For love of life

Heart rate: 0. Blood pressure: 0. CODE! One, one thousand one. One thousand two. One thousand three. Fast and deep.

It’s one of those moments in our lives as doctors when we are caught in that exact point between life and death. It’s in this moment of upheaval when we try to be objective on the very definition of life. Breathing? Heart beating? While time and again it has been life-saving to see patients coherently alive after a few days and, in as many cases, after just a few minutes, there are also instances when I am so unsure whether we are indeed prolonging life or just delaying the dying process.

Are we, in that moment, moving against the natural course of life—that when it’s someone’s time we pretend that it might be otherwise? That life—at that moment of pushing against someone’s chest, to make the heart beat for another second, and another, and another—is exactly flowing through the creases of our hands?

Check rhythm. Asystole. Continue compression.

As healthcare workers trained to perform resuscitation, we are basically just instrumental in this process of “saving” someone’s life. But deciding whether to proceed or not with resuscitation really lies on the patient’s loved ones (or, lawfully speaking, legal ones). Let’s put ourselves in their shoes. How do we decide to go or stop? Will the patient be alive after this? Maybe.

We cling to the hope that there is life after the procedure, that we have done everything, exerted all efforts, and touched every possibility. And when it’s finally time for someone to say goodbye to a partner who saved one’s life in another way, to a mother who never failed to see one off to school every morning, to a loving grandmother who gave one the sweetest candies, to a father who, one hopes, will still be able to feed one’s five hungry children waiting at home, or, much painfully, to a child who gave one’s life a whole new meaning—we will have no regrets. Saying goodbye will be less painful for us, knowing that we did everything to the last beat of their heart.

I recall a friend telling me how it was when with just one word from him the doctors would stop: that it was his father lying there, that being a doctor himself he knew there was very little chance of survival, that still one hung on to the little hope that maybe the 1 percent of survival would include this case…

Thirty seconds to check.

Really, do we play God? No. Of course not. It is in this instance that we recognize our humanity, and that there might be some being who will decide. We acknowledge that there exactly is where life might end, that there might be something else we can do, to at least give hope, to at least give someone one last chance to live.

However science has proved that the prognosis is so bad that the patient’s survival would be a miracle, or faith, or medicine, we do it anyway. We do it for the families who will be left behind, and for the patient who, we hope, we’ll still see smile at our presence. We do it for the love of this life, this science, this art of healing.

Rhythm. Asystole. Time of death: 1:45.

It is never easy to say goodbye. And every single time, like the family or the friend who got left behind, we nurse this feeling of loss.

Every single time, we grieve. And we let go.

Kris Conrad M. Mangunay, 26, a new graduate of the University of the Philippines College of Medicine, is reviewing for the licensure exams.