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May 23, 1990


Author Affiliations

Kalamazoo, Mich

Kalamazoo, Mich

JAMA. 1990;263(20):2798. doi:10.1001/jama.1990.03440200102033

Early one Sunday morning, even before I had the chance to change into my scrubs, I received a stat page to the emergency room. I was only a few months into my internship, and though I was becoming familiar with routine calls, stat pages had a tendency to mean runs of V-tach—mine. I arrived at the emergency room simultaneously with the ambulance. A 2-year-old, found unresponsive by her parents, lay motionless on the gurney. She had been intubated by the paramedics, but her heart had failed to respond. Despite prolonged CPR, countless rounds of drugs, endless fluids, and a temporary pacemaker, the young heart remained silent. Reluctantly, I stopped the code.

Explaining these events to Christy's parents was one of the most difficult experiences of my young career. Fortunately, the attending, who had supervised both the attempted resuscitation and my conversation, recognized my struggle. "You handled everything well," he reassured