"We Can't Kill Your Mother" and Other Stories of Intensive Care
by Lawrence Martin, M.D.
Table of Contents

NOTE: "We Can't Kill Your Mother" and Other Stories of Intensive Care can be downloaded in its entirety as an e-book from 1st Books Library ($4.95). The book can also be ordered in trade paperback format for $13.50. For purchasing the e-book or print versions, please go to 1st Books Library and enter part of the book's title or the author in their search engine. Below are the first few paragraphs of "SHOCK HIM!"

John Capowski, 51, came to the hospital for an altogether different problem than what brought me to his bedside. He showed up in our emergency room weak and lethargic, with a three day history of nausea, vomiting and diarrhea. He came because he couldn't keep anything down, and also because it was the middle of the night and Mrs. Capowski was afraid. She insisted he see a doctor and drove him to our ER. They arrived about 1 a.m.

The previous day he had missed work, calling in sick to the car plant where he worked as assembly line foreman; the line makes engine blocks for several car models. His job was not difficult, he liked the work and was seldom absent. A second day absent, though, and he would have seen a company doctor, if for no other reason than a return-to-work note. He rarely saw his own physician, certainly not for anything routine. And he wouldn't think of calling his doctor at midnight, so the ER was a convenient choice.

To the ER physician on duty Mr. Capowski did not seem acutely ill. Vital signs were normal, although his blood pressure was slightly on the low side. But vital signs like blood pressure and heart rate are not the whole picture. Despite his size a muscular 5'11", 210 lb he appeared wan and listless, sick enough to warrant further investigation. Vomiting and diarrhea can deplete the body of electrolytes and the only way to know for sure is to measure the blood levels. (And who would want to tell Mrs. Capowski to take him home? She hovered over him with an air of insistence: 'do something').

Sure enough, Mr. Capowski had a low blood sodium and potassium, meaning he had lost a significant amount of electrolytes. He needed hospitalization, a recommendation as much to his chagrin as to his wife's relief. Other tests in the ER, including chest x-ray and EKG, were normal, so he was admitted with the diagnosis "Probable viral syndrome, dehydration, hyponatremia [low sodium], hypokalemia [low potassium]." The plan on admission was "fluid replacement and monitoring of electrolytes." The ER doctor started an intravenous solution of sodium and potassium and sent him to the ward.

Mr. Capowski reached Tower 9 about 5 a.m. Four hours in the ER is not a particularly long delay, especially since treatment was started there. By the time of transfer he was feeling much better. The night shift nurse on Tower 9 noted he was "stable . . . not short of breath" and "has no complaints."

From then until 8 a.m. things went well. Mr. Capowski slept a little, made one call to the nurse for an extra pillow, and otherwise created no stir. Shortly after 8 a.m. he got up to go to the bathroom and halfway there slumped to the floor. A nurse in the hallway, Nancy Whitehead, heard a crashing sound (probably the IV pole hitting the floor along with the patient) and went in to check. She found Mr. Capowski on the floor, unresponsive, face down. She tried to arouse him. Nothing. She instinctively felt for his carotid pulse. Nothing.

One second he was standing, breathing, living; the next second, no heart beat, no respirations, a lifeless hunk on the floor.