I took a nap. Code Blue rang. I no longer go to it, since ER Doc does, and medico-legally it is best to avoid risk. Then the phone rang in my call room. 'Difficult airway in SICU'. So I went.
Actually, I went downstairs to the OR in L and D. I got my Fasttrack intubating LMA. I ran upstairs to see the worst airway of my life, with an ER doc ready to try conventional direct laryngoscopy that I could tell was not going to work.
Sats were okay, until he induced anesthesia, paralyzed the patient and went in. Couldn't see a thing. Kept looking. Kept desatting. Down to 15% and the patient turned blue. Started to brady down. Death was within seconds.
He withdrew and we masked him up. I held airway and mask. Back to 90% plus. Then I inserted the Fasttrack. Got good exchange. But when I went to intubate, the tube was so old the plastic connector ripped the tip of the tube off. I asked for another Fasttrack. And the Glide Scope from the ER. And the difficult airway cart.
I had a c-section scheduled for five p.m. I was away from the labor deck and committed to this airway. If there was a crash OB would be without anesthesia services. I called for back-up. There was none.
The head nurse thought the epidural cart was the difficult airway cart. The poor thing ran. When the right cart came, the fiberoptic scope was pediatric, and the connections to the light source were not able to connect. Another anesthesiologist had arrived. I took a Glide Scope ETT, went through the Fastrack, got end-tidal CO2, then re-anesthetized the patient and took out the Fastrack, leaving the tube in place.
I noticed the teeth on the bottom had dislodged since the patient bit the metal tube on the Fastrack device.
Where was the Reiki? I was calm. The whole time. No fear. No emotional letdown after the event. And everyone looked at me as the hero. Even the neurosurgeon for the patient when I saw him in the hall later. But even this did not register into my ego. It just was. I call this 'Reiki in action'.
Immediately after, I placed an epidural in a woman with a BMI of 54. I had to hub it and press in with the Tuohy needle. I put it in in less than fifteen minutes. During the whole procedure I felt and incredible tingling sensation coming through the top of my head, down and out through my arms. I was grounded and aware of this energy. Again, no anxiety. Just calm. Nurses looked at me like I did something special. But no ego reaction to the event. Just service. And the opportunity to do more good work.
Next was a c-section for HELLP, a life-threatening condition in a twin pregnancy. That went off without a hitch and was the smoothest OR procedure I had seen in months. No ego reaction. Just calm.
In the middle of the night, a woman with a spinal condition who had been told by her midwife 'no epidural' wanted one. I researched it. My assessment was that there was more to lose and less to gain by placing it. Conus medullaris syndrome, incontinence of urine and bowel. I explained it and offered nubain. She agreed. Confidence, no ego, no reaction.
Early morning, a nurse, senior who had worked the heart floor now headed up OB, could not place an i.v. I did. There was concern it was leaking. I reassessed. The connector was not right. We added a new extension to the i.v. and it worked fine. No ego. Just work.
I checked with all three of my patients to see how they were doing. They were glad to see me. This anchors the experience in their memory. No ego. No pride. Just doing the best for what is right.
This is not like me. I am an anxious and emotional person. I fall apart after close calls and emergencies. I am still standing. This work I am doing is not like before. It is different. I think it is a good idea to be open to Spirit when working in the service of others. I could not have done all of this on my own. Think about it.
Namaste,
Reiki Doc
