyes. The light flicked across her pupils, but they didn’t react. The glow of the light reflected back with the cold, indifferent stare of a body already slipping further away. “Pupils fixed and dilated…” Dr Jen observed, her voice barely audible, a heavy sigh escaping her lips. She took a step back, a troubled frown crossing her face as she shook her head, unable to hide the quiet disbelief. It wasn’t just the absence of any reaction to the light- it was the utter lack of life in Ella’s expression, as though her soul had already departed. Dr Sarah looked up from the monitor, meeting Jen’s eyes for a brief moment. The wordless exchange spoke volumes- their collective knowledge of what they were likely facing now. “She’s gone, isn’t she?” the resident asked. Lindsay’s eyes were cold, calculating. She didn’t want to say it, didn’t want to admit it- but the signs were impossible to ignore. She didn’t answer Jen immediately, focusing instead on the monitor as another cycle of compressions was completed. The v-fib was still there- persistent, chaotic, and now undeniably futile. “She’s not gone yet.” Lindsay finally said, her voice unwavering, though her words carried the bitter edge of disbelief. Jen nodded, though her expression remained pained. There was a subtle shift in her posture, the weight of the decision sinking in. They were pushing past the point of reason now- fighting for a life that might have already slipped through their fingers.

The defibrillator charged with a menacing hum, the quiet tension in the room palpable. “CLEAR!” Dr Sarah’s voice rang out, and in a single, tense moment, the shock hit Ella’s body with a violent jolt. Ella’s slender frame jerked sharply on the table, the electricity coursing through her body with an uncontrollable force. Her back arched slightly before slamming back down, her feet lifting briefly once more before crashing to the table. For just a split second, the brief twitch of her muscles seemed almost… human. But it was fleeting, just as everything else had been. Once again, the chaos on the monitor didn’t subside. V-fib persisted, a constant visual reminder that no matter how many times they shocked her, her heart refused to resume a proper rhythm. Heather, ever steady, resumed chest compressions immediately, the crunch of each compression reverberating in the room. Her movements were practiced and deliberate, a well oiled machine in sync with the others. But before long, Dr Lindsay held up a hand, halting the cycle. “Stop…” she said quietly, but with an undeniable finality. Heather paused, her hands still hovering over Ella’s bruised, battered chest as she looked up, waiting for the next instruction. Lindsay’s gaze remained fixed on the monitor, her eyes narrowing at the stubborn, erratic lines of v-fib. Her lips pressed into a thin line, the weight of the situation getting to her. Finally, she sighed, closing her eyes for a brief moment, before speaking the words that everyone in the room had been dreading. “She’s gone. Time of death… 21:55.” Lindsay shook her head. She turned away from the table, her frustration spilling out in a short, sharp exhale. The decision to call the time of death was never easy, but there was something particularly brutal about this moment. The countless attempts, the shock after shock, the tireless effort- it all meant nothing in the face of this. The team stood motionless for a moment, the weight of the loss settling over them. The room that had been filled with the chaos of resuscitation now felt oppressive in its silence. Heather slowly pulled her hands away from Ella’s chest, her face hard to read as she stood up, stepping back.

Dr Sarah, who had remained silent through the exchange, stepped forward with a slow, deliberate breath. Her gaze lingered on Ella’s face, the wide, unblinking eyes staring back at her, frozen in time. Jen was the next to speak, her voice subdued. “I’ve never seen a body hold on so long… like that.”

Dr Lindsay’s frustration deepened, her fingers gripping the edge of the counter as she stared down at the lifeless figure on the table. She didn’t reply to Jen immediately, instead filling out the paperwork with mechanical precision, marking the inevitable as if it were just another task. But the look on her face said it all. She wasn’t okay with this. “You did everything you could, Linds” Dr Sarah said softly, stepping beside her to offer some measure of comfort, but the words felt hollow.

The room was still, except for the soft rustle of movements as the team shifted into the next phase of their task. Nancy moved first, her hands shaking slightly as she detached the ambu bag from Ella’s ET tube. Next, Dr Lindsay reached over and turned off the heart monitor. The beeping- once erratic and frantic, now just a slow, steady buzz of failure- came to a sudden stop. Nurse Heather moved to the other side of the bed, her gloved fingers working methodically as she disconnected the EKG wires from Ella’s torso. The defib pads were peeled off, their sticky residue a faint reminder of the futile attempts to bring Ella back to life. With a small, practiced tug, Heather pulled the wires free, coiling them neatly as she set them aside, careful to avoid disturbing the fragile quiet that had settled over the room. Then, as if in slow motion, Dr Sarah stepped forward, her eyes looking down at Ella. She retrieved the toe tag from the corner of the room, the heavy paper crinkling in her hands. Her pen hovered for a brief moment over the space for time of death. It was already etched In her mind, a number that had haunted her since the moment they’d called it. With a steady hand, Dr Sarah filled out the rest of the tag. Afterwards, she glanced one final time at the patient- no longer a person they were fighting to save, but simply a body now- and placed the tag on the big toe of Ella’s left foot. The tag dangled gently against the wrinkled soles of Ella’s feet. Dr Jen stepped forward, her face a mask of quiet resolve. She moved to the side of the bed, pulling a cover from a nearby cart. With careful hands, she draped the cover over Ella’s body. The sheet covered everything except her toe tagged feet. The team stood back, an unspoken respect filling the air as they took one last look at the lifeless form before them. The sheet settled over Ella’s face, and with it, the last remnants of her terrified, vacant stare were hidden from view- concealed forever beneath the sterile fabric. “Let’s move her to the morgue…” Dr Lindsay said, her voice unexpectedly soft, almost apologetic. The words broke the silence like a whispered command. Without another word, the team began the quiet, methodical process of preparing Ella’s body for transport. Just like that, Ella became the latest beauty to find herself toe tagged and under a sheet in our emergency department.

[kk095]

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[kk095]

Kenzie’s Cardioversion

*good evening! Since my New Year's story didn't post the way I had hoped, I figured I'd post a different story I had saved. If you're interested in the new years story, I still have the read only link posted. Anyway, enjoy!*

The automatic doors of the emergency department slid open as a paramedic team wheeled Kenzie in on a stretcher. She was propped up, her broad shoulders and thick, sturdy, 5’11 frame making her look larger than life against the narrow confines of the gurney. Her light brown hair was tied back in a ponytail, and her blue eyes darted nervously around the bustling ER. Dr Sarah, the on-call physician, approached with her clipboard, her demeanor calm. Nurse Heather trailed behind, ready for whatever was next.

“Kenzie Cole, 28 years old.” one of the paramedics began, keeping pace with the stretcher. “Fainted at home earlier today, now presenting with severe chest pain, palpitations, and a pinching sensation in the chest. BP’s stable at 118/77, but her heart rate’s been sitting around 130. EKG shows some irregularities we couldn’t immediately identify.” The medic continued, relaying the information.

Kenzie let out a shaky breath and winced as another wave of pain shot through her chest. “It feels like my heart’s tryin’ to jump right outta me!” she said, her southern accent soft yet evident. Dr Sarah placed a hand on Kenzie’s arm to ground her. “We’re going to take good care of you, Kenzie. I just need you to stay calm for me, ok?” Sarah told her patient. “Mhmm…” Kenzie nodded, a hand on her chest. “Let’s get her into Trauma Room two.” Sarah instructed the paramedics, continuing to wheel Kenzie further into the hospital.

Inside the room, the team moved quickly, transferring Kenzie onto the trauma room table as the medics made their way out. “Hey, I need a CBC, BMP, tox screen, d-dimer, cardiac enzyme, and HCG.” Sarah called out to Heather, who sprung into action, getting the necessary equipment for the battery of blood tests just ordered. Sarah then approached the table. “Kenzie, I need you to describe the pain to me again.” Dr. Sarah said, her tone steady. “It’s sharp, like somethin’s pinchin’ me real hard right in here…” Kenzie replied, pressing a hand against her sternum. “And my heart just won’t calm down…” added Kenzie, looking down at her chest. “Alright, let’s start her on a beta-blocker to bring that heart rate down.” Dr. Sarah said to Nurse Heather. Turning back to Kenzie, she added, “Kenzie? We’re running a few blood tests to try and figure out exactly what’s going on. In the meantime, I want you to take slow, deep breaths.” Kenzie nodded, though her eyes remained wide with worry. As the heart monitor beeped steadily in the background, Dr Sarah glanced at the slightly irregular EKG readout, her gut telling her there was more to this case than met the eye.

