The report came through

On a Friday afternoon

A “Discharge Summary”

Just two pages – but it was ugly

Admitted and “discharged” on the same day

I had seen her just four days prior

She’d complained of feeling short of breath and tired

Mid-50s, morbidly obese – all the things that go with it: arthritis and diabetes

She’d fired an employee the day before and gotten into a fight with her daughter

The conflict and guilt were a bother

Her lungs were clear but she was tachycardic

She spilled all the details of her subordinates’ falling out

Told me all about her anxiety – it was cathartic

She walked down the hall with ease to the lab

I didn’t know that’d be all the time we had

I told her to get to the ER if she felt worse

She was insistent that nothing hurt

But the report said she’d presented with a STEMI alert

Her oxygen sats were low

Her chest CT glowed

EKG was abnormal

They laid her back for a cath

She crashed

Her numbers dipped

The report said she was alert enough to refuse intubation

Then suddenly, no pulse

Oxygen again, epinephrine, chest compressions

Multiple rounds but her heart wouldn’t pound

“No ROSC” – no return of spontaneous circulation
Had her final words been an intimation?

She was surely tired

Too much so to look over her shoulder

She told me she’d been doing that all week

One of the staff members in the room was close enough to hold her

–the same woman she had fired

The same one who’d never actually turned the oxygen on

At 7:20 pm the patient expired