Bioethics Blogs

My Thoughts While Doing Chest Compressions: Reflections on Care in the Intensive Care Unit from an Intern Physician-Medical Anthropologist by Kimberly Sue

I was doing chest compressions on a 29-year-old woman who had just come up from the Emergency Room, and I was trying not to look at her face. She was gravely sick, intubated, and we had no idea what was wrong with her. When she went pulseless, we started the American Heart Association’s Advanced Cardiac Life Support (ACLS) algorithm for pulseless arrest. It is the intern’s job to do chest compressions, a somewhat apt metaphor for their lowly but absolutely necessary position in the medical hierarchy of healthcare training institutions. The intern is the workhorse, the one both performing and enduring the brute and long labor of modern healthcare.

The teaching goes that if you’re not breaking ribs, you’re not doing chest compressions correctly. You have to be doing at least 100 compressions a minute. With your hands, you are literally trying to physically pump the blood out of the heart to the brain and other critical organs. Violence is absolutely necessary here.

I think about this woman’s life and my life. We are roughly the same age, brought together by the most unfortunate circumstances. I wonder what her voice sounds like. I will never hear it. As sweat drips off my face, I realize, sadly, that I am getting physical exercise for the first time in a week. It is during this moment that I have a glimmer of recognition that there are so many upstream structural forces that shape the texture of my day-to-day experience in the hospital, as well as the experiences of the patients we serve.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.