“How’re you holding up, Kenzie?” Dr. Sarah asked, glancing at the EKG monitor again. Kenzie gave a small, nervous smile. “I’m alright... Just wish my chest would stop feelin’ like this...” The patient answered. “We’re going to figure everything out.” Dr. Sarah reassured her. “First, let’s get a chest X-ray to see if there’s anything structural going on. Nurse Heather, will make it quick.” The cute, nerdy redheaded doctor continued. While Heather stepped aside to arrange the portable X-ray, Dr Sarah continued her examination, carefully pressing along Kenzie’s chest and ribcage. “Any pain when I press here?” inquired Sarah. Kenzie shook her head. “No, ma’am. The pain’s deeper, like… it’s on the inside.” Kenzie answered. Just then, Nurse Heather returned, wheeling the portable X-ray machine closer to the table. “Alright, Kenzie, I’m going to need you to sit up straight for me and hold your breath for a second.” Heather said as she positioned the X-ray plate behind Kenzie. As Heather worked, Kenzie tried to distract herself from the discomfort. “Y’all don’t sound like you’re from Tennessee, huh?” she remarked, her soft drawl making Heather smile. “Nope, born and raised in Virginia, but moved here after I got out of nursing school. “What about you?” Heather continued. “Tennessee through and through.” Kenzie said with a small laugh. “I grew up in Chattanooga. Moved here for work a couple years back. Still ain’t used to the winters, though!” The patient continued. Dr. Sarah chuckled. “Can’t blame you there. I’ve lived here my whole life, and I still complain about the snow every year.”

Heather stepped back and nodded. “All done here. It’ll take a second to get the x ray processed.”

Kenzie leaned back with a relieved sigh. “Thanks, y’all. I appreciate it.” Sarah smiled for a second “of course Kenzie, that’s what we’re here for!”

As they waited for the results, Nurse Heather took a seat beside Kenzie on a stool. “So, Chattanooga, huh? What brought you here again?” asked the young nurse. “Oh, a job offer I couldn’t turn down.” Kenzie explained. “It’s a big change, but I figured it was worth a shot. Didn’t think I’d end up in an ER like this, though.” Kenzie went on, looking down at her chest again, eyeing the wires and EKG electrodes stuck onto her. “Most people don’t, but I promise, we’ll get this sorted out.” Dr. Sarah said, pulling a chair over to review her notes.

Minutes later, the X-ray results popped up on the screen. Dr. Sarah leaned in, her brow furrowing as she examined them. “Well, it’s clear…” she said, a mix of relief and confusion in her voice. “No structural issues, no signs of fluid or anything else abnormal.” Sarah shook her head. Kenzie looked between Dr. Sarah and Nurse Heather, her expression turning more worried. “So… what now? Is that good or bad?” the patient asked. “Now, we have to dig deeper.” Dr. Sarah said with a reassuring smile. “We’ll probably order an echocardiogram. It just means we have to keep investigating. Don’t worry- we’ll get to the bottom of this, we always do sooner or later.” Sarah reassured. Kenzie nodded, though the uncertainty lingered in her blue eyes. She leaned back against the table, her accent softening as she murmured, “I sure hope so, Doc. I don’t like this one bit…” Dr. Sarah gave her arm a comforting squeeze before stepping out to confer with the team about the next steps.

A short time later, the portable echocardiogram machine was rolled into the room, and Dr. Sarah and Nurse Heather began preparing Kenzie for the next round of testing. Kenzie lay back on the table, her wavy, light brown hair cascading over the bed, and her blue eyes fixated on the machine. “We’re going to take a closer look at your heart, ok Kenzie?” Dr. Sarah explained, snapping on a pair of gloves. “This ultrasound will help us see how it’s functioning and if there are any structural abnormalities we couldn’t pick up on the X-ray.” Dr Sarah continued explaining. Kenzie nodded, her tan complexion slightly flushed, whether from nervousness or her condition was unclear. “I ain’t ever seen my heart before… Kinda strange to think I’m about to.” she said, her southern accent softening her words. “Most people haven’t. It’s pretty amazing, though- watching the heart work in real time.” Dr Sarah smiled. Heather applied a cool gel to Kenzie’s chest, and she flinched slightly. “Sorry, I know it’s a bit chilly.” Heather said with a grin, adjusting the probe as Kenzie relaxed. As Dr. Sarah began moving the probe across Kenzie’s chest, an image of her heart flickered onto the monitor. Kenzie’s eyes widened in curiosity. “That’s my heart?!” she asked, her voice tinged with awe. “Yep, that’s your heart, Kenzie.” Dr. Sarah confirmed, her attention divided between Kenzie and the screen. “Right now, we’re looking at the left ventricle- the part that pumps oxygenated blood to the rest of your body.” Explained the doctor, pointing to the screen with one hand. Kenzie’s gaze didn’t waver from the monitor. The rhythmic contraction of her heart was oddly mesmerizing to her- a tiny engine working tirelessly to keep her alive. “It’s kinda beautiful, ain’t it?” she murmured, a smirk on her face. “Never thought about it like that before.” Heather chuckled. “Most people don’t until they see it. It’s pretty remarkable.” Chimed in Dr Sarah, eyeing the ultrasound monitor. Dr. Sarah adjusted the probe, capturing different angles of Kenzie’s heart. The sound of the doppler flow filled the room, a rapid whooshing noise that matched the quick rhythm of her pulse. “Looks like it’s workin kinda hard.” Kenzie commented, her tone a mix of fascination and concern. “It definitely is.” Dr. Sarah said, her eyes narrowing slightly as she examined the images on the screen. “Your heart’s pumping well, but it’s moving faster than it should be. No obvious structural issues so far, which is good, but we’ll have to keep looking.” Sarah explained to the her patient. Kenzie’s curiosity didn’t waver. “Can y’all keep that thang over my chest for a another second? I just wanna look at my heart a little longer!” asked Kenzie, her tone oddly excited. Sarah shrugged, “why not.” Kenzie’s blue eyes lingered on the screen a moment longer, watching the steady rhythm of her heart. “It’s wild, y’all…” she said quietly. “That thing’s been beatin’ inside me since before I was even born. Never really gave it much thought ‘til now…” Kenzie thought out loud. Dr. Sarah gave Kenzie an encouraging nod. “You’re right- it is amazing. And it’s going to keep going while we figure this out! One step at a time.”

A little while later, there were still no answers. Sarah glanced at the monitor- Kenzie’s heart rate was climbing, and her EKG was shifting into a more worrisome rhythm. “Still no labs?” Dr. Sarah asked Nurse Heather, her tone sharp with urgency. “They’re backed up in the lab. I’ve called twice, but they’re swamped.” Heather shook her head, frustration etched across her face. “Alright, let’s focus on what we can do. For now, we’ll manage her symptoms and keep her stable until we get some answers.” Dr. Sarah shook her head. Kenzie, who had been lying quietly on the table, suddenly grimaced and pressed her hand to her chest. “It’s getting’ worse, Doc!” she said, her voice strained. “Feels like my heart’s ‘bout to burst…” Her eyes pinched shut for a second. Dr. Sarah sprung into action and stepped to her side immediately. “Dizzy? Short of breath?” asked the doctor. Kenzie nodded weakly. “Both! It’s like my chest is getting squeezed, and my head’s floatin’ away.” Explained Kenzie.

The monitor let out a louder beep, catching everyone’s attention. Dr. Sarah’s eyes snapped to the screen, where the EKG now showed a concerning pattern: stable ventricular tachycardia. Kenzie’s heart was beating dangerously fast, and the rhythm had taken on an ominously irregular look. “She’s in stable v-tach.” Dr. Sarah observed, her tone calm but urgent. “We need to start chemical cardioversion now. Heather, get me an IV push of amiodarone.” The doctor called out. Heather nodded and hurried to prepare the medication while Dr Sarah leaned over Kenzie. “Kenzie, your heart’s beating too fast, and we need to slow it down. We’re going to give you a medication that should help. You might feel a little strange when we do this, but we’re keeping a close eye on you.” Dr Sarah explained. Kenzie’s blue eyes were wide with fear, but she nodded. “Okay… just… just don’t let me die, alright?” Kenzie answered. Dr. Sarah squeezed her hand. “You’re in good hands. I promise.”

