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End of the Race – Book Excerpt

Preface to The End of the Race and Chapter 4 Hepatitis Babyend-of-the-race-book-cover
In the beginning, God created the heaven and the earth. In seven days.

And it is said that the world can be ended in seven days. Imagine

traveling the streets of Washington, D.C., in an ambulance, as a patient,

and you will come to understand what links us—how a week in this city

can shape a century—or bring an end to the race as we know it. See who

measures out health care and decides your destiny. Discover the secret

the Watergate Plumbers were in search of. Deep Throat never told you.

I will. Survival comes with the code contained within these pages—but

requires some presidential assistance.

Chapter 4

Hepatitis Baby

3:40 PM

Inside the ER, the drivers arrive unannounced. Resuscitations are taking

place in two different cubicles, and physicians and nurses hover over

mobile beds, shouting commands and acknowledgments.

“Lactated ringers! Give me another amp of calcium!”

“Right here. Ten milliliters calcium gluconate going in. Forty-four

milliequivalents bicarb. This is your second amp!”

A doctor reaches for a long-needled syringe and injects it into tubing

connected to the vein of a naked woman.

“Move away, everybody! Stand back!” he shouts from the side.

“Clear, please! Paddles on. Okay, fire!”

POOMMT!

A blunt noise is followed by silence. Everyone watches the cardiac

monitor, ignoring the odor of singed flesh.

“Okay, resume CPR. Get ready to defibrillate again. I saw a rhythm.”

Hinton stands in the first cubicle, uncertain what to do. He knows

CPR, has performed flawlessly on the practice dummy, but he’s still

nervous he’ll be asked to help. Olson wipes dust from his glasses and

leans against the incubator, waiting for someone to come forward with

transfer papers.

“Hold CPR! Okay, everybody back! Clear, please! Fire!”

POOMMT!

Another silence, shorter than the first, is followed by a resumption

of frenzied activity. Pharmaceutical interventions proceed futilely.

THE END OF THE RACE 27

“EMD! I don’t see a rhythm!”

“Pump harder! I’m not getting any pulses!”

“Somebody get OB down here! We called ’em five minutes ago!”

Hinton’s anxiety increases as he watches the heart tracing go flat.

The ER doctor changes places with a nurse who has lost stamina doing

compressions, and he moves closer to the bedside.

“You!” the physician says, spotting him. “I need you to switch with

me so I can run this code!

Hinton passes around the machines and stands next to the woman.

She’s spread-eagled on the emergency table, secured with gauze

restraints over her wrists and ankles. The IV bottles frame an image of

last rites as he puts the palms of his hands on the sternum and begins

pressing down.

“One thousand one, one thousand two . . .”

Her stomach is tight with air and the fetus pressing up on it.

“There they are!” the code doctor calls out as obstetricians approach

from the side door. “Get some instruments!”

Olson keeps his spot by the side of the incubator, cleaning his glasses.

Two orderlies next to him make their own assessment, having watched

the woman come into the ER with her boyfriend, both unconscious.

“Don’t think I wanna try anything they used,” the first says. “That

woman’s gonna go a lot lower than she ever got high, can tell that just

by lookin’ at ’er now. An’ that baby. That’s a crime.”

“Yeah, I heard that. Look at ’em. He’s colder than she is.”

In the next cubicle, the boyfriend’s resuscitation is not going well.

A large tube sticks out his mouth, and a nurse pumps saline solution

to rinse out the stomach. Besides an occasional retching noise, there are

few signs of life from the drug-laden body.

“Man, ’least he might live,” the first orderly continues. “She ain’t

gotta a snowflake’s chance . . .”

“Wait a minute. Watch, man. Just watch now, here comes OB, they’re

gonna, oh Jesus, can you believe this? Watch this, Olson, you watching?”

Codes rarely run longer than 25 minutes in the City Hospital. This

one has been going for 20.

“Damn, man,” one of the orderlies whispers. “Chief resident’s

doing it! Can you believe it, Olson? I’m telling you, the lady’s gotta be

infected.”

Olson wipes the back of his neck with a handkerchief and looks

over the crowd, watching the obstetrics residents rush into the room.

28 R. GODFREY

They speak with the emergency room doctor and go to the side of the

agonal woman.

“Knife, pick-ups!”

Hinton presses on the woman’s sternum, giving short, deep

compressions.

“Deeper!”

At the foot of the table, a surgeon directs his junior partner, who slides

a scalpel across the taut, distended surface of the woman’s abdomen.

Blood rushes out as successive layers of skin and muscle give way to

the underlying womb.

“Hurry up!” the chief resident urges. With the same knife, the female

resident cuts horizontally across the uterus and scoops out a helpless

form. Blood drips onto the mother, and the baby looks dusky.

“Give it oxygen!”

Hinton’s elated as he watches the baby squirm, turn pink, then emit

a high-pitched cry. The chief resident clips and divides the umbilical

cord and moves briskly to the incubator.

“Keep it warm. Bag it if you have to,” he tells Olson. “Get it to

Children’s Hospital in five minutes, and don’t crash!”

He reaches into the incubator, pulls out a blanket, and the baby cries

as he wraps it and hands it to Olson.

“Wait a minute, Doc,” he protests. “We need papers signed. We need

a name . . .”

“Jane Doe. Now go!”

4:05 PM

“Don’t worry about a thing,” Olson tells Hinton as they climb into

the back of the ambulance with the incubator. “You’re gonna be steward

on this run so you can get experience. We’ll be there in no time.”

He slams the door and hops in behind the steering wheel. As he flicks

on the red lights and glances back, Hinton looks worried.

“Damn, what am I supposed to do?”

“Keep it pink,” Olson tells him, accelerating forward. “And don’t

let it spread bad stuff!”

Hinton puts on gloves and searches through the cabinets. When he

looks back into the incubator, the baby has stopped crying. The pink

flush of its lips has become a mottled blue. A cold sensation runs through

his stomach.

THE END OF THE RACE 29

“Olson . . .”

“Yeah?”

“Baby’s blue. Where’s the Ambu bag?”

Olson gestures into the rear in several directions, hoping to pinpoint

the bag for ventilating.

“Over . . . there . . . look on top of the whadda-ya-callit. Right

there!”

“Come on!” Hinton says, tossing away an obviously oversized adult

Ambu bag.

He has an urge to jump out, to abandon this failing venture and its

tiny victim. Instead, he reaches for the infant, lifting him gently from

the incubator so that he can seal his mouth around the nose and lips.

He blows short, quick breaths.

“Damn!” Olson proclaims, looking back at the blue-colored baby

and then ahead at approaching traffic. “I seen a lotta resuscitations, but

you take the cake, buddy. Your eyes are gonna turn yellow from all that

kid’s viruses!”