The Corridor Between Heart Beats
The shift started like any other, with our ambulance smelling of wet antiseptic vinyl and orange Lifesavers. Dispatch sent us to a warehouse after a man collapsed beside a pallet of discontinued orthopedic braces. The fluorescent lights buzzed above; as dust floated throughout the room. The patient was in his mid-40s, a white male with salt & pepper hair. He was gripping his left chest, classic levines sign. He was moaning about pins-and-needles radiating down his left arm. The ECG showed an evolving MI. Oxygen was started, chewable aspirins administered, leads placed, with diversion to a Cath-lab debated among the crew. Blood pressure trended low-normal; he was alert and focusing hard on something over our shoulders.
Curious. In his “Hot-Socks” tote we discovered an odd totem: a polished stone about the size of a thumb hitched to cowhide with a prayer note scribbled on the back of a supermarket receipt. The patient stated he kept it “for the road. Part joke, part makes-me-believe.” As we neared the scene, another employee of ours arrived—same colored crew shirt, different story altogether. He dropped to a knee at the patient’s side and scooped the patient’s hand into his own, humming quietly a snippet of some ancient hymn under his breath without thought.
The warehouse drone seemed to fade. The patient’s breathing, previously jagged like a gas engine sputtering to life, eased into something softer. Patient began to describe an intersection. “A doorway with light at the end but not blinding. It was a warm light. Like someone looking for you!” The patient denied loss of consciousness except for “the smallest feeling of leaving your body to tie its shoes.” En route to Cath-lab he suffered arrest. ACLS was initiated—compressions, defibrillation, epinephrine—and we were able to achieve ROSC. Between compressions, patient continued speaking of the hallway. Of feeling attended to by kindly people dressed in bright vests, passing him tools: tools you might need on a journey. Maps. Band-Aids. Names. The patient voiced certainty that these people were caretakers. Spirits of past EMTs, maybe. Or perhaps, something else. No clue, but in any case, they were there to help him return. The stone sat on our dashboard, smooth and cold like centuries old water-smoothed granite.
The Cath-lab staff identified a focal occlusion and deployed a stent. The patient woke to a stable rhythm and asked quietly if anyone had shared his vision of the hallway. Our paramedic coworker simply nodded, hand warm where it had been clasped over patient’s heart and said only, “We all do, sometimes. Take the stone.” The patient slid it into pocket close to his heart. Like a promise. We all wrote our reports, and sat with our coffees together in silence.
Tonight’s clinical decisions was braided with quiet grace, like a strong rope: salvaged heart stitched back with something we all want to believe in.
