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My breathing is heavy, lumbering, and my chest pounds. I hear the blood pulse past my eardrums. What have I done? It can still be undone, I tell myself, but I don’t want to undo it. I want it to be over. I want her to be dead. I breathe in. I breathe out, knowing I have to find a way to relax, that I have to be patient because it won’t happen right away. It will take a little time, her condition worsening before she goes into cardiac arrest and all the while, I have to act like nothing is happening, like nothing is wrong.
I force myself forward again. I silence the alarms in the room. Eventually she’ll become tachycardic, her heart rate high, and I don’t want anyone to know because they might try and save her too soon. I can’t take any chances that she survives this. On our unit, we don’t have teletechs sitting around, analyzing heart rhythms. Instead, as nurses, we’re trained to pick up on subtle differences on an ECG or to listen to the alarms. Caitlin watches me as I silence hers, her eyes fully open and I wonder if she knows what I’ve done, if she knows what’s happening to her and if she’s scared.
I leave the room because I can’t just stand here for the next hour and watch it happen. I have to go about my day. I have to act normal. I go to check on my other patients. I take vitals and administer medication, but, all the while, my mind is on Caitlin, wondering what’s happening in her room, if she’s experiencing heart blocks by now, the electrical signals slowing down, failing to conduct.
I leave one patient’s room, stepping into the hall for the nurses’ station to make a call. At the same time, I see Luke coming in the opposite direction. He smiles and I think he’s just going to pass by, but then he says, “I’ve been meaning to talk to you. Penelope has a friend,” at the last second before we pass, gently grabbing a hold of my forearm, turning me to face him. We’re just outside of Caitlin’s room when he does, and, because of my positioning, I’m forced to look in, to see sweat on her forehead, her skin turning red. “Dan—Daniel—Murphy,” he says, though I can barely hear him because I’m thinking about Caitlin and wondering if anyone else can see the sweat but me.
“Earth to Meghan,” Luke says, teasing. I blink my eyes into focus, forcing them on him. “Did you hear me?”
“I’m sorry, no,” I say, shaking my head. “What did you say?” I ask, knowing that if Luke were to turn his eyes a little to the right, if he were to move his gaze just another couple feet, he would see into her room. Would he also notice her sweating or am I only being hypervigilant?
“Is everything okay?”
“Yes. Why?” I ask, stepping away from the glass, further into the hall so his eyes will follow.
“I don’t know,” he says, cocking a head. “You seem distracted.”
I force a laugh that’s anything but genuine, the sound of it unpleasant to my ear. “I’m totally fine,” I say, overemphasizing the word fine, making it lack credibility.
Luke holds my gaze too long. “Are you really?”
I clear my throat and collect myself. “Yes. Honestly. I’m fine,” I say, my words more grounded, more like myself. “I’m sorry, I just dazed off. Long day. What were you saying before?”
“I said I think you and he would make a good match. Penelope’s friend, Dan Murphy. What do you think?” he asks, a grin forming on the edges of his lips. “A double date?”
“Penelope is on bed rest.”
“We’ll have you and Dan over to our place. I’ll cook, I’ll do the dishes, so that Penelope doesn’t have to lift a finger.”
“Spoken just like a man who’s never been pregnant or on bed rest before. I’m sure she’d love that.”
“She’s going stir-crazy, Meghan. I’m sure she would. Think about it, okay? Let me know later. Just don’t wait too long to decide because he’s quite the catch, as Penelope says,” he says, putting air quotes around the words. “If you wait too long, you might lose your chance.”
“Okay.”
“You promise?” he asks, lingering too long when I wish he would leave.
“Yes. I promise.”
When he walks away, the relief is profound.
But it’s short-lived. Because at nearly the same time, the doors to the ICU open and I brace myself, imagining the Becketts coming back to visit at the wrong time, seeing it happen, watching their daughter die.
Twenty-Four
Her heart slows. She goes into cardiac arrest. It’s not V-tach but pulseless electrical activity, where the electrical activity in the heart is too weak to make the heart contract, to pump blood to the rest of the body. She has no pulse and the amount of electrical activity in the heart is not enough to keep her alive.
I’m in the room when it happens, watching as she loses consciousness, as she becomes unresponsive, as she turns pallid.
I do nothing yet, though my nerves scream out and my brain is on fire.
She’s dying.
By the grace of God, the Becketts haven’t returned from their house. They’re still there, or they’re somewhere in-between, like in a cab, the hospital lobby, or riding the elevator to our floor. I look out into the hall to be sure no one is there, that no one is watching Caitlin die, and then I let my eyes return to her, stepping to the bedside to check again that there is no palpable pulse.
Death from pulseless electrical activity happens within minutes, so that by the time I decide to call a code blue, she will already be edging towards death. Within five minutes of the brain not receiving blood and oxygen, her brain cells will start to die, and once that happens, there will be no reviving her.
I stand watching for as long as I can, to be sure that the damage is substantial and irreversible and then I know I have to attempt to resuscitate her. I have to make it look like I want to save her life as I would any other patient. I call a code blue, screaming it out into the hall, and then I start chest compressions, which are passive at first until a witness arrives and I put more effort into it, feeling Caitlin’s ribs break under the pressure of my hands.
