VSA

 is a Public Health & Preventive Medicine Resident (R2) at Queen's University

 

It’s 1 AM. The call comes in: VSA en route. Your team assembles.

Efficient, empathic, skilled — the team prepares for arrival. Roles are assigned, facts are reviewed, and questions are posed. The team is ready. You wait.

The patient arrives. Pulse check — asystole.  On to the chest. Transfer the patient to the bed. The team knows what to do — whether through simulations or past cases, everyone knows the algorithm. Everyone knows their role. With heads, hearts, and hands, everyone works on.

The clock marches. Tick. Tock.

 The skin is mottled. Bagging is going well, but intubation is tricky. Paeds and Anesthesia are on their way. Keep bagging.

Breathe. Stop.

The IVs aren’t working. It’s time to go IO. The drill is ready; a team member starts.

Drill. Stop.

It flushes. Fluids are started.

Drip. Drop.

Pulse check — asystole. Back on the chest. One and two and three and… Meds are in. You keep pushing to get them to the heart. One and two and three and… The team continues. Summarize. Are we missing anything?

Think. Thoughts.

The team does everything right, but tragedies still happen. Life in the emergency department doesn’t always have a perfect ending, because life itself so rarely does.

The decision is made. Two months old. Peaceful and cold.

You know the family is arriving. The team leader will deliver the news. Your heart breaks.

One life stops, but one hundred others call for your attention. You check your list. Down the hall, a young girl breathes though the pain of costochondritis. A woman with a swollen leg waits on a D-dimer. Another miscarries a fetus that, yesterday, she celebrated as her soon-to-be second child.

Patients call. Please, Doc.

You check your patients to make sure they’re stable. The team gathers again. You debrief.

Tears drop.

You feel almost numb — still processing. VSA — vital signs absent, or vague self-awareness?

The night goes on; the caffeine flows. Emotions are mixed. You find happiness in small victories and in gentle moments with patients. In between, you think of the child. So young. So small.

Your team is still there. Supportive. Surviving. Mentors, peers, new faces bonded by moments in time… moments that (for many) will last forever in their minds.

Your patients call. Fulfill your oath.

“I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family […] My responsibility includes these related problems […] I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.”

The sun comes out. Your shift wraps up. Some patients are handed over as they await imaging, but most go home to the comfort of their beds.

You go home to rest and heal, hoping your team does the same. Getting ready to come back another day — perhaps another VSA.