Code Blue: A Medical Morality Play in 3 Acts
Code Blue, Code Blue, blasting over the hospital loudspeaker. Of course, it’s hardly a code. Everyone knows what it means: a patient is dying.
It was the fall of 1961, a typical day at Mount Auburn Hospital in Cambridge, Mass., where I was a surgical resident. When I heard the Code Blue bugle call, I ran up two flights to a private room, where a respiratory therapist and a nurse were desperately trying to keep the patient alive, punishing him with blow after blow to the chest.
I took the shards of his history. A slender man in his 40s who’d been doing well after a first heart attack, until — bingo. His heart just stopped.
I took over, asking for the usual: check oxygen level, call anesthesia to insert breathing tube, get the defibrillator, notify the family — “tenderly, please, just say ‘turn for the worse, please come back to the hospital.’ ” The defibrillator arrived (“Everyone away!” “Hit it!”) and current flowed through the patient, a tsunami of an electric wave.
Suddenly he rose with a jerk, traveling on the crest of the wave back to normal rhythm , and before long he’d stabilized. By Day 3 he was talking, moving arms and legs, recognizing his family. I peeked in to say hello. He nodded, seeming wary, and I too felt cautious. Why tell him I resuscitated him, remind him he almost died?
Four years passed. In the summer of 1965 I returned to Boston after a hitch in the Army. We had two small children, a third on the way, and we found a promising rental on the lower floor of a house in a Boston suburb — a nice place, spacious even, compared with officers’ housing.
During surgical residency, I’d learned to control the startle reaction. Don’t raise your head from the exposed heart even if the orderly knocks over the rinse basin or the nurse drops a tray of instruments. I had learned that calm worked best. I was not perfect the day we faced our prospective landlord. My head jumped back, my eyes widened. He did not notice; he had no idea we’d met the day his heart stopped.
After my shock passed, I had the same thought I’d had back then: “Why tell him? Surely he has suffered enough.” We signed the lease. Over the next 12 months I saw him regularly, working in the garden, taking out the trash. The heavy work belonged to his wife, a quiet lady who seemed to carry her grief past sadness, to an anticipation of future sorrow. By June I had a real job, a decent salary, and we were moving again.
We had left a deposit when we signed the lease. Now the landlord checked the apartment like a lion after a wildebeest, zeroing in on the fireplace, where our oldest children had decorated the white mantel in a motley design of red, orange and blue crayon.
He turned toward me. He became adjacent and angry. “You owe me $300,” he snarled, shaking with each word.
What to say now? Should I let my own rage speak — “You idiot, $300 to paint a mantel? I saved your life!” We had no extra money; I’d counted on the same $300 for the trip to our new home.
I took a deep breath, and I gently asked him if he remembered his heart attack.
“Do you know your heart stopped?”
“I think so.”
“Well, I was the one who saved your life, brought your heart back.”
He hesitated. “I didn’t know that.”
He turned to the door, distressed, in pain. Turned again. “You still owe me $300.”
We paid. He had his old life. We had our new lives.
Older now, I would not have told him. In 40 years of practicing and teaching, I’ve learned this much: his agony was not worth $300 to either of us.