A true story that I wish could be played back. We could try different interventions, like maybe an Intra-aortic balloon pump. That was probably the only thing that would have helped. It's always wrenching to second-guess in the aftermath of disaster.

This Moment in Our Fame

Another San Onofre’ meltdown
Was headed for our floor,
A mystery diagnosis
Seven drips and so much more,
A scant report was taken
On the phone an hour past,
I was ready for disaster
But the time went by too fast.

A commotion could be heard
In the hallway by the door,
As I walked to meet the entourage
I tallied up the score,
The patient was attended
By a crew of EMT’s,
With a Doctor and a Lawyer
Haggling over fees.

A hundred different IV lines
Were tangled on the gurney,
I had to push aside the Doctor
And wrestle the Attorney,
To acquire my position
Of authority and leverage,
I tossed them both a dollar
To get some candy and a beverage.

With the patient safely settled
And his life support attached,
I did a brief accounting
To see if facts and figures matched,
Then I sent some bloody lab tests
To bring us up to date,
When we had gathered all the data
We could figure out his fate.

In the meantime I was struggling
With a metabolic mystery,
Profound acidosis
And a complicated history,
Respiratory failure
In cardiogenic shock,
There weren’t a lot of hours
Left upon his clock.

What a night, it seemed like days
But the morning finally came,
Was he better?; not at all
Though we’d fought a vigorous game,
We had stabilized his pressure
But his oxygen was worse,
In this metabolic setting
Could his heart rate be the curse?

In the future we’d look back
At this moment in our fame,
We’d search for untold answers
And try to shake the blame,
That the choice of intervention
In this case, to beta-block,
Was the icing on the cake
In fact, it stopped the clock.

His heart rate slowed, that was the plan
But the progression wouldn’t stop,
His pressure held on for a bit
But soon began to drop,
The Code-blue team performed on cue
But the fiber of life unraveled,
Before the survivors left the scene
His soul had long since traveled.

Another San Onofre’ meltdown
History written in a book,
We could read the notes in retrospect
To contemplate, to look,
Prepare to meet the future
A little wiser, that’s for sure,
In certain situations
Beta-blockers aren’t the cure.

Fibril_late; 5/94