Heather returned with the syringe and began administering the amiodarone through Kenzie’s IV. Dr. Sarah kept a close eye on the monitor, watching for any sign of improvement. “Take slow, deep breaths, Kenzie.” Dr. Sarah instructed. “In through your nose, out through your mouth. That’s it. Stay with me.” Continued Dr Sarah. Kenzie closed her eyes briefly, her tan complexion now pale. The chest pain was unbearable, but she focused on her breathing, trusting the team around her.

Dr. Sarah kept her eyes glued to the monitor as the amiodarone infusion ran through Kenzie’s IV. The jagged peaks of the EKG line showed no signs of calming, the ventricular tachycardia holding steady. She glanced down at Kenzie, who was visibly struggling. Kenzie’s breaths came quicker now, shallow and labored, her hand gripping the thin blanket tightly. She moaned softly, her face contorted in pain, tears brimming in her wide blue eyes. “Doc… it’s not workin’..,” she uttered, her voice trembling. “It’s getting’ worse. Somethin’ ain’t just ain’t right…” Kenzie shook her head. Dr. Sarah placed a reassuring hand on Kenzie’s arm, though her own heart sank at the sight of the monitor. “I know, Kenzie. We see it. We’re not giving up- just hang in there a little longer for me, okay? We’ll get this under control.” Soothed Dr Sarah. Kenzie turned her head slightly, tears slipping down her cheeks as she winced again. “It hurts so bad…” she moaned, pressing a hand to her chest. “It feels like somethin’ inside’s about to explode!” her voice wobbled. Nurse Heather returned to the bedside, her expression a mix of calm professionalism and urgency. “Vitals are holding, but her heart rate is still climbing-160 and rising. BP’s 124 over 78, but I don’t like how pale she’s getting.” Heather called out. Dr. Sarah nodded, her mind racing. “We need to stabilize her before this escalates. Prepare for synchronized cardioversion. Let’s get the defibrillator ready and explain the process to Kenzie.” Sarah told Heather.

Heather moved swiftly to grab the defibrillator pads while Dr. Sarah knelt by Kenzie’s bedside. “Kenzie, we’re going to try another method to get your heart back to a normal rhythm.” she said, her tone calm but firm. “It’s called synchronized cardioversion. It’s a quick electrical shock, but we’ll give you something to make you comfortable beforehand. This is the next step we need to take.” Explained Dr Sarah. Kenzie’s eyes widened with fear, her chest rising and falling rapidly. “Shock me?!” she asked, her voice breaking. “You’re gonna shock me?! But my heart’s still beatin!” Kenzie asked, trying to make sense of what was about to happen. Dr. Sarah nodded, her expression softening. “I know it sounds scary, but it’s controlled, and it’s necessary. Right now, your heart’s working too hard, and we need to help it reset. We’ll give you medication to relax you first- you won’t feel a thing.” Sarah tried to reassure. Dr. Sarah took a deep breath, bracing herself as she crouched next to Kenzie. The young woman’s fear was palpable, her tear-streaked face turned toward the ceiling as her chest heaved with rapid, shallow breaths. “No, no, no!” Kenzie sobbed, shaking her head. “You can’t shock me while my heart’s still beatin’! That ain’t right! Please don’t do this to me!” resisted Kenzie. “Kenzie, I know this is scary.” Sarah began, her voice calm but firm. “I need you to listen to me, okay? Your heart’s in a dangerous rhythm. If we don’t intervene now, it could get way worse- this procedure will help your heart reset before that happens.” Sarah went on. Kenzie’s sobs grew louder, her hands clutching at the thin blanket draped underneath her. “But it’s beatin’! My heart’s still beatin’! Y’all don’t need to shock me! Please don’t do this!” Kenzie continued to resist. Nurse Heather moved closer, her voice gentle but steady. “Kenzie, I know this sounds terrifying, but synchronized cardioversion is different. It’s not like the shocks you see on TV during a code. We’re going to time it carefully with your heartbeat to reset your rhythm. You’ll be relaxed, and it’ll be over in seconds.” Heather chimed in. Kenzie turned her tearful gaze to Heather, her body trembling. “You promise I won’t feel it?” asked Kenzie nervously. “You won’t feel a thing, and we’ll be right here the whole time, keeping you safe. Heather assured her. Kenzie sniffled, her sobs beginning to subside as she processed their words. She wiped at her face with the back of her hand, her breathing still uneven. “Alright…” she whispered shakily. “Alright, I’ll let y’all do it… but please… just get it over with so I’ll be alright.” Consented Kenzie. Heather nodded and began setting up the defibrillator, moving with practiced efficiency. “We’ll take good care of you, Kenzie. You’re doing great.” Smiled Heather.

As Heather peeled the adhesive backing off the defibrillator pads, she glanced at Dr. Sarah. “I’ll place these while you give her something to calm her down.”, to which Sarah nodded. Dr. Sarah met Kenzie’s gaze, offering a reassuring smile. “The procedure will be quick, and complications from this are very rare. You’re in good hands.” Sarah told her patient. Kenzie sniffled again, her tears still flowing but her demeanor more composed. She shivered slightly as Heather placed the first pad on her upper chest, the cool adhesive making her flinch. “Almost there, Kenzie.” Heather said softly, placing the second pad below Kenzie’s left ribcage. Kenzie nodded weakly, her voice barely above a whisper. “Please… just make me better…” Sarah rested a hand gently on Kenzie’s arm, squeezing it lightly. “We’re going to take care of you, Kenzie. Just relax- we’ll handle the rest.” Reassured Sarah. Kenzie nodded again, her blue eyes fluttering shut, though a single tear slipped down her cheek. “Okay…” she murmured.

As Sarah administered the medication and synchronized the defibrillator, a quiet settled over the room. The hum of the monitor and the faint rustle of equipment were the only sounds. The defibrillator began to hum, a low, rising tone that sent a fresh wave of fear through Kenzie. She moaned softly, her body tensing in nervous anticipation. “I can hear it…” she whimpered, her voice trembling. “Oh God, I don’t wanna do this again…” Kenzie thought to herself. Dr. Sarah leaned in, keeping her tone calm but firm. “Kenzie, I know this is hard, but you’re doing great. Just stay as still as you can, okay? We’re going to try the first shock now. It’ll be quick.”

Kenzie nodded shakily, her hands gripping the edges of the table. “Alright…” she whispered, barely audible “Clear!” Sarah called, ensuring everyone had stepped back before pressing the button. Kenzie’s body jolted briefly as the shock coursed through her. “Ooooo!” she grimaced, her face contorting in discomfort. As the jolt passed, she exhaled sharply, her chest heaving. “That’s… that’s it?” she asked breathlessly, blinking back tears.

Heather leaned over the monitor, scanning the EKG. The jagged, rapid peaks of ventricular tachycardia remained stubbornly unchanged. “No change,” Heather announced, her tone clipped and professional. Sarah’s face tightened, but she quickly masked her concern. She stepped back to Kenzie’s side, crouching slightly to meet her gaze. “Kenzie, I need you to listen to me.” she said gently. “The first shock didn’t work, so we’re going to try again. This happens sometimes. It can take more than one attempt to reset your heart.” Sarah reassured. Kenzie’s blue eyes widened, and fresh tears spilled down her cheeks. “Again?!” she groaned, shaking her head. “You mean y’all have to shock me again?!” Kenzie’s voice wobbled. “I know it’s not what you wanted to hear.” Sarah replied, her voice steady but compassionate. Kenzie sniffled, her bottom lip trembling as she tried to compose herself. “Alright… just… just do it. I can’t take too much more of this...” she whispered hoarsely. Heather gave Kenzie’s hand a reassuring squeeze. “You’re strong, Kenzie. We’ll get you through this.” Promised Heather. Sarah turned back to the defibrillator, resetting it for another shock. The hum of charging electricity filled the room once more, and Kenzie squeezed her eyes shut, bracing herself. Sarah’s finger hovered over the controls. Kenzie braced for what was to come, unaware of how much her fight to survive would leave an indelible mark on everyone in the room.

