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There is a bustling, fluorescent clamor that governs hospital hallways during the day and so fills the air that any sound wanting attention has to vie for it, each alarm louder and more cacophonous than the last. But at night, an altogether different temper settles over the hospital. A restrained, low-lit quiet descends, transforming those long corridors into a space that seems smaller and almost comforting. Almost any sound stands out at night.

I was once trudging down one of those subdued nighttime hallways after many busy hours on call, allowing the glimpse of sleeping patients in each passing room to give me hope for a nap that night, too. My head was down and my thoughts were elsewhere, but the faint sound of a person struggling for breath stopped me cold. At a nearby workstation, a young nurse’s aide was sitting bent over the desk, breathing heavily and holding a burrito. Her eyes were glassy but vaguely focused on the burrito, which she looked intent on eating.

I asked her if she was all right.

She struggled to tell me between gasps that she felt faint, and that she thought she would feel better if she could eat.

She did not look in any shape to be eating; I suggested that she put the burrito down.

Acquiescent and apparently relieved, she let the burrito drop into its Styrofoam container.

She was becoming pale and sweaty. Her eyelids fluttered closed, and she began to slide from her chair as she mumbled that she was going to fall. As she did, I found my way under her to catch her. We landed in a heap, her weight pinning me to the wall while she slumped backward onto my chest and outstretched legs like a large, sleeping child.

A nurse came by, and I asked her for a stethoscope. Because of our tandem position on the ground, I turned the stethoscope back toward us as though the aide were a part of me and I was listening to my own heart through a double-thick rib cage. Her heart was racing. The nurse took her vital signs, which confirmed an extremely fast heart rate, but were otherwise stable. I glanced down at her, still slumped against my chest and breathing heavily. She looked pale and scared and on the edge of consciousness.

By that time, quite a crowd of nurses and aides had gathered around us. One of them called the emergency department and reported back that someone would be up soon with a stretcher to take her there. Another nurse brought ice water for me to apply to her face (a maneuver that could decrease her pulse if the cause was an aberrant electrical conduction path in her heart). I held an ice-cold washcloth to her face and asked her to take deep breaths, trying to calm her down, but her heart rate stayed stubbornly high in the 180s.

While we waited for the stretcher, she was able to tell me her name, her medical history, her medications and allergies. The nurses who knew her filled in the gaps—this had happened several times before, she had undergone a thorough workup, and the cause had not been found. When the emergency department staff arrived, we transferred her to the stretcher. When I stood up, I felt light and insubstantial without her weight upon me.

I rode the elevator down to the emergency department with her, followed her to the trauma bay, and waited for the emergency physicians to rush in. I quickly gave them all the information I had about her. When I said goodbye to the girl on the stretcher, she still seemed to me like a child, terrified and young. We looked at each other. She thanked me, and I told her I’d be thinking about her.

I rode the elevator back upstairs and went to my call room, this time without incident. I lay down, no longer sleepy, and stayed awake worrying about the young woman for a while before nodding off. When I woke several hours later, one of the nurses told me that she...


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pp. 9-10
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