Late in the afternoon on a winter day a "trauma code" came overhead and through my pager. This case is the singularly most horrifying case that I experienced during my year of residency. It still haunts me.
A patient was brought in on a search and rescue stretcher. The EMS team tracked tons of snow into the trauma room. There was so much snow and ice brought in on this patient that the social worker and myself ran to the blanket warmer, grabbing stacks of blankets to place over the floor to prevent the team from slipping. The doors of the trauma room were closed. Maintenance was notified to crank up the heat to over 85 degrees. The team who was performing CPR was sweating profusely. I wrapped warm blankets around tearful firefighters and EMTs who were shivering even in the heat of the ED.
They needed to talk. The patient was found in the water in the mountains. Clothes were frozen. Shoes were frozen. They didn't know who this person was or where they came from or how long they were in the water.
The Emergency Tech came out of the room in tears. She couldn't start an IV. She couldn't draw blood. The patient's veins were ice. She laid her head on the counter. A nurse came out of the room. He said, "the patient isn't dead until they are warm and dead. The patient isn't warm yet, so they aren't dead."
Warm and Dead.
And so for the next hour or so, rounds of CPR continued on the patient with ice in their veins. It is heart breaking to watch such fervent life-saving efforts. It is heart breaking to watch people who have dedicated their life's work to saving lives to be trying to save an impossible life.
Once a warmer body temperature was reached, resuscitation stopped.
I still don't know how the patient's family knew to come to our hospital. I know I didn't call them, and that was usually my job. I looked for a wallet, but there was none. I think the state patrol somehow notified them. And also notified a victim's advocate who came to the ED covered in freshly fallen snow. Such pure snowflakes amid such unrelenting horror.
From the family we learned that the patient disappeared after a call made several days earlier.
But after that, we don't know. Only that the patient was submerged for a few days and somehow their family ended up weeping into my arms.
When I thought of this patient, I could only think of white skin, the color of ice, frozen solid. And of ice in veins. And I would weep for the senseless and horror and aloneness of this death. And I would pray that this person knew some kind of comfort in their last moments out in the elements. And that when they were declared warm and dead, they might know how many techs and EMS workers and nurses and chaplains wept for them in a fluorescent ED.