The defibrillator charged again, the rising, electrical hum filling the room with a sense of tension. Sarah glanced at the monitor, the jagged peaks of Kenzie’s arrhythmia still unchanged. “Kenzie, we’re going to try another shock, okay? This one might do the trick.” Sarah eyed Kenzie for a moment. Kenzie barely nodded, her lips trembling as fresh tears streamed down her face. “Please… just make it stop…” she begged, her voice cracking. “Clear!” Sarah called. “AHHH!” Kenzie cried out in pain as the second shock hit her. Her body arched slightly off the table, her large frame twitching involuntarily before falling back against the table. Her breathing was heavy, and she clutched at the sides of the stretcher, her knuckles white.

Heather scanned the monitor. “Still in v-tach…” she reported grimly. Sarah sighed and crouched down next to Kenzie again. “Kenzie, I know this is hard, but we need to try again. I’m going to deliver a third shock. You’re doing so well- just one more try.” Sarah held Kenzie’s hand for a second. Kenzie moaned, shaking her head as her sobs grew louder. “No… no… I can’t do this anymore! Please, y’all, stop! I can’t take it!” she cried, her voice breaking. Heather leaned closer, her tone soft but insistent. “Kenzie, I know it hurts, but we’re trying to save your life. Just hold on a little longer and we’ll get through this together.” Reassured Heather. Kenzie couldn’t speak, her cries turning into gasping sobs. Sarah nodded at Heather, her expression resolute. “Charging…” Sarah said, her voice steady despite the tension in the room. “Clear!”

Kenzie let out a piercing scream as the third shock dashed through her. Her 5’11 frame twitched violently on the table, her legs briefly lifting off the bed. She collapsed back with a loud yelp, clutching her chest as tears streamed down her face. Heather’s eyes remained on the monitor, her expression tight. “Still no conversion, Sarah.” she said quietly. Sarah hesitated for only a moment before addressing Kenzie again. “Kenzie, I’m so sorry, but we need to deliver one more shock. This could be the one that works.” Sarah gently strokes Kenzie’s hair for a second. Kenzie’s head snapped up, her tear-streaked face a mask of anguish. “NO!” she screamed, her voice raw and trembling. “Y’all better not shock me again! I can’t! No more!” she resisted. She clutched at her chest, sobbing uncontrollably as the sound of the defibrillator charging filled the air once more. The hum grew louder, relentless, as Sarah and Heather exchanged a quick glance, each understanding the weight of the moment. Sarah crouched down again, her voice as soothing as she could make it despite the chaos. “Kenzie, I know you’re scared. I know this is hard. But we have to keep trying. You’re stronger than this- you can do it.” Kenzie shook her head frantically, her sobs wracking her entire frame. “No… no more… please…” she whimpered, but the charge was ready, and time was running out.

“Clear!” Sarah called as the defibrillator delivered its next shock. Kenzie’s body jolted violently again, her toes curling involuntarily at the end of the stretcher. Her large, size 13 feet tensed up hard, exposing the soft, thick wrinkles in her soles, and the faint sheen of her white toenail polish glinted under the fluorescent lights. She let out a sharp cry as the electrical current coursed through her, her frame trembling before collapsing back onto the table. Heather’s eyes remained glued to the monitor, her heart sinking as the v-tach persisted. “Kenzie?” Heather leaned over, her tone calm, trying to mask her growing concern. “We’re going to shock again, okay? We’re not giving up.” Heather explained. “NO!” Kenzie sobbed, her voice trembling with terror. Tears streamed down her face as she gripped Heather’s hand tightly, her fingers digging in. “No more, please… I don’t wanna die. I don’t wanna die!” Her voice cracked, raw with desperation. “I’m so scared!” Sobbed Kenzie.

Heather gave Kenzie’s hand a reassuring squeeze, locking eyes with her. “Kenzie, listen to me.” she said, her voice steady and soothing despite the chaos. “You’re not going to die. We’re going to fix this. You’ve been so strong- we’re not giving up on you.” Heather told her patient. Kenzie sniffled, her sobs growing quieter but no less heart-wrenching. She nodded faintly, her chest heaving with uneven breaths. “Okay… Just… just help me…” she uttered, her voice barely audible. Heather brushed a strand of light brown hair from Kenzie’s forehead. “We will.” she promised softly, even though deep down, she couldn’t shake the growing ominous feeling in her chest. The sound of the defib pads charging up filled the air again, rising in pitch. Time was running out, and the unrelenting rhythm on the monitor told a story none of them wanted to face.

“Clear!” Sarah’s voice rang out as she pressed the button to deliver another shock. Kenzie’s body tensed violently, her busty chest thrusting forwards as the current surged through her. “AHHH!” she yelped loudly, the sound echoing through the trauma room. Her hand shot to her chest, clutching it tightly as if trying to shield herself from the pain. Her tear-filled blue eyes darted between Sarah and Heather, no longer seeing the compassionate caregivers who had reassured her moments ago. Instead, her gaze was filled with fear and betrayal, as if she were staring at two torturers. Kenzie gasped heavily, her breaths labored and erratic. “I… I can’t… I…” Her words broke into a series of hyperventilated sobs. Her eyes dropped to her chest, her face growing increasingly pale. She started taking deep, dramatic gasps, her whole body shaking. “Kenzie, stay with us!” Heather urged, moving closer and resting a hand on her shoulder. “You’re okay. Just breathe with me- slow breaths in and out.” Heather continued. Sarah leaned over the monitor, watching her vitals closely. “Kenzie, we need you to stay strong for us, ok?” she added, her voice steady with subtle worry. But Kenzie didn’t respond. Her gasps grew shallower and slower until her eyes glazed over, staring blankly at the ceiling. Her body slumped back onto the table as her muscles went limp. “She’s unresponsive!” Heather called out, moving quickly to check for a pulse. “Crap. Start bagging her!” Sarah instructed, her own heart racing as she glanced at the monitor. Kenzie’s heart rhythm had degraded further. “Get the crash cart back over here! We need to act now!” Yelled Sarah.

“Heather, let’s move!” Sarah commanded, her voice sharp as the team sprang into action. Heather immediately lowered the bed and positioned herself beside Kenzie. Grabbing a pair of trauma shears, she snipped through the fabric of Kenzie’s bra in one swift motion, exposing her chest and large, natural breasts. She interlaced her fingers and placed her hands in the center of Kenzie’s chest, beginning firm, rhythmic compressions. Heather’s compressions, steady and precise, caused Kenzie’s body to shift slightly with each push. The sound of her effort filled the room, accompanied by the steady beeping of the monitor. “Come on, Kenzie, don’t do this…” Heather muttered under her breath as she worked tirelessly on Kenzie.

At the head of the bed, Sarah was laser focused on securing Kenzie’s airway. With practiced efficiency, she opened the intubation kit and inserted the laryngoscope into Kenzie’s mouth, maneuvering it carefully to visualize her vocal cords. Her own breath hitched for a moment as she caught sight of Kenzie’s wide, lifeless blue eyes staring blankly up at her. It was an eerie sight, as though Kenzie was silently witnessing the scene around her. “Tube ready.” Sarah said, sliding the 8.0 endotracheal tube smoothly into place. She secured it with one hand while quickly inflating the cuff with the other. “I’ll start bagging.” Sarah called out, attaching the ambu bag after taping the tube in place. The rise and fall of Kenzie’s chest with each squeeze provided a slight glimmer of hope amid the urgency. “Pulse check!” Heather called after completing her cycle of compressions, her face flushed. Sarah leaned over, her fingers pressing against Kenzie’s carotid artery. She shook her head. “Still no pulse. Resume compressions.” She instructed. Heather nodded and immediately began another round, her hands pressing deeply into Kenzie’s sternum. Each compression caused a ripple through Kenzie’s body, her large frame shifting around. Kenzie’s chest caved in hard, her large breasts juggling around in sync with each individual compression. Kenzie’s belly rippled out as Heather continued pumping away at her chest. “Epinephrine, one milligram, IV push.” Sarah ordered, not taking her eyes off the monitor. Sarah got the medication ready, and administered it into Kenzie’s IV line. “Let’s prep for another shock, she’s not converting.” she added, the tension in her voice rising. “Charging to 200 joules. Everyone clear!” shouted Sarah. Heather momentarily stepped back, lifting her hands off Kenzie’s chest as Sarah delivered the shock. Kenzie’s body jerked sharply on the table, her arms and legs twitching before falling limp once again. “Resume compressions.” Sarah ordered, her tone resolute. Heather immediately leaned back over Kenzie, resuming the relentless compressions, her hands pressing into Kenzie’s sternum with tremendous force.

