It was July, the start of summer holiday for kids and fun in the heat for many – not quite for me. It was my second last rotation in my PharmD program, a rotation in Intensive Care Unit (ICU).

It was nerve wrecking.  I was already exhausted from the travelling and all the work from my previous rotations. I wanted to relax at the beach but I was stuck in the ICU.

Then a new admission arrived, a 22 yr old male unconscious with acute pancreatitis. I thought to myself, “What do I know about acute pancreatitis? Absolutely nothing. Ok. Mental note – read up on acute pancreatitis tonight.”

I started to gather my information: name, age, gender, allergies, past medical history, current medications.  The patient was unconscious with no collateral source available. There were few blanks in his story waiting to be filled out.  I started to look at  his lab results… out of wack, especially the LFTs, GGT, Alk Phos….

Then someone called the Code Blue.

It was him, the new admission, my first patient. Everyone gathered around him, started calling out instructions, a crash cart came, the defibrillator went on his chest  and the rest was a blur. I was standing at the back, watching the entire scene unfold. It felt like watching Chicago Hope, ER, House or Grey’s Anatomy. Only it was real.

After about 10 mins, the patient was pronounced dead.

Then I look at my barely started work up plan. It was supposed to be my first patient in ICU, to work up any drug related issues, to figure out a master care plan to “wow” my preceptor.  It was no longer needed.

Then my preceptor came to greet me with a smirk, “Welcome to ICU!”  I took a look at the dead patient before he got wheeled out. I knew it was going to a long month here.

“I am so dead.”, I thought.

But then I started to console myself, at least if I developed a cardiac arrest, I was at the right place at the right time, probably would receive the right treatment with the right monitoring plan. That was my perfect care plan for myself.  

So I started to regain my composure and began to search for my next patient, hoping that I could fix something before he or she coded before my eyes.