A Funny Thing Happened On The Way To The Code Blue

I have had many funny things happen to me in my life. The general consensus among most of my friends is that one particular story stands out as the single most absurdly funny thing to ever happen to me. The incident occurred in the first year of my medical residency and against my better judgment I have decided to share this story with the rest of the world.

The evening began innocently enough. Little did I know that by the end of this evening, I would be setting a state record that would still stand to this day. I was a 26-year-old medical intern on call at the hospital on Thanksgiving night. One of the other resident’s wives was nice enough to bring me a home cooked Thanksgiving dinner because she knew I was stuck in the hospital for the night. Unfortunately, this delicious meal had a little “extra something” that in retrospect was probably Salmonella. Within a few hours, I began vomiting uncontrollably. I was up in the call room, actively vomiting when I suddenly discovered that my intestines had another surprise for me. I started shooting from both ends like a water sprinkler and both my underwear and the lower half of my scrubs ended up in the trash.

This is where the real fun begins. Standing in the call room completely naked from the waist down, I realized that I had no other change of clothes available. I was working that night with a very nice young female resident as my supervisor. She was a tiny doctor who weighed about 90 pounds soaking wet. I called her for emergency back-up. “Hey, I need you to come up to the call room and bring me some scrubs…” I could tell that she was sitting one floor down in the Labor and Delivery area among a room full of nurses. “Why?” she asked. I hesitantly told her that I had become sick and had to throw my pants in the garbage. “YOU POOPED IN YOUR PANTS?” she asked loudly. “Damn it, you don’t have to advertise it, just bring me some clothes”, I barked.

I was in the call room bed under the sheets when there was a knock on my door. I told my upper level to come in and she barely stuck her head through the small space in the door frame. “Did you poop in your bed?” she inquired. “No, I did NOT poop in the bed. Do you have my scrubs?” I replied. She handed me the pair of scrub bottoms and exited the room. I realized quickly that I did not give my friend enough information. She had brought me a very petite sized pair of scrubs that she would probably wear for herself. I could not even pull these up over my knees. I immediately got her back on the phone, “These scrubs are too small”, I grumbled. “What size do you need?” she asked. “I don’t care. Just something bigger than these”, I answered quickly not knowing at the time that this simple statement would end up being the biggest mistake of the evening and perhaps even my life.

My upper level resident arrived back in the call room a few minutes later. As the intern, I had been holding the code pager and was responsible for any Code Blue emergency calls that evening. I had decided that I was in no condition to run a code and asked her if she would take the code pager for me. It apparently had been quite a while since she had actually run a code on her own and she looked at me as if I had handed her a dried up dog turd. “I guess so…” she said reluctantly while taking the pager. She left me alone once again to try on my new pants.

What I had been brought could not really be described as “pants”. They appeared to be something made by Omar the Tentmaker. I usually wore size 30 pants at that time and these were easily over the size of 50. Given that it was already 3:00 AM and I had gotten rid of the code pager, I decided that I did not care that I was wearing clown pants and decided to finally go to bed and try to get a few hours of sleep.

“CODE BLUE!” shouted a frightened voice on the other end of the phone about thirty minutes into my sleep. It was my upper level resident on the other end of the line. “Your code pager went off. Room 513! You have to go!”. “Damn it”, I thought to myself, “That is not what I meant when I asked you to take the code pager…” I bunched my giant scrub bottoms in both hands and began running across the hospital to meet with the code team.

As I entered the patient room to assess the situation, I kept my hands clutched firmly on my pants as I remembered that I was going “full commando”. The nursing supervisor maintained her professionalism as she described the patient’s sudden respiratory arrest. Many of the other fifteen people in the room must have noticed my grotesquely oversized scrub bottoms but said nothing. I quickly determined that this unconscious and critically ill patient was going to have to be intubated as soon as possible and placed on a ventilator.

As I positioned myself at the head of the patient’s bed, I realized that I was in a situation best described as a conundrum. I was the only person in the room that was qualified to perform the endotracheal intubation which is a two-handed procedure: One hand uses a tongue blade to lift the soft tissue structures and visualize the vocal cords while the other hand gently guides the ventilation tube into the trachea. Unfortunately, my pants required at least one hand to hold them up at all times. Time was of the essence and I had very little time to work out my strategy.

I quickly decided that if I spread my legs as far apart as humanly possible instead of stooping over, this would allow my pants to stay up long enough to perform the procedure. I spread my legs as far apart as they would go and picked up both instruments to perform the procedure. My scrub bottoms immediately fell to my ankles.

I was standing in a room full of women whose ages ranged from about 25 to around 65. There was a brief second of silence followed by an audible gasp. A young woman working as a respiratory therapist was stooped over right next to me while manually bagging the patient’s lungs. She looked up to discover that she was just a couple of feet from my manhood. I thought to myself briefly, “We are all medical professionals here. I can just quickly intubate this patient and then pull my pants back up”. I made a move towards the patient and the respiratory therapist’s eyes said it all, “Oh hell no, I am not working with that thing so close to my face…” She looked me directly in the eyes in order to avoid looking anywhere else. She gently shook her head and mouthed the word “no”. I placed the endotracheal tube back on the bed and pulled my giant pants back up to my waist. I leaned back toward this young woman and whispered, “Could you, maybe” I hesitated, “Could you hold my pants up for me?” She answered under her breath with a quick but decisive “No”. Her parents must have raised her to hold herself to a very high standard and I am sure they would have been proud of her. This was obviously never part of her job description.

Usually when running a code, the doctor will often ask the nurses to move the patient bed farther away from the wall to allow for more room. The nurses appeared to look confused as I asked them to move the bed towards the wall pinning me against it. I pushed my backside as hard as I could up against the wall in an attempt to hold my pants up. I once again picked up my instruments and moved towards the patient. As I lifted the patient’s head with the tongue blade, I could feel my pants fall to my ankles once again. I thought to myself “Screw it! I am finishing this right NOW!” I visualized the vocal cords and successfully placed the endotracheal tube in the patient’s airway in under three seconds, all while completely naked from the waist down.

The patient was eventually stabilized and was transferred to the ICU. He went on to make a full recovery.  Word quickly spread about the fastest pantless endotracheal intubation ever performed in the state.  The respiratory therapist and I both mutually decided that it would be in our best interest if we never spoke to or looked directly at each other ever again.

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Michael Guyer

Dr. Michael Guyer graduated from Hendrix College with a degree in chemistry and then obtained a medical degree from the University of Arkansas for Medical Sciences. He is now a software developer for Apple Computer. He has formal computer programming training in C++, Objective C, Visual Basic, Java, HTML, and Swift.

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