Heather positioned her gloved hands firmly on Kenzie’s chest, her fingers interlocked and arms locked straight. With each forceful compression, Kenzie’s body shifted on the table, her chest visibly caving under the violent pressure. “five, six, seven…” Heather silently counted in her head as she delivered deep, rhythmic compressions. The monitor beeped steadily with no signs of improvement, the jagged waves of ventricular fibrillation mocking the duo’s efforts. After two minutes of relentless CPR, Sarah glanced up. “Okay, everyone, . Charging to 300 joules.” Sarah called out as Heather backed away from the patient. Heather stepped back, wiping her forehead with the back of her hand as the defibrillator charged. The hum of the machine filled the room, a sound that made everyone hold their breath. “CLEAR!” Sarah pressed the button, releasing the shock. Kenzie’s body flopped violently on the trauma room table, her head rolling slightly to one side as the electricity coursed through her. A sharp, guttural gasp escaped her lips- a reflexive response to the shock rather than a sign of life. Heather’s eyes flicked to the monitor. No change. The unrelenting v-fib pattern still dominated the screen. Sarah sighed heavily, her voice steady but tinged with frustration. “Still in v-fib. Resume compressions.” Sarah shook her head. Heather immediately moved back into position, pressing her hands against Kenzie’s chest once more. The force of each compression sent ripples through Kenzie’s sturdy, motionless frame, her pale skin glistening under the harsh overhead lights. “Come on, Kenzie…” Heather murmured under her breath, her voice almost pleading.

Heather’s hands moved mechanically as she continued chest compressions, but her mind was a whirlwind of emotions. Just a short while ago, Kenzie had been laughing nervously, chatting about her home in Tennessee, her southern accent adding a charming warmth to the conversation. Now, that same vibrant young woman lay motionless beneath her hands, her life slipping further away with each compression. “She was fine… she was fine…” Heather muttered under her breath, her voice barely audible over the whoosh of the ambu bag and the occasional beeps of the monitor. Her jaw clenched as she fought back a wave of frustration and helplessness, tears threatening to blur the young nurse’s vision.

At the head of the bed, Sarah worked diligently, her gloved hands adjusting the ambu bag between compressions to ensure Kenzie’s lungs were properly inflated. But her focus was fractured, her thoughts gnawing at her composure. “Did I miss something?” Sarah’s mind replayed the entire case like a film on fast-forward. Kenzie’s EKG abnormalities, the unsuccessful cardioversion attempts, the worsening symptoms. Had there been a sign- something subtle, that she’d overlooked? “She trusted us…” Sarah whispered, the weight of responsibility settling heavily on her chest. Her voice was so low that no one else heard it. She swallowed hard, pushing the guilt aside as best she could. There was no time for self-incrimination. Heather’s voice broke through the tense silence. “Another two minutes of compressions done.” she announced hoarsely, stepping back as Sarah moved to check the rhythm. The monitor still displayed the chaotic, disorganized waves of v-fib. Sarah closed her eyes briefly, forcing herself to take a deep breath. She had to stay strong for both Heather and Kenzie. “We’ll go another round,” Sarah said, her tone firm but betraying the faintest tremor of weariness. Heather nodded, stepping back into position, but she couldn’t shake the haunting image of Kenzie’s wide, terrified eyes as she begged them not to shock her again. Heather’s heart ached as she resumed compressions, the repetitive motion a grim reminder of how fragile life truly was. During this cycle of compressions, the air in the room grew heavier, the emotional strain palpable. Despite their best efforts, the team felt the creeping despair of a battle they feared they might lose.

Heather’s hands returned to Kenzie’s chest without hesitation, delivering powerful, forceful compressions. Each downward thrust sent subtle ripples through Kenzie’s thick, sturdy frame, a stark contrast between her strong build and her fragile condition unnerving to the team. “Charging to 360.” Sarah announced, her voice steady despite the hectic battle ensuing in the room. The defibrillator’s high pitched whine filled the air as it prepared for the next shock. “Clear!” Sarah called, stepping back as Heather moved aside. The shock was delivered, and Kenzie’s body arched slightly, her feet kicking up reflexively at the end of the table. Less than a second later, her feet plopped back down unceremoniously, her large feet landing with a soft thud, the deep, wide, prominent wrinkles in her soles on full display. Despite the dramatic response, the monitor’s display remained unchanged, with v-fib continuing to display. Heather let out a shaky breath, immediately resuming compressions. “Come on, Kenzie…” she murmured, her voice a mixture of determination and desperation as she continued to press into Kenzie’s bare chest. “Pushing another dose of epi.” Dr Sarah called out, her focus unwavering.

“Let’s prepare for another round.” Sarah instructed, glancing briefly at the clock. The code had been ongoing for several minutes, but she refused to give up just yet. Heather maintained the cycle of compressions, sweat beginning to bead on her forehead as she worked tirelessly to sustain circulation. The team worked in near-perfect synchronization, their actions precise and deliberate. “Hold compressions, Heather.” Sarah said, reaching for the defibrillator controls. The pads were once again recharged to 360 joules as Heather stepped back from the table. “CLEAR!”

The next shock was delivered, the current visibly jolting Kenzie’s body once more. Her arms shifted slightly, and her chest rose briefly before settling back down, but the monitor’s erratic waves refused to stabilize. “No change.” the nurse confirmed solemnly. Sarah clenched her jaw, her mind racing through the remaining options. “Resume compressions.” she ordered. Heather obliged without hesitation, her hands returning to their task as Sarah began to strategize the next steps.

The atmosphere in the trauma room grew heavier with each passing minute. The monotony of the code-compressions, medications, shocks- was relentless, each cycle blurring into the next. The monitor stubbornly displayed the chaotic, disorganized rhythm of ventricular fibrillation, its jagged peaks a grim reminder of Kenzie’s condition. Heather’s movements remained methodical, but her exhaustion was evident in the faint tremble of her arms as she pushed down on Kenzie’s chest. “Come on… come on Kenzie…” she whispered, more to herself than anyone else. She fought the mounting dread gnawing at her, unwilling to accept the thought that their efforts might be in vain. “Another dose of amiodarone in.” Sarah informed Nurse Heather, her voice sharp despite the weight in her chest. She wiped her brow with the back of her glove, glancing at the clock on the wall. The minutes ticked by with an almost mocking speed, the relentless pace of time a cruel contrast to the stagnant rhythm on the monitor. “We need to shock. Charging to 360 again.” Sarah said, her voice steady but her stomach twisting. Heather stepped back as the defibrillator charged, the familiar high pitched whine filling the room like a warning bell of sorts. “CLEAR!” Sarah called, pressing the button. Kenzie’s thick body twitched slightly, her head tilting back as the shock coursed through her, but the monitor remained unchanged. “No response.” the nurse said quietly, avoiding eye contact with anyone in the room. Heather stepped back into position, her hands returning to Kenzie’s chest. Her compressions were just as strong as the first cycle, but the emotional toll was starting to show. Heather avoided looking at Kenzie’s face at all costs, the sight of her lifeless eyes too much to bear. “We’re going to shock again, pushing another dose of epi and atropine first.” Sarah decided, almost her voice almost mechanical, as if detaching herself emotionally could shield her from the growing sense of failure. She caught herself glancing at Kenzie’s face, the memory of her vibrant personality from earlier flashing in her mind. The dread in Sarah’s gut turned into a cold knot. The duo continued, but the energy in the room was shifting. The once vivid determination had given way to a quiet desperation, each team member acutely aware that they were likely fighting a losing battle.

Trauma room two was filled with the incessant beeping of the monitor and the rhythmic thumping of Heather’s compressions. Kenzie’s body shuddered under Heather’s strong hands, her chest rising and falling with the brute force. “Charging to 360.” Sarah said again, her voice strained but composed as she prepared for yet another shock. The defibs whined as it powered up. “CLEAR.” Sarah called. Heather stepped back, her hands hovering as the shock was delivered. Kenzie’s body tensed, her head tilting slightly, and a faint, involuntary moan escaped her lips- a reflex, nothing more. Heather immediately resumed compressions, but the monitor showed no change. V-fib stubbornly persisted, as deadly and unrelenting as it had been since the start of the code.

