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FEATURE

By: Robert G. Johnson, MD

Okay. I get it. There are medical emergencies. If you’re not an honest-to-god true story: It was a quiet evening on the ward. My
breathing or your ticker crumps, get off the couch, put down the two-day post-op patient had an uneventful day — swallowed his over-
day-old lemon Danish from the surgeon’s lounge and run like — salted broth without gagging, stood at the bedside, sucked on the in-
#*!!! I preferred the old terminology of Code Blue. Sounded mys- centive spirometer like he loved it. All was well — until 2304h (that’s
terious, important, like something you’d hear on ER or Grey’s 11:04 at night). At four minutes past the hour the door to my patient’s
Anatomy. To be followed by a stampede of smoking hot, perfectly room is breached. Not sure if they used explosives or just a good
coiffed, gleaming-toothed, freshly starched lab coats. And, of kick. In floods a SWAT team of white coats and blue scrubs and RT’s
course, over chest compressions and barked instructions for calcium and MD’s and even a few PhD’s. My patient is overwhelmed. Nobody
and epinephrine, McSteamy is flirting with McGorgeous, and before explains the reason behind the ambush. He somehow manages to
normal sinus rhythm is restored has secured a date and reservations ring up his wife in New Braunfels and sputter: “I’m being transferred
at a dark corner table for later that same evening. Today, the drama to the ICU”. His wife, understandably frantic, races into the hospital
has been down-graded to a watery “Medical Alert,” or “Rapid Re- at breakneck speed (a 45-minute drive). She eventually gets to see her
sponse Team,” with regular folk in stained scrubs and bad-hair days. husband and was given some half-baked story about sepsis. Managing
So… I guess the ID and wound care and guys who lance boils or a grin, her comment to me later was: “I felt his face. It was neither
drain pus got to feeling left out. Why should the cardiologists and hot nor room temperature.” (She figured it out without the ten years
pulmonary docs have all the fun? Share the drama. Pass around the of medical training.) The next day I visit him in the ICU, sitting up,
“We’re Important Too” casserole. Announce us over loud speakers eating bacon and eggs. He quips: “I’m still above ground.” I ask the
so all will perk up, cock an ear, and clear the path. nurse in the unit why the patient was transferred. He shrugged.
Enter — ta-daaa — Sepsis Alert. Really? Hearing sepsis alert over- “D***ed if I know.” After less than twelve hours in the unit he was
head is right up there with the green Chevrolet that’s left its lights on. sent back to the ward. It took that long for his family’s collective heart
Alright. To be fair, true sepsis is a serious medical problem. Here is rate to return to double digits.

34 San Antonio Medicine • January 2019