(This passage is intentionally short and chaotic to convey the atmosphere in the trauma bay)

Setting: Open, round-table learning session about A as in airway.

A call comes in: GSW to left chest, no pulse, s/p Compressions for 15 min, 10 min out.

Doc 1 – ready shock room 1.

Prepped the room, suited up.

Nurse 1 – he’s here.

(Felt like only 5 min.)

2 inches, “stayin’ alive”

Has been dancing for the last 25 min.

Not sure ‘what-when-how’ before that.

“Stayin’ alive” …


Tubed, wired, cuffed.

“Stayin’ alive” …

C, C, C.

“Stayin’ alive” …

We went on for three rounds of Epi.

Nothing, nada, zilch, A as in asystole.

Just as quickly as he came in, he was gone.

(vacuum, “isolation of affect.”)

Checked him, cleaned up, regrouped, “intellectualized”

Doc 1- have you guys had something like this happen before?

Me – not for me, first time.

– if you want to discuss it or talk about it

– it was too quick to really get emotionally involved

– people cope with it differently, if you need to talk about it later …

BHTs, burns, battery victims, MVCs.

Then it happened.

(Screams out in the hallway.)

I ran over to … (to do what, I don’t know.)

Some girl ran into the trauma bay.

– (crying) where is he? Where is he?

Security grabbed her, took her out.

Out in the hallway, people screaming.

Pacing up and down the hallway, shouting.

On the floor crying.

Denying, bargaining…

Angry and depressed.

Just as quickly as he came in, he was gone, but the cries still echo in the hallways as I leave the hospital after a 30 hour call shift.


A, B, C, D, E: Airway, Breathing, Circulation, Disability, Exposure/ Everything else.

GSW: gun Shot Wound.

s/p: status post.

“stayin’ alive”: from the song “staying alive” by Bee Gees; the rhythm being similar to that of CPR.

Isolation of affect: a defense mechanism in which the individual screens out painful feelings by recalling a traumatic or painful event without experiencing the emotion associated with it.

Intellectualization: a defense mechanism by which reasoning is used to block confrontation with an unconscious conflict and its associated emotional stress.

BHT: Blunt Head Trauma.

MVC: motor vehicle collision.

Denial, bargaining, anger, depression, acceptance: the five stages of grief.

Mohammad-Kazem is completing his Doctor of Medicine (M.D.) degree in the United States. He immigrated to Canada from Iran at 18. He has captured the choppy experience of a Resident’s chaotic immersion in a trauma center in as choppy a narrative as he can muster.