Minutes blurred together, each one a cruel thief of hope. Heather kept going, her hands now aching with fatigue, her breaths short and heavy. At the head of the bed, Sarah leaned over Kenzie’s face, shining a pen light into her wide, unblinking eyes. Kenzie’s head bobbed slightly with each compression, her lifeless gaze fixed on nothing. Sarah straightened up, exhaling sharply as she slid the pen light back into her scrub pocket. “Pupils fixed and dilated.” she announced quietly, her tone edged with defeat. She checked the clock on the wall. “Kenzie’s been down for 35 minutes, still in v-fib.” Continued Sarah. Heather hesitated, her movements faltering for the first time. She stopped compressions, her hands lingering on Kenzie’s chest before she finally stepped back, her lips pressed into a thin line. The room fell silent except for the relentless alarm of the heart monitor, the jagged peaks of v-fib still mocking the duo’s efforts. Sarah scanned the room for a moment, before looking at Heather, her own face a mask of exhaustion and guilt. Finally, she drew a deep breath and made the dreaded announcement, “Time of death… 14:47…”

The words hung In the air, heavy and final. Heather swallowed hard, her hands clenched at her sides as she stared at Kenzie’s lifeless form. For a moment, no one moved. “Let’s clean her up…” Sarah said softly, breaking the silence. The room was somber as the team began the grim process of postmortem care. Dr. Sarah remained at the head of the bed, her movements mechanical as she detached the ambu bag from the ET tube, setting it aside. Her fingers lingered briefly on the monitor before she reached for the power. button, silencing the alarm that had marked every failed moment of the code. Heather worked delicately at Kenzie’s side, removing the IV lines from her arms and disconnecting the EKG wires. She peeled off the defib pads from Kenzie’s chest, each movement feeling heavier than the last. Her eyes darted to Kenzie’s face- a face frozen in its final, terrified expression. Kenzie’s wide, unblinking blue eyes stared blankly at the ceiling, a hauntingly beautiful stillness overtaking her features. The ET tube remained in place, its end hanging awkwardly out of her mouth, brushing lightly against her pale lips. Heather’s throat tightened at the sight of the death stare, a memory she knew would be impossible to erase.

Sarah filled out a toe tag, her pen scratching softly against the paper. She paused for a moment, as if the simple act of writing Kenzie’s name made the loss feel all too real. With a steadying breath, she knelt by Kenzie’s left foot and slipped the tag onto her big toe. It dangled there, brushing against the deep, thick wrinkles in the soles of Kenzie’s feet- a stark, unyielding symbol of the young woman’s untimely fate. Heather stepped back as Sarah got a cover from a nearby drawer. Together, they pulled the cover up and over Kenzie’s still form, concealing the lifeless gaze that had captivated and haunted them in equal measure. The trauma room grew quiet, except for the shuffle of their feet as they moved around the bed. The finality of it all settled over them, heavy and suffocating. Dr. Sarah placed a hand gently on Heather’s shoulder. “Let’s take a minute, Heather.” she murmured, her voice heavy with emotion. Nurse Heather nodded, but her eyes remained fixed on the covered body before them. No matter how many times she went through this process, the weight of loss never grew lighter. Just like that, Kenzie became the latest beauty to find herself toe tagged and under a sheet in our emergency department.

[kk095]

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[kk095]

New Year's Eve in the ER

*happy new year everyone! I'm going to post a read-only link for my latest story. I still can't figure out a reasonable way to get my story posted in its entirety. Due to the character and file size limits on here, I'd have to break this story up into five parts in order to post it and I'm straight up not doing that! I apologize, and hope you all enjoy it!*

https://1drv.ms/w/c/1c77f7ad4e75304c/EX6oOaIXcsJHn67JvlrFHX8BClWYjI0xC-INaAqqqDUx1g?e=ph6up1

[kk095]

Good evening everyone! I'm at a loss on what to do. I believe my file size is too big to post the story I promised in its entirety, but at the same time, I'm not posting five installments to a short story because that's just stupid and nobody's going to read the entire story if it's posted that way. I apologize, and bear with me a little longer until I come up with a reasonable solution! I worked hard on this story and know you'll all like it, so bear with me a little longer!

[kk095]

Hey everyone! I'm working on posting my story as promised, but I keep getting an error message from Tumblr every time I attempt to post it. Not sure what the difficulty is on the app's end, but I intend to post the story as soon as possible. Just bear with me!

[kk095]

Xmas in the ER

*Hello there everyone, and merry Christmas to those who celebrate! As promised, here's my latest story. I hope you all enjoy the story as much as I do, and feel free to shoot me a message, comment, or leave me asks if you have any questions! I will also be posting another story sometime on New Year's Eve.*

As the old saying goes, Christmas is the most wonderful time of the year. The holiday is a great opportunity to spend time with loved ones, exchange gifts, and make lifelong memories. But for Dr Lindsay, this year’s Christmas was just another Wednesday where she was tasked with holding down the 7pm to 7am overnight shift in our ER. Naturally, Lindsay was bummed out about the idea of having to work on Christmas, but the emergency department is a 24/7 operation! Little did she know, she’d still have a holiday she’d never forget!

That night, the weather was awful. It was dark, freezing cold, and snowing heavily. Visibility was limited, and the roads were covered in a fresh coat of snow and ice. “Jeez… I bet we’ll have a couple of MVCs tonight.” Lindsay thought to herself shortly after she started driving, trying her best to carefully make her way to work through the frozen, wintery landscape. Fortunately for Lindsay, the roads were mostly empty, most people in the area opting to stay indoors. Even though the roads were empty, the conditions were less than ideal, so she felt the best move was to drive slowly.

Despite Lindsay doing everything in her power to arrive safely at the emergency department, fate had other plans for the cute, sporty tomboy doctor! On the highway about 10 minutes or so from her destination, Lindsay’s car slipped on a patch of ice on the road. The car almost immediately lost control, redirecting the doctor’s vehicle towards a cement barrier in the median of the highway. Lindsay’s heart raced as she white-knuckled the steering wheel, frantically attempting to regain control of the errant vehicle. But it all happened so fast! There was only so much Lindsay could do in those few seconds. Lindsay was unable to stop or change the trajectory of her car and slammed head on into the cement median.

CRUNCH! The windshield shattered, glass fragments flying everywhere inside the vehicle acting almost as little bits of shrapnel. Lindsay raised one arm to attempt to cover her face from the glass shards, but a few nicked her face and neck. The steering column was forced inwards, slamming Lindsay in her chest with tremendous force before being blown back a second or so later when the airbag deployed. “AHHH!” Dr Lindsay yelped, feeling something pop inside her chest. Even with the vehicle stopped after the impact, the momentum generated from the accident caused Lindsay to be thrown around a bit. Just like that, the roles were reversed, and now Lindsay found herself in need of assistance in the ER.

Upon arrival at the emergency department, Lindsay was awake, alert, and doing anything and everything she could to fight through the pain. While being wheeled in through the main entryway of the ER, she was laid out on a backboard atop a gurney with a c-collar around her neck. Lindsay was stripped barefoot, down to just her black sports bra and scrub pants. EKG electrodes and wires were stuck onto her torso, while IV lines were set up in each arm. A blood pressure cuff was wrapped around her left bicep, and a pulse oximeter was on her left index finger. The ER doc’s body was in relatively good shape, but she had some cuts and scrapes on her face and neck from the glass shards.

While being wheeled in, Dr Lindsay was experiencing a weird déjà vu of sorts. She’s walked through those same entryway doors more times than she could count, but she never saw the emergency department from that angle. She couldn’t wrap her mind around the idea of being brought in as a patient. Her pretty blue eyes scanned her surroundings, attempting to make sense of the nonsense. “33 year old female, blunt chest trauma, single car MVC. BP 60 over palp, heart rate’s 140 and climbing, pulse ox down to 90. Got IVs going on scene and started fluids, but her vitals aren’t looking too good.” Lindsay heard a female medic rattle off while wheeling the stretcher down the hall towards trauma room one. “Ok, thank you. Let’s get her over to trauma one. I’m gonna start her on the MTP and get a chest x ray.” A familiar voice replied to the medic. “who is that?” Lindsay thought to herself. “Dr Sarah maybe? I know she was supposed to work the day shift today.” Lindsay answered, still thinking to herself.

