BLOG: Who called the code blue?
The patient in the ICU was feeling progressively short of breath. She later said she felt like she was drowning with fluid in her respiratory passages. She felt like she was going to die. She knew that if she did not push the “code blue” button, she would die.
Soon, a “code blue” alert went out. The code team arrived quickly, as they were in a nearby room in the ICU.
The patient was clearly in impending arrest: The code team resuscitated the patient. She survived.
As the code team rushed into the patient’s room, one of the team’s members asked: “But who called the code?”
The patient said, “I did.”
A “code blue” is usually used in hospitals and additionally in some sophisticated clinics or health care institutions or facilities that have a “code team” on board. Most typically, a code blue is called when a patient in the hospital has a cardiac or respiratory arrest or less commonly when a patient’s condition deteriorates severely to the extent that the health care personnel believe the patient may deteriorate further (an imminent arrest).
Immediately, once a code blue is called to a hospital’s operator, a loud announcement will be heard on a hospital’s overhead speakers. Everyone will hear the emergency call. Code blue is typically called by a health care professional.
In this case I just described, the patient wrote later:
“As I drowned, my vision tunneled, until all I could see was a small circle above the head of my bed. My eyes focused on a small blue square button, labelled CODE BLUE. The universal alarm would activate the code team in the event of a dying patient. I struggled to raise my arm and pressed it. Within seconds, the team rushed in. They had been rounding just feet away, oblivious to my distress. The first two to arrive looked at each other, and one of them asked, “But who called the code?” before quickly realizing that was, in fact, not the most pressing issue. They worked quickly, almost wordlessly, with a grace that suggested it had been choreographed. A tube was placed to decompress my stomach, a higher level of supplemental oxygen was supplied. A portable chest X-ray was shot. A wordless decision was made to drain the effusion surrounding my right lung, and a thick needle entered my chest wall like a dart. They attached a catheter to a vacuum bottle, and I watched as liters of foamy red liquid drained.... within minutes, I could breathe again. “I called the code,” I said, addressing their forgotten question.
“You called a code on yourself?”
I nodded. They smiled, incredulous. Their work done, they began filtering back out to return to rounds.
“I nearly died,” I said to myself as much as anyone....”
That patient was Dr. Rana Awdish, a pulmonologist and critical care specialist at Henry Ford Hospital, in Detroit, Michigan.
Dr. Awdish told the story, with the aforementioned quoted paragraphs, on pages 67 and 68 of her recently published book In Shock: My journey from death to recovery and the redemptive power of hope (St. Martin’s Press, 2017 New York).
I told the story of Dr. Awdish in a prior post on my MedBlog.
Dr. Awdish described her life-threatening illness, in which she bled so profusely into her liver, while she was 7 months pregnant. She stayed in the hospital for over 3 months. She described that she almost died. And she lost her baby.
In her powerful book, Dr. Awdish described not only her experience as a patient, but also her experience as a doctor-patient. She used the term the “hybrid physician-patient”. Dr. Awdish described throughout her book how her illness taught her things she had not known prior. It taught her what it was like to be a patient. To go through what patients go through.
In my opinion, when doctors become patients, this could be a transforming experience. It could become a powerful teachable moment. Tthis could be a powerful instigator of empathy inside of doctors, if such experiences prompt them to begin to put themselves in the shoes of their patients.
I also discussed this doctor-patient status in another post on my MedBlog. In the post, I described how becoming a patient can make a doctor more empathic toward his patients.
Reading the book has boosted empathy inside me, and I trust it will do the same for anyone who reads it. As a sometimes doctor-patient myself or as a relative of patients, I have experienced situations of non-empathy from some doctors. And, over the last decade, I have read numerous publications which underscore the observation of lack of empathy from some doctors.
In this post, I have just shared one story told by Dr. Awdish.
Dr. Awdish’s book is plentiful with stories which blend lighthearted humor with irony in a beautiful story-telling fashion, in the most eloquent writing style that one can come across!