A wall.

My intern was calm, always calm.

The patient's mother on the other hand was unsettlingly still, watching her daughter with distant eyes. Moving her pediatric stethoscope across our patient's heaving chest, my intern closed her eyes in order to focus. Feeling uneasy about what was happening, I stared at my watch and started to count. Twenty shallow yet labored breaths in 15 seconds. Shit.

"She always goes straight to the ICU when I bring her to the hospital," the mother commented. This scene was unfolding about 11 floors too far from the ICU I thought, and tried to mentally urge my intern to pull the alarm. "Come ON Tina! She's in respiratory failure! I do NOT want to do CPR on my last day here..."

We excused ourselves as the respiratory tech came in to administer a scheduled breathing treatment. Outside the room at the nursing station our upper level resident raced over while my intern was on the phone with our attending. She opened the vitals sheet and cursed silently, then dialed in the Rapid Response Team.

If someone's heart stops, a team descends upon the "code" in order to perform CPR. At the children's hospital I was rotation at, a Rapid Response Team could be called whenever a patient is at the brink of disaster. Hopefully the RRT could avert the disaster and prevent patients from coding via timely intervention.

Timely indeed was the intervention. First 3 upper level residents arrived immediately, then a couple of cardiac fellows swung by because we were on the cardiac floor. My intern's calm presence was replaced by a orchestrated chaos, dancing around our patient with the heaving chest.

In the frenetic activity swirling around the patient, the mother was strangely calm, sitting still while observing the action. What kind of emotions were bottled up inside? Was she now simply used to the idea of death's hand constantly on her daughter's shoulder?

My attending was the last to arrive, and avoided everyone in order to walk to then squat next to the mother. He made sure to be at her level, and spoke in a slow and reassuring manner, an anchor while waves rocked the patient's bed. Soon the wires and tubing was disconnected from the walls, and the bed carrying our patient was wheeled out of the room, and to the direct elevators to the ICU. My attending remained by the mother's side, and continued his conversation with her.

When it was time to go, the mother simply squeezed my attending's hand, then shifted her gaze back to the empty space where her daughter's bed had been.