The gurney was still being wheeled towards the trauma bay. Dr Sarah leaned over, coming into Lindsay’s line of sight and lowered a stethoscope onto her chest. Sarah didn’t look down at Lindsay’s face, so she didn’t immediately realize who her next patient was. “Diminished breath sounds on the left side, we might need a chest tube.” Sarah observed, pulling her stethoscope away after a brief listen. Dr Sarah then looked down at the gurney, her eyes locking with Lindsay’s. Sarah’s eyes could be seen widening behind her glasses, absolutely stunned at what she was looking at. Sarah gasped, unable to get a word out. “Sarah….?” Lindsay whimpered, her voice weak and breathy. “OHMYGOD, Linds?! What happened?” Marveled Dr Sarah, still processing the concept of Dr Lindsay- a friend and coworker, being her next patient. Lindsay’s lip quivered, her eyes started to moisten. “my car… it just slipped… I don’t know what happened…” Lindsay explained to Sarah, her voice wobbly, now on the verge of tears. “It’s ok Linds, it’s gonna be ok! We’re gonna take a good look at you!” Consoled Sarah, gently grabbing Lindsay’s right hand, her voice a bit panicked.

Once in the trauma room, the stretcher was lined up parallel to the table, where Nurses Heather and Nancy waited. “LINDSAY?!” Heather exclaimed the instant she recognized who the patient was. “Hunny?! What happened?!” Nurse Nancy chimed in, equally surprised. Lindsay didn’t answer, but the familiar voices certainly comforted her through the terrifying uncertainty she was experiencing. “Let’s get her on the table on my count! One… Two… THREE!” Sarah barked out. The trio of beautiful ladies picked up the backboard and carefully moved their coworker onto the table while the paramedics took their stretcher back and exited the room. “Ah….” Winced Lindsay, feeling some pain inside her chest while being placed down on the table. Dr Lindsay squinted, the bright, fluorescent overhead light practically blinding her. “BPs 60 over palp and dropping. Hang 4 units of O-neg and prep Lindsay for a chest tube.” Ordered Dr Sarah, her voice urgent. “Linds? I have to put in a left chest tube. You know how bad they hurt, but be strong for me, ok? I promise I’ll be fast.” Dr Sarah kept Lindsay in the loop about her treatment. Lindsay hesitated for a moment, trying to mentally prepare for the pain she was about to endure. But the logical, doctor side of her took over, realizing that the brutal, painful procedure had to be done. Dr Lindsay’s eyes looked up at Sarah, and she nodded. “Go ahead.” Permitted Lindsay, giving Sarah the green light to begin chest tube placement.

Lindsay laid on the table in the supine position, her left arm raised above along her head. The normally calm and collected Dr Lindsay had a nervous expression on her face. The doctor turned patient’s lips were pinched tight, her forehead puckered, her icy blue-grey eyes looking in the direction of her left ribcage where the tube was to be inserted. She watched Dr Sarah insert a needle full of lidocaine to numb the skin. Lindsay felt a quick pinch, but nothing too worrisome. Sarah then sterilized the incision area with an alcohol wipe. “Ok Linds… Here we go…” The cute, nerdy redhead doctor told Lindsay, reaching for a 10 blade scalpel that sat on an equipment tray beside the trauma room table. Sarah took the scalpel and made a 1 inch cut at the intersection of the 4th intercostal space and anterior axillary line. Lindsay could feel the cold, sharp blade’s every move as it effortlessly slashed her skin apart. Lindsay saw stars, her eyes rolling back in pain. After the cut was made, Sarah attached a Kelly clamp to the proximal end of the chest tube, then bluntly inserted it into Lindsay’s chest cavity. “YAHHH!!!!” Yelped Lindsay, her eyes shooting wide open. Dr Sarah continued the procedure, guiding the tube further into Lindsay’s chest cavity into the pleural space. “AHHHH!!!” Lindsay let out a blood curdling scream, in absolute agony, her eyes tearing up, both her hands making tight fists, feeling the plastic tube forcing its way deeper inside her chest. There was a hiss of air once the tube reached the correct location from trapped air vacating Lindsay’s chest cavity. Lindsay gasped loudly and dramatically, then attempted to sit up. “whoawhoawhoa!” Nurse Heather stepped in, gently laying Lindsay back down on the table. “Stay still for us Linds. So far so good hunny.” Nancy chimed in, gently stroking Lindsay’s hair. Sarah lowered her stethoscope onto Lindsay’s chest and had a listen. “Tube’s in.” Sarah nodded.

Although Lindsay’s breathing improved following the chest tube placement, her vital signs continued to drop. Dr Sarah started another round of blood products and upped Lindsay’s meds, but that didn’t seem to be doing the trick. Lindsay began to shiver dramatically. Her long legs trembled and shook, and at the far end of the bed, her toes were scrunched up hard, showing off the white and red candy cane themed nail polish on her toes, along with the thin, wavy, prominent wrinkles that permeated the soles of the big, size 12 feet Lindsay was always so self conscious of. “Mmmmm…” Lindsay moaned. Dr Lindsay began taking rapid, shallow breaths, continuing to moan. “Shhh. It’s ok Linds. Hang in there a little longer for me…” Nurse Nancy’s calm, soothing voice told Lindsay. “I…I…” Lindsay babbled. “You what sweetie?” asked Nancy. “I just… I can’t believe I’m gonna die on Christmas…” Replied Lindsay, an impending sense of doom consuming her. The trio of caretakers in the room stood there frozen for a second, taken aback by Lindsay’s response. Nobody could believe that words like that were coming from Lindsay’s mouth. “You’re not dying hunny! We need you here New Year’s Eve! You know how we get slammed every year!” Nancy tried to encourage, her tone of voice upbeat and positive. “New Year’s Eve? Pshhh…” Lindsay scoffed, continuing to shiver. “I’m gonna be toe tagged and under a sheet in a little while…. Forget New year’s…” continued Lindsay. “No hunny, don’t say that! We’re gonna fix you up!” Nancy reassured, her voice getting a bit wobbly, upset by how Lindsay was talking about her own fate.

Before Lindsay could even answer, she started gasping loudly, taking deep, dramatic gasps. The heart monitors began beeping louder and faster, playing an almost ominous tone. “She’s crashing…” Heather announced. “linds? Stay with us hunny!” Nurse Nancy said to Lindsay, holding her right hand for a second. Again, Lindsay didn’t answer. Her frantic hyperventilating continued, her eyes WIDE open. “We need to intubate. 8.0 ET and a laryngoscope!.” Ordered Sarah, her voice roaring through the room. “Lindsay? I’m gonna intubate you, ok?” Sarah told Lindsay, moving to the head of the bed. Dr Lindsay looked up at Dr Sarah, their eyes locking for a moment. Lindsay looked like she was trying to mouth something, but couldn’t get the words out. “What’s up Linds?” asked Sarah. Lindsay didn’t answer. Her eyes shifted away from Sarah’s. Lindsay’s eyes remained wide open, but became locked at the ceiling. It was like a switch was flipped. Lindsay’s shivering and gasping came to an abrupt stop. The monitors began to alarm at that point. “V-fib! Starting compressions!!!” Nurse Heather shouted out. Heather immediately began chest compressions, pushing down on Lindsay’s chest hard and fast. Nancy swooped in, snipping off Lindsay’s sports bra, exposing her small breasts and hard nipples. At the head of the bed, Sarah got right to it, beginning rapid sequence intubation. The nerdy redheaded doctor carefully navigated the flexible plastic tube into her friend’s airway. Lindsay’s head bobbed and lolled around from the residual force of Heather’s hearty compressions, creating a moving target for Sarah- nothing that Sarah couldn’t handle! The breathing tube was navigated further into Lindsay’s airway, ending up in the correct depth and location in a matter of seconds. “I’m in!” Sarah confidently announced, taping the tube in place.

