The Pediatric Arrest

We are called to the code, like we are called to all codes during our watch in the hospital. As the senior resident in internal medicine, I am at the helm of the resuscitation team. By now, I have run many codes. They do not scare me; I know what to do. At this moment, however, I am terrified. Tonight it is a girl, 8 years old or so, who is lying unresponsive in the emergency department. I do not treat children. They are small, and they seem fragile and medically mysterious to me. I do not know how to dose their medications properly without looking them up. I worry that there may be many other things about children that I do not know.

I have attended only 1 or 2 other pediatric codes. Usually the child is already improving by the time medicine arrives, and the pediatrics residents no longer need our assistance. We leave, praising the heavens as we go. “Thank goodness,” we sigh once out of earshot. “I don't know how they can handle that. There are reasons I chose adult medicine.” Tonight, though, this girl is very, very sick, and I will have to stay and help.

The atmosphere in the room is calm and controlled. This is the way it is in codes. Right now, nothing else in the …