Post-intubation, the trauma team decided to shock Lindsay. The defibrillator paddles were charged to 200 joules, gelled, and pressed up against Lindsay’s bare, flat chest. “Alright! Everyone…CLEAR!” Sarah shouted, sending the first shock into the patient once everyone backed away. “MMMPH!” Lindsay moaned, as if she felt the shock. The first defibrillation didn’t do the trick, onto the second one! The defibs were recharged to 250 joules, and shock #2 was promptly delivered. “Mmm….” Moaned Lindsay, again, almost as if she knew what was being done to her. Shocks one and two didn’t do the trick, but third time’s the charm, right? The paddles were charged up to 300, and Lindsay was shocked. Her chest shot up and her back arched. She held that position for a second or two before plopping down onto the orange backboard. “Damn it, no change! Shocking again at 360. Everyone… CLEAR!” Barked Dr Sarah. KA-THUNK! Lindsay’s 6’1 frame was tossed around effortlessly by the stronger shock, but like before, v-fib persisted. With the paddles still pressed up against Lindsay’s bare chest, Sarah shocked Dr Lindsay again at 360 joules. At the far end of the table, Lindsay’s feet kicked up, slamming back down hard half a second later, wrinkling the soles of her big feet once again.

Following the fifth shock, the trauma team switched gears, giving CPR and ambu bagging another try. Heather placed the heel of her gloved hand on the middle of Lindsay’s chest and began pumping away hard and fast. Lindsay’s chest caved in, and her toned belly with abs rippled and jiggled out from the sheer force of the chest compressions. Heather felt Lindsay’s ribs break, but nonetheless, she kept up her life saving efforts. At the head of the bed, Nurse Nancy attached the ambu bag to the ET tube, puffing the light blue bag every few seconds or so, sending critically needed oxygen directly into the coding doctor’s lungs. Dr Sarah stood off to the side of the table injecting the first doses of epinephrine and atropine into Lindsay’s IV line in hopes of stimulating positive cardiac activity. While waiting for the meds to kick in, Heather kept at it, brutally going to town on her coworker (now patient’s) chest. Heather looked down at Lindsay’s face while continuing CPR. Lindsay’s head bobbed and bounced around in sync with each individual compression. Her eyes were WIDE open, her face locked in a full-blown death stare. The ET tube hung out the side of Lindsay’s mouth, taped in place, hugging her pale lips. Heather couldn’t believe a familiar face was in such dire shape. “The ones with their eyes open never make it…” Heather thought to herself. Back at the head of the table, Nancy continued ambu bagging. “You’ve got a long life ahead of you… We all love you and need you here Linds…” Nancy whispered into Lindsay’s ear, as if she was trying to convince Lindsay to not die.

Over the coming minutes, Lindsay’s chest began to take an absolute beating. A nasty bruise started to form in the center of her chest on top of the breastbone. Mid code, Lindsay’s chest tube began to drain a substantial amount of blood seemingly out of nowhere. “What the hell?...” A surprised Dr Sarah thought out loud. In the blink of an eye, a couple liters of blood drained through the tube. “She’s bleeding somewhere in her chest. Maybe a cardiac chamber or great vessel injury.” Speculated Sarah, trying to explain away what she was seeing. “I’m gonna do an echo. Let’s see what her heart’s doing. Maybe that’ll give me something to work with.” Sarah went on. With CPR ongoing, Sarah squirted a little bit of clear, conductive ultrasound gel onto Lindsay’s bare chest. She turned on the ultrasound monitor screen and lowered the wand onto the portion of Lindsay’s chest where the gel was and began moving it around for a second or two to spread it out a bit. Sarah then moved the ultrasound wand over Lindsay’s heart and eyes the monitor screen. “….oh Lord…what a mess in there…” Uttered Sarah. “Hmm?” Heather overheard. “Massive tamponade.” Sarah shook her head. “Pericardiocentesis?” asked Heather, wondering what the next step was. “I don’t think that’ll do the trick. We need to crack her chest and see what’s really going on in there. I’m gonna set up a thoracotomy tray.” Sarah explained to Nurse Heather. Nurse Heather’s eyes went wide once she heard the word “thoracotomy.” That was a last ditch effort, hail Mary procedure used in the most critical patients. Heather has seen many patients get their chest cracked during her time as a nurse in our ER, but the idea of a friend, coworker, and familiar face being the recipient of such a procedure really bothered Heather at a deeper level.

Betadine was splashed across the left half of Lindsay’s chest. The strong, chemical scent of antiseptic hit everyone’s nostrils in less than a second. Sarah picked up the scalpel, making a crude, but decisive incision. The cut started just to the left of Lindsay’s sternum, extended laterally across her chest, underneath her left nipple, and concluding just shy of her left armpit. Heather halted CPR while Sarah worked to separate the underlying tissue and muscle to make way for the rib spreader. With an adequate space created, the metal rib retractor was placed, and Lindsay’s chest was forcefully pried open. A loud popping and cracking sound echoed around the room while Sarah turned the knobs on the spreader. Upon entry to Lindsay’s chest cavity, there was a massive rush of blood. “Suction! SUCTION!” Shouted Sarah, packing handfuls of surgical sponges into the fresh incision area. Heather lowered a suction tube into Lindsay’s chest cavity and began removing the excess blood to create a good line of sight for Sarah. The suction tube made a wet slurping sound as it removed the blood. Meanwhile, Sarah incised the fibrous lining of the pericardium to relieve the tamponade and placed a vascular clamp on the descending aorta in order to redirect blood flow and quell any arterial bleeding- at least temporarily. Heather continued to apply suction every few seconds or so, the line of sight clogging up with blood like clockwork. “Starting cardiac massage.” Announced Sarah, reaching into Lindsay’s chest, beginning to vigorously massage away at Lindsay’s strong, athletic heart. Sarah’s gloved hands were wrapped firmly around the beautiful tomboy doctor’s heart, squeezing much needed blood to the rest of her body. A wet, rhythmic squishing sound was produced from Dr Sarah’s internal resus efforts. “Come on… come on Linds…” uttered Sarah under her breath.

Sarah squeezed and squeezed, but her multiple cycles of cardiac massage failed to restart Dr Lindsay’s heart. Next up, the team opted to give the internal paddles a try. The internal paddles were charged to 20 joules and lowered into Lindsay’s chest around her erratically twitching heart. THWACK! Lindsay’s heart tensed up for a second before going right back to v-fib. Sarah sighed. “No change, going again at 30. Everyone… CLEAR!” Sarah shocked again. Lindsay’s torso jolted sharply in response to the shock, but v-fib remained. “Hitting her again at 40!..... CLEAR!” Sarah’s voice surged. “Mmm….” Lindsay moaned in reaction to the shock. “she’s still in v-fib, let’s go again…. CLEAR!” Sarah yelled out passionately. A dull, wet thump was heard, however, Lindsay’s heart still couldn’t be shocked out of v-fib. “AGAIN!... CLEAR!” Yelled Sarah, lowering the blood soaked internal paddles back onto Lindsay’s cracked open chest. “Still nothing. Recharging the internal paddles to 40!” Sarah announced, her tone of voice growing more and panicked. The high pitched, electrical whirring sound of the paddles recharging bounced around the room. “Ok…. CLEAR!” Sarah defibbed Lindsay again. Almost instantly after the shock, the heart monitors flatlined. Lindsay’s heart sat completely motionless in plain sight. Dr Sarah removed the large, spoon shaped paddles and gently set them back on the crash cart. Sarah began removing her gloves and eyeing the clock on the wall. “It’s over. Time of death, 19:35.” Sarah called out, abruptly terminating the code.

The trio of caretakers stood there shell shocked for a moment while the high pitched hum of the flatlined monitors droned around the room. Nancy removed the ambu bag, a small amount of air quietly hissing out. Heather switched off the monitors, making the once loud, chaotic room eerily silent. Nobody said a word, but knew exactly what to do next. The IV lines were taken out of each arm. The EKG electrodes were disconnected. The BP cuff was taken off Lindsay’s left bicep. The pulse oximeter was taken off her left index finger. A blue surgical drape was hastily tossed on top of the thoracotomy site. Lindsay’s eyes remained wide open as her body was covered, appearing as if she watched the sheet get pulled over her head. Last but not least, a toe tag was filled out and placed on the big toe of Lindsay’s left foot. The tag dangled in front of Lindsay’s hot, wrinkly soles, serving as a harsh reminder that no Christmas miracles would be taking place that night. In this alternate reality, Lindsay was now the latest beauty who found herself toe tagged and under a sheet in our emergency department.